First Shot with Fiasp

A few days ago, I picked up the new insulin, Fiasp, brought to us by Novo Nordisk. (German article here.) Below are a few quick facts in case you haven’t heard of Fiasp yet:

  1. Fiasp stands for faster-acting Insulin aspart.
  2. Can be injected 2 minutes before meal and up to 20 minutes after, unlike Novolog/Novorapid where a pre-bolus of 20-30+ minutes is necessary.
  3. Fiasp is absorbed 2x as fast as Novolog/Novorapid, hence point 2.
  4. Contains Vitamin B3 (niacinamide) which helps with speed of absorption AND contains Amino Acid (L-Arginine) for stability.

source: Novo Dordisk Press Release dated 27 March 2017

Drum roll, please.

I have tried Fiasp twice and am excited about my results. There are however, a few quick things that I want to clarify first. I am still using Novorapid (Novolog) in my pump and injecting Fiasp via pen. In both scenarios below, I simply injected once per meal, literally right before my first bite, with no dual injections following.

Test #1 SUSHI

I felt pretty confident going into my first shot with Fiasp (no pun intended). A few weeks ago, we went to the same all-you-can-eat sushi restaurant and I bolused somewhat successfully for 120g of carbs (crap, that’s a lot). I feel like it is accurate to say I ate basically the same amount this time too. A nice controlled test. So what happened with Fiasp?

sushi

I went in with a stable 131 BG, and one hour later I was at 175, two hours after 173, and finally, three hours later I was at 236. WHAT? That was not what I expected. I am impressed with the initial relatively low spike, 44 mg/dl isn’t horrible. However, ending at 236 quite surprised me. It seems that Fiasp might be more effective used via pump, or a dual injection. It kept me stable the first two hours, but gave up when my body wanted to spike one more time. A double injection, perhaps about one hour into eating, would have been better. And for those who say I didn’t bolus enough, nope. My previous experience eating at this same restaurant tells me I bolused correctly.

*correction dose at 15:33 was given via pump (Novorapid), not Fiasp.

Test #2 Keto Porridge

Fiasp shot number two was used for Keto Porridge. I also ate this prior to using Fiasp, so I knew what to expect with carb counting. With Novorapid/Novolog, I bolus successfully for 15g of carbs (2 servings of this recipe, yeah I’m hungry in the morning). This time with Fiasp, I chose to add a dollop of Nutella, because why not? So I took enough Fiasp to cover 30g of carbs. Results?

keto porridge

Importantly, I had a stable BG before eating. Again, I took the 3 units RIGHT before my first bite. One hour after eating, I was at 88, only a 9mg/dl rise. WOW! Two hours after meal, I went up a bit to 134, and finally, ending three hours later at 154. Again, Fiasp held off spiking immediately, but ended with a raised BG. I am quite surprised with the result of the Keto Porridge experiment, as it is a low glycemic index food, minus the Nutella. I honestly was not expecting to end at 154 and I really don’t know why this happened. It could be a fluke, we all know how diabetes is. Any thoughts?

To summarize, Fiasp keeps my BGs somewhat stable for the first two hours, without pre-bolusing. However, by hour three I spike. Of course, this was my experience after only two attempts at Fiasp. I am really looking forward to more experiments, and possibly using Fiasp in my pump, as I believe a dual bolus would be more beneficial.

What are your thoughts and/or analysis of my results? 

What questions do you have about Fiasp?

Honestly, all thoughts are welcome!

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12 Comments

  1. What app are you using to show your glucose and insulin? I’ve never seen it charted like that and I’d love to try using it. I started Fiasp yesterday and seeing some of the rapid fall-off effects AND I’m seeing that if I underestimate the number of carbs and don’t get enough Fiasp I get a fast spike and then not enough tail insulin to bring me back into range. I suspect that getting the correct amount of Fiasp right away is more critical than with Apidra AND that I may need to really shorten my insulin action time (DIA) on my Omnipod to account for this. Unfortunately, Omnipod uses a linear insulin on board approach which may not work for Fiasp.

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    1. Hi 👋 I use MySugr to track my data on my phone. A quick google search will bring it up, or in your App Store. I experienced the same issues with Fiasp. And as you said, i changed the action time to 2 hours as it really doesn’t last longer unless very large doses are given. Good luck!

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  2. Pingback: Novolog vs Fiasp
  3. Do you have any idea of the protein and fat content of sushi rolls? Let me say, they are not fat free – just the opposite.

    And the Keto porridge is about 51% fat. I would suggest talking to your ENDO about using the dual bolus on your pump to avoid a 4 hour after-meal spikes from high protein and/or high fat foods. They are metabolized differently than carbs.

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  4. I am not a Dr, nor am I in the medical field but I was recently diagnosised and have been doing a lot of research since I wasn’t getting what I needed from my Endocrinologist.

    I would suspect that the reason your blood sugar levels rising 3-4 hours later is due to Gastroparesis (delayed stomach emptying). Novolog tends to peak at between 2-3 hours but gradually tapers off for 5 hours after injecting. Rapid acting insulins peak within an hour but rapidly taper off after 1.5-2 hours upon injection. I found Diabetes Solution by Dr. Bernstein to be very useful and practical information. If you get a chance I highly recommend reading it.

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    1. That’s definitely not why. There are plenty of other symptoms that come with Gastroparesis which I have never had. The most likely solution is the fat content in food. When food has a high fat content, it takes much longer to break down. In this case a second injection about 30-45 minutes would have helped the later spike.

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