When shiny new rocket-fuel insulin Fiasp hit the market, my insulin tart tendencies immediately sprung into action. I had a chat with my consultant (“I’d like that please, I think it might help with post-meal highs and it costs the same as the stuff I use now”), we grappled through the mysteries of the NHS formulary to work out how to prescribe the stuff, and blast off, I was off.
Fiasp is Novo’s attempt to create an insulin that’s faster than the current batch of “fast” acting insulins like Humalog, Apidra and NovoRapid. I’ve been using it for around a year now, here’s my experience…
- Post meal highs are lower (eg if I’m a 6 before a meal, I top out at a 9 after, whereas I might have got to 14 previously if I didn’t pre-bolus) and general BG profile is flatter. When I get it right.
- It seems to be no quicker at tackling highs than Humalog, just better at preventing them.
- Mentally it takes time to get used to – being a 7 an hour after a meal with 6 units of insulin on board screams impending hypo to me. But it just flatlines then returns to around 6. When I get it right.
- I bolus as I eat and that seems to work quickly enough to avoid any post meal high. Unless I’m high, I don’t pre-bolus, when I have it has generally ended up in a low.
- I’ve reduced active insulin time to 2.5 hours and that seems to be working – for me the tail is noticeably shorter than Humalog. This makes exercising easier, as there isn’t active insulin hanging around for quite as long.
- For the first time ever I’ve been able to feel a bolus going in – it was a very mild itching sensation that stopped as soon as the bolus ended. Not bad, just different. That lasted a couple of months and now I rarely feel it, perhaps once or twice a month.
- I find I have to change my site max every 3 days. With Humalog I could easily go to 3.5 days if the timing was more convenient and see no impact. With Fiasp, if I leave it longer than 3 days I go high, the insulin seems to lose potency.
Conclusion? Overall I’m impressed with Fiasp and for me it’s a good, incremental step forward from Humalog. This isn’t life-changing stuff, just a nice step in the right direction.