With the advent of FIASP now coming to the United States, I thought I'd finally get around to doing my much promised write up on how my trial with FIASP went earlier this year. If you can't wade through my words here ... just go to "Dr. Google" and type in "FIASP review" and you'll get lots of hits from various bloggers around the globe - some engineeringly intense- and some - like mine - less so. Again, remember, what I write here ... does not mean it will be the same for you. Our bodies are all different as to how it will react.
I went against my endocrinologists wishes. She felt that because of no medical proof/research showing that it works in an insulin pump (I'm presently on the soon to be dinosaur Animas Vibe
... sigh) that she doesn't recommend it. I'm such a #diabadass, and off to my favourite pharmacy here in Canada, and viola, a freshly squeeze vial of our juice of life called Fiasp
... with a touch of Vitamin B3 (niacinamide) to increase the speed of
absorption, along with a naturally occurring Amino Acid (L-Arginine) for stability. These last two additions are what make Fisap work supposably much faster to absorb. It's like they're describing a fine bottle of Chianti, maybe with some fava beans
My experiment involved for 2 weeks, keeping my insulin pump filled with NovoRapid purely for the basal portion of my insulin regime. For meal times, and corrections, I injected Fiasp according to my blood sugar results. Taking the injection a few minutes before a meal resulted in hardly any spike at all, e.g. I tested a 5 mmol/l ... 2 hours later 8 mmol/l . I didn't eat any differently when I ate, I just did my usual thing as a semi-low carb eater (I try to stay under 150 grams of carbs a day which according to my medical team ... is not enough ... but that's the way I've always eaten).
Testing it out 20 minutes later resulted in various results, rarely did I go over my zone of 10 mmol/l after eating. As well, it all depends on how accurate you are with figuring out carbs for that yummy dessert you decide to have later.
Correcting via injection with Fiasp went well if I had to, but I found it very rare that I went crazy high, unless, again, I didn't calculate the insulin to carb ratio (I:C). We have to be precise in our calculations in order to stay within the range we want to be in, without sacrificing ourselves to either a low blood sugar or high blood sugar. At times when you think about it, diabetes can be a game of chance like at a casino of rolling the dice
Next came a 2 week session with having Fiasp in my insulin pump, so both basal and bolus were taken care of it. Testing it out the same way, the results were no different than just using NovoRapid. The other problem I had with the Fiasp was when removing the infusion set after 3 days, the puncture point of the Contact D set was red and irritated. I'm thinking it maybe due to the additive, not sure. Also, there was stinging at times with infusing insulin, but not often.
I keep on wondering if the reason it didn't work as well for me in my insulin pump was due to the insulin not being "fresh", which it is when drawn up by syringe each time. Hard to say.
One thing before I forget, I tend to do something I've learned from the Diabetes Online Community (#DOC) that my endocrinologist and her team chastise me about. That's the intramuscular shot (IM) of rapid insulin to lower a high blood sugar (for me this is only done when in the 20 mmol/l range). I do it in the upper muscle of my shoulder, and based on my Insulin Sensitivity Factor (ISF), I am usually in range within an hour or two. Because the pump with Fiasp didn't do as well, I did hit a few above 20's ... and found that Fiasp via syringe worked the same. No sudden drastic drop into no-no-land which is what I have been warned about over and over again from my medical team.
So, that's it, in a nutshell, how my little trial went. It's worth giving it a go, if the vials aren't too expensive (here in Canada I can get a vial for $35 ... or 5-pack of penfills are $72 ... I have no insurance ... so according to my "legal drugs dealer" aka pharmacist ... I'd be paying about $10 more if I had insurance (urrrhhhh). Both my pharmacist and myself are curious to see what Americans pay out of pocket for Fiasp - so if you do look past your co-pay - and do question why you pay such and such for a drug ... great ... let me know.
!!! WAIT - WAIT - WAIT - I'M NOT FINISHED !!!
Since this experiment with Fiasp - I have found that with NovoRapid in my insulin pump ... in order to NOT
have spikes ... waiting almost an hour for the insulin to start doing its "thing" ... rather than 20 minutes which is usually recommended for most of us ... gives me much better results. Therefore, I may give Fiasp another go and try different waiting time before eating. Also, with contemplating what insulin pump to go on due to Animas Canada
pulling out of the pump business and my dislike for the company that has said they'd replace our pumps with theirs - I'm on the fence post about continuing with an insulin pump. I was injecting for 40+ years before going onto a pump, and can if I have to, go back hopefully with Tresiba
being introduced in Canada this month as another long lasting insulin (and that'll make another blog post one day in the near future).