Mealtime insulins, or fast-acting insulins, are injected before or after each meal to regulate the blood sugar. Type 1 diabetics require mealtime insulin injections as their pancreas does not produce insulin, whereas type 2 diabetics may only require mealtime insulin if they struggle with blood sugar control after meals or are not achieving their target A1C.
What is Fiasp indicated for?
Fiasp is a rapid-acting insulin indicated to improve blood sugar control in adults with type 1 or type 2 diabetes.
It will be available as a 10 ml multi-d0se vial, and a 3 ml single-use disposable FlexTouch Pen.
What dose of Fiasp will I need?
Your doctor will determine your exact dose based on your metabolic needs, blood sugar monitoring results, and your blood sugar control goal.
Dose adjustments may be needed if you experience changes in kidney or liver function, physical activity or meal patterns.
Is there anything unique about Fiasp?
Yes. Fiasp is a new formulation of NovoLog, in which the addition of niacinamide (vitamin B3) helps to increase the speed of the initial insulin absorption, resulting in an onset of appearance in the blood in approximately 2.5 minutes.
Is Fiasp approved for kids?
No. At this time Fiasp is not approved in pediatric patients.
For more information, see the press release from the manufacturer Novo Nordisk.
For people who need to take insulin, there are a couple of different types—long-acting, short-acting, rapid-acting, intermediate-acting, etc. That’s a lot of options!
One question I see most often is the difference between rapid-acting and long-acting insulins. So, let’s get into it.
What is rapid-acting insulin?
Rapid-acting, or meal-time insulin, is a type of insulin that’s usually taken before, during, or after a meal to lower your blood sugar levels associated with meals.
How long does it take rapid-acting insulin to begin working?
The onset of action varies between rapid-acting insulin products, but can begin working in as little as 5 minutes, or could take as long as 30 minutes, depending on the insulin.
The following are the typical onset of action times for each individual rapid-acting insulin products.
What is long-acting insulin?
Long-acting, or basal insulin, is a type of insulin that gives you a slow steady release of insulin that helps control your blood sugar between meals, and overnight.
How long does long-acting insulin last?
The duration of action varies between long-acting products but should last anywhere between 22-24 hours. The following are the typical duration of action times for each individual long-acting insulin product:
Do I need more than one insulin?
Maybe. It’s up to your doctor to determine the best medication regimen for you.
Some type 2 diabetes patients may only need to use a long-acting insulin to get their blood sugar control on track; whereas others may need a combination of meal-time and long-acting insulin to best control their blood sugar.
If you are using an insulin pump, you will only need to use a rapid or short-acting insulin. The pump is able to give you a slow and steady amount of insulin to cover you all day like a long-acting insulin would do. However, it’s a good idea to have a back-up of long-acting insulin on hand in case your pump should fail.
Is there anything in between rapid-acting and long-acting?
Yes. There are short-acting and intermediate-acting insulins available.
- Short-acting insulins are used like rapid-acting insulin to cover blood sugar elevation from eating.
- Intermediate-acting insulins are similar to long-acting insulins as they are used to cover blood sugar elevations when the rapid-acting or short-acting insulins finish working.
Are there any combination options available for those who don’t want to inject themselves so often?
Yes. Some insulin products combine fast and longer-acting insulins that work together to help manage blood sugar between meals and at night, as well as blood sugar “spikes” that happen when you eat. Here are a few examples of these:
- Humalog 50/50
- Humalog 75/25
- Novolog 70/30
- Humulin 70/30
- Novolin 70/30
- Ryzodeg (FDA approved but not yet available)
Combination insulin products typically only need to be injected twice daily since they are single insulin products that work in 2 ways.
Are there any insulin products that last longer than long-acting insulins?
Does all insulin need to be injected?
No. Currently, there’s 1 rapid-acting insulin product, Afrezza, that’s inhaled through the mouth.
Currently, spironolactone is only available in tablet form, which is not an option for those who have difficulty swallowing pills. In order to make this drug more accessible to all, the FDA approved CaroSpir, the 1st liquid version of spironolactone.
What is CaroSpir indicated for?
CaroSpir is for the treatment of heart failure, high blood pressure, and water retention (edema) in certain patient populations.
How is CaroSpir sold?
CaroSpir is available as a liquid suspension in a 118 ml bottle with a strength of 25 mg/5 ml. It is banana flavored and can be stored at room temperature.
Before the approval of CaroSpir, what did patients do?
