Fiasp: newer faster acting rapid insulin is here

Adapted from Diabetes Digest supplement volume 16 No 2 2017 by Dr Lalantha Leelarantha Consultant diabetologist Manchester Royal Infirmary
Fast acting insulin aspart, Fiasp, is a new formulation of Novorapid, in which niacinamide and l-arginine have been added to enhance absorption and stability. This produces a faster onset of action more similar to what happens in non- diabetic people in response to food.

Compared to conventional insulin aspart, the new formulation appears twice as fast in the blood stream, produces twice the insulin in the first 30 minutes resulting in twice the insulin action during this period of time. Results are even better when delivered in a pump when more than double the insulin action is achieved.
There have now been several double blind randomised controlled trials done. As part of multiple daily injection therapy, the use of the new insulin, has resulted in lower post prandial blood sugars and a statistically significant drop in HbA1c. Other studies have shown that the new insulin works in pumps and that better post prandial blood sugars result compared to standard insulin.
Researchers think that use of Fiasp in closed loop systems will improve blood sugars even more.
Fiasp is available in a Flex-Touch pre-filled pen and this is cheaper than the IASp Flex Touch pre-filled pen. The penfill version is the same cost as the usual Novorapid. (NB the penfill is still cheaper than the disposable pens but requires a separate prescription for the pen)
The product data states that the new insulin should be injected 2 minutes before the meal to 20 minutes after the meal is started. It can be used in pumps. It has not been tested in the under 18 age group. Hypos can occur, as with any insulin, but can occur quicker after injection due to its rapid onset. It has been used successfully in diabetic pregnancies and during breastfeeding.
Five disposable pens cost £30.60 and five penfill cartridges cost £28.31.