Meet the Insulins, Part 2 - Fast Acting Insulins

[@emreulusen8904]

This lecture is great. I'm a pharmacist from Turkey and it realy helped me renew my diabetes medication knowledge, thank you.

[@lucieni]

Just switched from Humalog to Fiasp and I’m loving it! My work doesn’t allow me to be rigid with injections 15-20 mins before eating as I can get caught up with issues on the ward (I’m hospital pharmacy) and as the SPC for Humalog states it can be injected right before a meal... that’s not strictly true as I found out with a spike after every lunch.

[@xheidio]

Hey there boss! I've been a type one for 42 years! I found your video to be very informative and I will definitely be back for more if my new scripts for Tresiba and Fiasp don't work out. I've had a rough start. Quick suggestion: while I really love your music, I would find it easier to concentrate on what you're saying about if it were just a wee bit softer!

[@rebeccabrown5014]

Yes, I have a horrible time taking in information when music is played at any volume. Just let your voice be heard. No music is needed.

[@covishen]

I'm taking the relion version of insulin, when I started it, I was uninsured and my doctor wanted to 'help my pancreas out' as he put it. It took a few months, but both him and my wife convinced me. I have had really good results. Now I am also on Trulicity which has caused my usage to really go down significantly. Now I understand why and how it's working and that has also helped me out. Thanks

[@BrianMurphy80]

Thanks! You are my go-to for figuring these things out. :)

[@viniciuspaini10]

Your content is awsome, i am studying medicine in brazil and you have a great didatic! thank you!

[@sugarhighchannel]

Thanks for your feedback; I’m glad you enjoyed it. Best of luck in your studies!

[@Lauriezp123]

A Big help, Thanks!

[@lesliehyde]

I have been found to be not just manufacturer specific but also insulin type specific. The insulin that I use is Novolin 70/30. I get it 4 times a day (before meals and bed) unless I am sick and have to adjust up or down depending upon my blood sugar numbers.

[@lucieni]

@9:49 Us pharmacy staff need the crap confusing out of us so keep on prescribing weird stuff… it gets us thinking!

[@jkl6868]

On Novolog for fast acting, but do not bolus if I eat low carb. Endo refused to Rx Alfrezza, will get Fiasp during next appointment.

[@motorsmt]

Thanks. Extremely informative and answered many questions I had.

[@sugarhighchannel]

Thanks for your feedback! I’m really glad you found it helpful.

[@alfredmcbride1020]

Afrezza is the worlds only active Monomeric inhaled insulin all other insulins are non-active zinc bonded hexomeric insulin so regardless how those are delivered they will always be to slow in and to slow out. Afrezza is less than 30 seconds difference then the healthy pancreas release. Superior glycemic control and fastest insulin on the planet. (Long MNKD)

[@sugarhighchannel]

You’re absolutely right. It’s honestly a bit of a bummer that people don’t get prescribed Afrezza more often; it’s one of the most underrated insulins out there.

[@alfredmcbride1020]

@@sugarhighchannel FDKP (Technosphere) a known inert nano particle self assembles active Monomeric Human Insulin..in a stable state..no one else has ever been able to do this except the healthy pancreas..Afrezza is release through the 1 cell thick lung wall..and is systemically delivered into the blood stream and goes to work immediately...other insulins just sit in the blood in an inactive state until the body eats through that zinc bonding and they become monomers...to slow..and stay in the body so long raises risk of hypo's so eating and weight gain..However Afrezza is weight neutral..lower risk of hypo's

[@ButcherAndTheTinMan]

Agree that the best of the bunch, objectively speaking, is Afrezza. Probably more expensive than the others, but sometimes you get what you pay for.

[@jamesmuldowney5500]

I have used Fiasp for 2 years. It can take up to an hour to work. I have been type 1 for 35 years A 1c 6

[@sireenshatat1825]

thank you for all the information, it really helps

[@lucieni]

I’m still finding Fiasp to be not as fast as it states… I can inject and not go low for over an hour after without eating. We don’t have Lyumjev in the U.K. as far as I can see but I’m looking forward to it and will ask my DN one day (It’s not on the formulary where I live or work for the NHS currently July 2021).

[@mbassi1787]

Thank you for the great information. My daughter is 7 just got diagnosed with T1 I'm January 2022 she's on Humalog and humulin n. We are still getting lots of ups and downs. I have asked her pedestrian if we can change to better long lasting. So she doesn't have to inject 2 times long-lasting and also she gets lows at night.

