It has been a long time since the diabetes world has seen a new rapid acting insulin brought to market. The last one that I can remember was Apidra released back in 2004. It is not surprising then that the release of Fiasp by NovoNordisk is creating a lot of buzz. Not to be let out, my son recently began using this insulin. Since Fiasp insulin is the new kid on the block, I thought I would give everyone a brief rundown on the highs and lows associated with it.
What is it?
Fiasp insulin was released by NovoNordisk onto the Canadian market in March of 2017. Many of us scrambled to get a prescription because it promised better blood glucose levels without pre-bolusing for meals! According to the press release, you can dose up to two minutes before a meal and up to 20 minutes after starting a meal without compromising overall glycemic control or safety!*
How is it different?
A Medscape article states that Fiasp is absorbed twice as fast as its counterparts.
It does this with the help of two excipients–Vitamin B3 is responsible for the increase in the speed of absorption and Amino Acid (L-Arginine) has been added for extra stability.**
What do users think?
All of this science is great but most people are wondering how well it works in real life settings. From what I have seen, the bulk of users really like it. I could only find one person out of about a dozen users who had returned to their old insulin aspart.
When I asked my son for his review I was told “I still have highs. I still have lows BUT if I have a heavy carb loaded meal, Fiasp kicks butt and I don’t have the same crazy swings that I always did before.” For a 19 year old who can definitely binge on carbs, this is huge.
Other users seem to have had similar results.
Some people with diabetes found that the insulin peaks were no longer as pronounced. They had some difficulty battling highs with Fiasp however while others found it perfect for corrections. In fact some people are purchasing Fiasp just for corrections.
Other users explained that the faster insulin action allowed them to more quickly respond to rising blood glucose levels. This in turn meant resulted in much tighter control. The quick action has also left one user to caution about the timing of any prebolus.
Most seemed to agree that Fiasp insulin resulted in fewer food spikes and more stable blood glucose levels but as I said not everyone loves it. For some users, their traditional rapid acting insulin seemed to work better.
All in all, most people with diabetes who are trying the new kid on the block seem to be happy with it. It offers another insulin choice for those who struggled with post-meal spikes or don’t pre-bolus meals.
It must also be noted however that while Fiasp is not currently approved for use in insulin pumps in Canada, both those on insulin pumps and MDI are using this insulin aspart.
Finally, I was also happy to see that the price of Fiasp insulin was par with NovoRapid. This meant that there was no need to worry about an increased cost for out of pocket insulin expenses. My understanding is that Fiasp insulin is not yet on many (or any) provincial formularies. This most likely will mean that if you decide to use the insulin and are currently using a publicly funded program, you may have to either pay for this insulin out of pocket or speak to your doctor about having special authorization added to your benefits to ensure full coverage.
Please remember to check with your diabetes team before starting any new insulin regimen.