Before the approval of CaroSpir, if a patient needed liquid spironolactone the medication would need to be compounded. The compounding pharmacy would crush up spironolactone tablets and place them into a suspension formula typically using water for irrigation or propylene glycol and cherry flavored syrup.
The main disadvantage to compounded spironolactone liquid is dosing inconsistency which has been a persistent challenge for physicians.
How much will CaroSpir cost?
At the moment, patients can use a GoodRx Coupon and get CaroSpir for around $1000. Not cheap.
However, there is a way to make it more affordable! CaroSpir has a prescription savings program called the EasyPay Program so patients can lower the out-of-pocket costs associated with a CaroSpir prescription. Patients can save up to $75 on each prescription using their EasyPay Card.
For more information, see the CaroSpir website here.
What is Lyrica CR prescribed for?
Lyrica CR is for the management of neuropathic pain associated with diabetic peripheral neuropathy (DPN), and postherpetic neuralgia (PHN).
What does CR mean?
The CR means this is an extended release formulation (aka controlled release). This means that a drug dissolves over time and is released slower into the bloodstream.
Advantages of extended release tablets include better control of pain, increased tolerability, and the convenience of only taking the medication once daily. The benefit of Lyrica CR is that you will not need to take the medication multiple times a day.
What strengths will Lyrica CR be available in?
What are the common side effects of Lyrica CR?
Common side effects include dizziness, tiredness, headache, fatigue, peripheral edema, nausea, blurred vision, dry mouth and weight gain. Be sure to speak with your doctor if you experience any of these symptoms for a prolonged period of time.
Does Lyrica have a generic?
As of November 2017, there is no generic available for Lyrica. However, it may become available as generic pregabalin as soon as December 2018.
If you have diabetes, you’re probably used to checking your own blood sugar with a glucose meter. These blood sugar measurements are important for controlling levels on a daily basis but are less useful for understanding your long-term blood sugar levels.
Your doctor has a way to determine if your blood sugar has been in the recommended range by checking your hemoglobin A1C levels through a blood test. Your A1C shows how well you have been controlling your blood sugar levels over time and can help your health care team determine your average level over the past three months.
What does my A1C mean
An A1C level below 5.7% is normal whereas an A1C level between 5.7 and 6.4 signals prediabetes. For most, the goal is to lower A1C levels. Here’s what the A1C means in reference to average daily blood sugar.
6% A1C = 126 average blood sugar
7% A1C = 154 average blood sugar
8% A1C = 183 average blood sugar
9% A1C = 212 average blood sugar
10% A1C = 240 average blood sugar
11% A1C = 269 average blood sugar
12% A1C = 298 average blood sugar
How often should I check my A1C?
Your doctor or health care team will determine how often you should get your blood work, and A1C tested. Usually, you will be directed to get your A1C levels checked every three months. However, if your diabetes is well-controlled, your doctor may only require you to get your blood work done every six months.
Is there a way to check my A1C besides going to the doctor?
Yes. You can now purchase over-the-counter A1C test kids right from your local pharmacy.
However, using an at-home testing kit for your A1C is not a substitute for regular blood glucose measurements or regular visits with your healthcare provider.
What should my A1C goal be?
Your doctor will help you determine what your personal A1C goal should be. According to the 2017 American Diabetes Association, a reasonable A1C for many is less than 7%. However, less strict goals may be appropriate for those who have a history of low blood sugar, limited life expectancy, advanced complications, or extensive comorbid conditions.
How can I lower my A1C?
There are many things you can do to get your A1C within your goal.
- Take your medication properly. This means abiding by proper injection technique, and taking your medications as directed by your doctor.
- Adjust your medications with your doctor. In some cases increasing or decreasing your medications can help you reach your A1C goal.
- Increase your diabetes knowledge. Diabetes educators can be a great resource to help you with healthy habits.
- Abide by a healthy diet. Did you know that many grocery stores employ dieticians to help their customers including diabetics increase their food knowledge? Reach out to your specific grocery store to see if they have a dietitian to help. Also remember that fruits, veggies, and lean-protein can also help lower your A1C.
- Exercise. 150 minutes or more of moderate-to-intense physical activity over 3 days per week can help lower your A1c!
- Lose weight.
- Check your blood sugar as directed. Your doctor will help you determine a schedule for testing your blood sugar. A continuous glucose monitor can help you consistently check your levels without a fingerprick!