Fiasp Insulin. The New Kid on the Block

Fiasp Insulin the new kid on the blockIt 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.

Final thoughts…

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. 




Please Forgive me Mr. Banting

It has been hot here for most of July which is greatly appreciated when you realize that some areas in our province had record snow on the Victoria Day long weekend in May. Because of the heat, yesterday I finally broke out my insulated eco-bag.  It’s not often that I have to use it.  I bought it to bring home fish and berries that last time I was home in Western Canada.  Since then it has basically sat in my closet looking neat and clean.
Yesterday was different however.  I had to run out and buy milk and then was invited out to dinner. There was no time to drop off the milk in between nor could I buy it after.  Well I suppose that I could have but I decided to use my eco bag instead!
I pulled it down off of the top shelf of my closet and was shocked to find the skidoo boot liner that had been missing since October! I had torn apart the house looking for it to no avail and there it was quietly tucked away in my cooler bag! I took out the liner to return it to its rightful owner and came across something that made my heart sink.  There, in the bottom of the bag, were not one but TWO pristine vials of insulin.  They were still in their boxes.  They had a lovely little pharmacy label on them stating that they were two of three.
I wanted to cry.  They had been in the bag for at least nine months! Insulin is only good at room temperature for 30 days.  I felt horrible.  How many people struggle to pay for a vial of insulin and I had wasted two of three!? How many dollars was I going to have to throw away? How did that happen?
I know that I am not the first person to lose vials of insulin. I know that I am not the first person who has had to throw unused insulin out–when my son was first diagnosed, we would throw away half a vial of insulin every month because his needs were so small. It still hurts to think of that life-saving elixir being tossed however.
Please forgive me Mr. Banting! I will try to be much more careful with your gift from now on. Forgive me

My Petition to Mankind

Today’s blog week prompt challenges us to come up with our own online petition. There have been a few petitions circulating lately so if I had my choice, what would I petition for?
That is a real challenge.  I have read a few posts asking for greater meter accuracy and even petitioning test strips to find their way to the garbage can. I would of course love to see both of those things happen! I would also love protection for all children with diabetes in schools. I would love for cheaper air fares that would allow families to travel with greater ease to diabetes related events.
I think the thing that I truly want more than anything else is access to devices and supplies for EVERYONE!  I don’t care where you live in the world, you should have access to enough insulin, syringes, test strips, pumps, and CGMs. I cringe when I hear of anyone who can only test once a day (or less).  I cry when I hear of people barely able to afford insulin. My heart breaks when people have to choose which child will have an insulin pump because both children have diabetes but they can’t afford a pump and supplies for two children. That just should not be.
So pharmaceutical companies, governments of the world, humanity, I am begging of you…
  • Please ensure that everyone who needs insulin has access to  the best available insulin no matter where they live.
  • Please make sure that everyone, no matter where they live, have clean and sterile syringes.
  • Please ensure that all people living with diabetes have adequate access to the most effective glucometers and as many test strips as they need to manage their diabetes care to the best of their abilities. 
  • Please ensure that the most innovative insulin pumps are available to anyone with diabetes, anywhere in the world, who wants to use them.
  • Please ensure that Continuous Glucose Monitors are available to everyone who wants to use them as another management tool no matter where they live or how much insurance they have.
  • Please ensure that all people living with diabetes have access to the best possible tools, education, and devices regardless of insurance, race, financial background, or geographical location.
No one should have to make the choice between food and life, between electricity and insulin.  Let us become a humane and just society offering the best possible healthcare to all of the Earth’s citizens not just a select few.
A mother who cares.

Another Diabetes Blessing

Last night I rolled over in bed, put my arm near my face and went…YUCK!

My son had dropped insulin on my arm! I was laying in bed when I realized that we had forgotten to reset his basals back to “school days” after 10 days of Easter vacation. 

He made his way into my room with pump and site change gear in hand. I told him that I just needed his pump but he said that his alarm had gone off earlier so he might as well do both. 

Holy cow! Was it a full moon yesterday? It must have been because his site change alarm went off AND he changed it the same day??? This was beyond belief! We did the site change, fixed the pump and he was on his way but unknown to me, he had left me that present…a large drop of insulin.

After my initial “YUCK!”  I had to laugh to myself.  Before diabetes moved into our lives, that smell was reserved for the opening of a BandAide brand bandaid.  You knew that the cut was safe and sanitized. Now it evokes new images of syringes, cartridges and life saving liquid. 

The smell is still rather disgusting when it arrives in the form of a puddle on your arm as you are trying to fall asleep but without it…well its definitely a blessing more than anything else.

Spare a Rose, Save a Child

I am not really into Valentines Day.  When my boys were younger, we did the cards for their class. If I was feeling creative, we did “hugs and kisses” or Valentine pencils.  For those times when I totally forgot that Valentines was about to happen, we did heart shaped sugar cookies that the boys took to share with their class. 

