Initially I wasn’t enjoying using Fiasp very much, but I was querying whether I had a dodgy cartridge. I requested some FlexTouch pens (much smoother than the Novorapid FlexPens I’m used to, which are also available in FlexTouch btw) instead to give it another go. I wanted to wait until I’d used up either a whole pen (100 units) or a full week – both happened yesterday, so I thought now was the perfect time to update y’all.
In a sentence: I am LOVING Fiasp!
What is it?
Fiasp is the latest rapid-acting insulin from NovoNordisk, who make Novorapid and Levemir. It’s designed to “address [the] critical unmet needs” of those diabetics who spike at mealtimes by working twice as fast as Novorapid.
Additonally, it’s only supposed to be given as a pre-bolus by a maximum of 2 minutes, and up to 20 minutes after eating. I find Novorapid takes about 45 minutes to have any effect on me, so that means waiting 45 minutes for food, and pretty much never snacking. I was keen to try Fiasp to see if I could eliminate pre-blousing, which isn’t always ideal!
The scientific reason behind why Fiasp works faster is the addition of vitamin B3 or niacinamide, which makes your bloodstream absorb the insulin molecule faster. It’s the same molecule as in Novorapid – the innovation is the addition of both vitamin B3 for faster absorption, and L-Arginine for stability – so that the effects of Fiasp don’t fluctuate (more on this later).
Where can I get it?
Fiasp is the newest insulin available on the market. It’s been available in the UK for a few months, but is not yet on most formularies.
January 2018 update: it is available in Cambridge, Hertfordshire, the Isle of Man, Warwickshire, and West Sussex. Among other places, it is NOT yet available in Croydon.
When do I bolus?
I’m used to pre-bolusing by up to 45 mins with Novorapid, so it’s been a bit of mental adjustment to “only” take my insulin as I tuck into food, but I’m beginning to get used to it. I’ve found that taking Fiasp 0-5 minutes after eating works best for me. I usually inject as I start to eat because who has time (LOL) to set a 5 min timer every time they eat?! But I might start doing this as I’m still having a few (though far fewer than before) Fiasp-induced hypos. I would NOT recommend following the 2 min pre-bolus advice. It has failed me every single time, leaving me with a stubborn hypo. I am yet to try the 20 min post-prandial bolus, but I know my body, and I’m fairly sure that this would be too late for me. However, I have found a use for a 10 min post-prandial bolus…
Fiasp hacks (pizza):
I selflessly tried Fiasp on pizza for the second time (the first time I ended up hypo for half an hour after taking Fiasp 2 mins before eating). For the sake of an ahem comparative medical experiment, I ordered the same pizza, but this time I set a timer on my phone for 10 mins as soon as I took a bite. After 10 mins, I took my usual 20u (6g ratio for 120g) and ended up with a lovely, gentle, slightly upwards trend. I stayed under 10 all evening! I would post the Dexcom graph but my camera roll is filled with Dexcom screenshots, and I can’t for the life of me tell which one is my pizza graph!
Will I continue using Fiasp?
Yes. Yes. Yes. Look at these Dexcom Clarity graphs from the week of using Fiasp, compared with the previous week of using Novorapid. I doubt Fiasp is going to lower my a1c or anything magical like that, but that was never my aim when I tried to get it prescribed. I’m sure when CGMs are more common, standard deviation will become the gold standard way to measure diabetes management, and that’s why I pay more heed to that number. Like I’ve said numerous times on Instagram, your a1c is NOT a measure of how much effort you put into your management. Neither is your standard deviation, but I feel like it’s a much better marker of management, at least for me.
My breakfast and lunch spikes are much gentler. I’ve still not figured out dinner, but I’m sure that’ll come with some practice.