Why November 14th is Special

Banting birthday

November 14th is  World Diabetes Day.  Those who live with diabetes often remark that every day is diabetes day! That is true but November 14th is special.

The 14th is the day that Sir Frederick Banting was born. For those who don’t know, Banting was a Canadian born medical scientist.  He received the Nobel prize for his work isolating insulin for therapeutic use with his colleague Dr. Charles Best.  He is the reason that my son is alive and thriving today.

Before 1922, a person with Type 1 diabetes was not expected to live long. The only way for them to survive was on very strict diets and those diets often left them malnourished.  Injected insulin came along and changed that.

The incredible before and after image of Leonard Thompson shows us just how dramatic of an impact insulin had on the lives of those living with diabetes.

From https://www.trumanlibrary.org/histday/insulin/impact.html

While my own son wasn’t as emaciated as poor young Leonard. He was gaunt and skeletal before he was diagnosed. My youngest child had always been a thin child. He had been sick but seeing him teetering in the bathroom after he began to receive insulin sent me into shock,however. His skin was hanging off of his tiny body and it had happened so quickly.

Thankfully on November 14, 1891 a man was born who would find this miracle elixir.  He would discover a way for my child, and millions like him, to receive the insulin that they were lacking in their own bodies. Dr. Banting gave them their lives back.  He gave parents back their children.

Those of us who use insulin, no that it is not a magic pill. We understand that it must be respected.  People living with diabetes quickly learn how the smallest doses of insulin can have life-threatening consequences. Despite the risk, the reward is incredible.  We have our children, our partners, and our friends.  They thrive, contribute and enrich our lives.

On this day we say “Happy Birthday Dr. Banting!! Thank you so very, very much for giving us this incredible gift of life.”

Fiasp Insulin. The New Kid on the Block

Fiasp Insulin the new kid on the block

It 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 left 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 Fiasp?

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.**

But what do Fiasp 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 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 pre-bolus.

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.

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. 

You can read about all of the types of insulin available in Canada here.