My boys are now much older and school Valentines are no longer important.   This weekend I received an email that has made this “Hallmark holiday” very special however. Diabetes Advocates and the Diabetes Online Community have come together to help the Life for a child program, sponsored by the International Diabetes Federation, which aims to take “contributions for donors (to) go to established diabetes centers enabling them to provide the ongoing clinical care and diabetes education these children need to stay alive.” 

There have been times in the past 13 years when money was tight, insurance was not available and I had to limit the amount of testing my son did during the run of a day.  That was scary enough but I never had to worry about him not having insulin to cover his food or stay healthy.  For children in developing countries, these worries are very real but this Valentines Day you can help! 

Spare a Rose, Save a Child, is a simple and amazing way to make a difference.  This year, when you head out to buy your beloved a dozen roses buy eleven.  No, you will not then be spending your night alone or sleeping on the couch because you will have taken the money that would have paid for that last rose and donated it to the Life for a Child program! You will have helped to save a child with one beautiful rose.  Your partner will love your thoughtfulness much more than the extra rose.  It really is a win-win opportunity!

So if you were planning on sending me a dozen roses on Thursday, I will fully understand when I receive 11–actually I will be pleased to note that a child will be able to inject life saving insulin for another week because I received one less rose. And, if you weren’t sending them to me, I am sure whomever was getting them will be just as happy to know that you spared a rose to save a child

Happy Valentines Day!

Happy World Diabetes Day!

Today is World Diabetes Day.  This date was chosen because it was the birth date of the famous Canadian, Sir Frederick Banting.  Dr. Banting of course is one of the scientists credited with the discovery of insulin.  

Insulin is the life sustaining hormone that allows my son to annoy me and live his life to the fullest today.  On March 17, 2000 I saw firsthand how vital insulin is to a body. That is the day that doctors finally realized that my son was no longer producing his own insulin.  He was dying before our eyes.  His body was surviving by eating itself and in a two year old, there is not a lot of body to use as nourishment.  He was given 12 hours to live. But live he did and today I remain eternally grateful for Dr. Banting’s discovery. 

When Dr. Banting made his discovery he felt it was the first step to a cure for diabetes.  He did not envision that over 80 years later we would still have no cure for this disease only his life sustaining vials of insulin. He did not know that for many, insulin would be a costly extravagance.  He did not know the difficulties that people in both first and third world countries would have in obtaining this life saving therapy.  

In his honor, we continue to fight to make the world better for people living with diabetes.  In Canada we work to get our provincial governments to cover life sustaining insulins and devices that will reduce the risk of complications in later years.  We lobby our federal government to provide more funding to groups and organizations who are working hard to improve technology and ultimately fulfill Dr. Banting’s vision of curing diabetes forever. 

Today, I am wearing my blue for my son who lives with this horrible disease each day with dignity and courage.  I wear blue for hope…hope that his life with diabetes will improve.  Hope that he will never have to struggle to afford his supplies.  Hope that one day he will say “When I had diabetes I wore an insulin pump.”   

Today I am wearing blue for the millions of other people living with diabetes, many of whom I have never met.  This disease takes a horrible toll on both those living with diabetes and those who love them.  It also has brought together many amazing people and for that I am extremely grateful.  So thank-you again Dr. Banting for saving my son’s life.  Thank-you to researchers for not giving up and working to create a better life for my son and others living with diabetes.  Thank-you to the many friends, family, and followers of this blog, my  Facebook page, and the website.  Your support for these past 12 and a half years have given me strength and courage to continue each day. 

Easter Vacation…Part Two

The good news was of course the fact that we actually remembered to bring insulin on our Easter vacation. I packed not one, not two, but three vials.  We were set. They were put in a lunch bag with an ice pack, close but not with the insulin.  We had cartridges to put the insulin in and infusion sets for site changes. Life was good.

Our holidays went well. My boys enjoyed time with their grandparents as well as a great aunt and great uncle.  The weather was pretty good so there was yard clean up, tree trimming and lawn tractor riding to fill the days as well as a bon fire for the evening.

Diabetes is less stressful at my mom’s because I know that when I am not around that she is asking my youngest son all of the right questions…
Did you bolus for that?
Have you tested lately?
Do you need the scale to get the carbs for that piece of cake?

Its a great feeling! Obviously my son feels pretty relaxed as well and quickly begins to forget that he still has some diabetes responsibilities.  His site was changed before we left.  A few days into the trip, I heard the beloved Cozmo let him know that it was time for him to change his site.  I asked if he had done it.  He was going to do it later on.  After having the site in for over five days and us heading home, he finally said, “I guess I need to change my site.”

He once again claimed that he didn’t want to change his site earlier because “Timmy”, the tried and true site was perfect. It was working he felt and it would be wrong to try a new one.  In an exasperated voice, I explained to him that the “wound” created by his site was healing and “Timmy” would not be doing the job very well much longer.  I asked how his readings were. They were high.  I rested my case.  I did not freak out but I wanted to.  My other son and Larry each had a say also.  They told him that it sounded like it was time to change things. Eventually he agreed and said he would do it at our next stop for the night.

The site was changed but the cartridge was getting low.  Once again, my young procrastinator felt that there was more than enough insulin to get him through the next day.  He was going to his father’s house the next day so I gave up.  He would fill the cartridge once he got there and was settled.  He had three vials so I would not have to worry….until I dropped him off and was six hours away from him.

At that point I got a text message from my mother.  “There were three vials of insulin left in the fridge”
Wonderful!!! was my reply.

I started to text my son but decided to call.  I asked what he planned to do.  He said he had some insulin in his Cozmo bag and it should do him.  I was worried about how potent this vial might be. I did not know how long it had been out of the fridge but I would have to take a chance before telling him to ask his father to go to a pharmacy and buy a vial of insulin.

As I began to breathe again, I decided that I could only be so mad.  He is 13 and admittedly very forgetful.  He did do the right thing by putting the bag of insulin in the fridge.  I was wrong in “assuming” that he had left it in his suitcase.  I should know better than assuming anything wth children.

Today I texted him again asking how things were.  All was fine. I needed to know how the insulin was working and figured a call was again the best method of communication.  He had been really high, he had been in range and he had been low.  The insulin appeared to be working and he was good to go until Sunday night when he comes home. I could relax until then and enjoy not having to test at night.

Okay, I am totally kidding about that last part.  I woke up at 3am the first night he was gone. I wanted to test him. I couldn’t fall back to sleep. I took solace in the fact that he did wake up to one low recently and he will hopefully be more diligent when Mom isn’t there to test. He will only be gone a few more days. I will try to not think about what can go wrong but be happy that he is enjoying time with family and friends. Now where is that wine glass???

Obsessed…is it a bad thing?

Merriam-Webster’s Dictionary defines “obsess” as to excessively preoccupy the mind. People have said that I obsess over my son’s diabetes. I have jokingly gone along with it on occasion. I have also been shocked at times to realize how much it is a part of my day and my life.

A couple of times recently, I have had the opportunity to go to lunch with my oldest son while my child with diabetes is involved in other things.  As we sit at a table, I want to ask him to test.  After his meal arrives, I automatically figure out the carbs and then have to stop myself from telling him how much to bolus. Maybe that is a little “obsessed” or perhaps its just habit.  

For over ten years he has been with me most of the time. During most meals, I have had to remind him to wash his hands and to test his blood glucose level.  Even when he has not been with me, I have had the carbohydrates calculated in almost all of his meals done for him ahead of time. I don’t think that wanting to ask someone else to test or calculating carbs is an obsession then. I think its just our way of life. 

Its not just meals that make me think about diabetes related stuff either.  I have been packing and unpacking as we adjust to a new home, new city and new way of life.  Things have been more than just a little stressful as the school year end was happening at the same time. I have been organizing diabetes walks, packing clothes, throwing out items stored for years, filling prescriptions, changing doctors and preparing myself and my son for his two week visit with his father. 

When all of the boxes were packed, the house was cleared, we had made our nine hour drive to our new home.  I had wonderful help in terms of my family to get things boxed up and shipped on. There was nothing left behind that was not meant to be.  Every piece of toilet paper was picked up. I was exhausted when we pulled away from our old house but I was confident that we had everything that we needed and that my son had all that he would need for his two weeks with is father.

Being exhausted and emotionally drained before a nine hour drive can only make your mind worse at the end of said drive. When we arrived here, my son and I grabbed the coolers and began to put things in the fridge and deep freeze.  Where was the insulin? I had about six vials of insulin.  Where was it? I took it out of the fridge. I put it on the counter. There was nothing left on the counter.  I had to have it.  What did I do with it? It was driving me crazy.  How could I have misplaced something so incredibly important?

For those who don’t understand the reaction is obvious…why are you obsessing? The child is not even here and won’t be for two weeks! He has his insulin and you do not need any.  You can buy more when you need it.  What is your problem? Why can’t you let this go? Why is it so important to you now when you should be thinking about sleep?

Those questions did run through my head.  I have to have our prescriptions moved over before he gets home.  There is some insulin here even if I don’t get it done in the next two weeks exactly.  Am I obsessed? The short answer to me at that time was YES! How can I not be? I have lived this life for the past ten and a half years.  I have seen how vital insulin is.  Yes, it may be about my child’s life but this is my life as well. Whether he is here or not, diabetes has become something that I live and breathe.

Is that a good thing or a bad thing? Some may say its a bad thing and that I need to loosen up.  I think that it is okay.  I have seen too many deaths from this disease. How can anyway say that being concerned, being on top of things and worrying about your child’s complete health is a bad thing? Oh and for the record…I still have about 50 boxes to go through (or so it feels like) and I still have no clue as to where the extra insulin is…or my cheese for that matter!