[@manojagrawal5113]

Thanks for such a nice video. Can we have a video on structural modification in long-acting insulin products in detail?

[@Ray-re8om]

Thank you so much very informative

[@stevee8698]

Insulin takes sugar from blood and stores it as FAT. I haven't heard you talk about weight gain.

[@mariawright3042]

Do you have information on the 70/30 insulin?

[@prajwalprajwal7392]

Why does bodybuilders use both long acting and short acting insulin together with hgh

[@kevinallen1409]

On average is one novolog or humalog faster acting, and with a longer acting time?

[@cowlover8942]

My endo tried me on fiasp but alas it was like injecting water 🤷‍♀️ so I ended back On NovoRapid

[@aragorn8gb]

Thank you very much

[@tracyballard3180]

Still kind of confusing. I’ll watch the video again

[@andreymartin8748]

I'm using novolog and lantus but keep running out quicker than usual,if my insurance didn't cover novolog when I needed my refill could I use novolin r?

[@kathleenlloyd2682]

It's great to know how long it takes a particular insulin to begin working, but it would also be nice to know how long each type of insulin lasts in the system. For example, Fiasp begins working immediately, but how long will it keep working? Does it keep working as long as say, Humalog, or does it stop working sooner?

[@sugarhighchannel]

Fiasp starts and ends more quickly than Humalog and Novolog. This is nice because some people get hypoglycemia four hours or so after a meal time injection. Since Fiasp hits and quits more quickly, there is less of a “tail effect“ hours after the meal.

[@kathleenlloyd2682]

I need to enter the active insulin time into my pump. I had Humalog entered at 3.5 hours, what is the general Active Insulin Time of Fiasp?

[@simonettepiedad7247]

Thank you for another fun learning. Insulin has helped me a lot in my blood sugar control which used to be 2-3x higher than normal when I wasn't on insulin yet. I transitioned from Lantus to Toujeo. My questions are about the fast acting insulins. Why aren't all diabetics like me (Type II) prescribed with one? How many hours of high blood sugar after a meal should last until it gets back to normal? How dangerous is it if like me for example, I use long acting insulin, so after a meal, when I do self check, my blood sugar spikes (up to 10 mmol/L) and it will take a few or many hours to get it back to normal. Sometimes, it gets back to normal only the next morning before breakfast . Throughout the day, even before the next meal, it is up (7 or 8 mmol/L) . My A1C results are normal though. Should I worry about the long hour spikes throughout the day? Will it further worsen the complications I already have? Is my normal A1C results REALLY showing a good control? Thanks again and more power!

[@sugarhighchannel]

Hi! The reason most Type II diabetic people don’t get A fast acting insulin is that it quite often isn’t necessary. If the glucose comes back down to normal 2 hours after a meal (for example 140 mg/dL or 8 mmol/L), then your pancreas is still able to release enough insulin to manage the meal on it’s own. 10 mmol/L is still considered “at goal” (barely) in many treatment guidelines, including the ADA, but my personal opinion is that 10 is still a bit high. I’d shoot for 8 or less. Now, that doesn’t necessarily mean you need fast acting insulin, there are many other medication options that might help instead. Of course, if the carb content in the meal is the cause of the glucose staying high, then adjusting that would be the best option. You’re absolutely right in your observation that there can be a disconnect between A1c and glucose readings throughout the day. A1c still counts, but more and more we are looking at “time-in-range”, meaning how much time are you spending with your glucose in the target are vs above or below it, in addition to just using the A1c as the only marker. Your situation certainly doesn’t look critical, but keeping that time-in-range” as high as it can be definitely gives you the best chance for success. Keep up the incredible investment in yourself!!

[@jkl6868]

I am in socal too, where is your practice? I’m in the beach cities in the southbay.

[@sugarhighchannel]

Sorry for the late reply- my practice is is in Lancaster, Ca. Northern Los Angeles county

[@karenslatus7672]

Why is Novolin R not recommended I take this along with a Very low dose hs of Lantus.

[@sugarhighchannel]

It depends, for Type 1 diabetes, there's no reason why Novolin R couldn't be used for mealtime coverage if someone is using Lantus for long-acting insulin. For Type 2, it isn't not-recommended per se, but if a type 2 person is on only 5 units of Lantus, that person may not really need fast-acting insulin in the first place. It's a case-by-case thing, but there's no specific interaction that would make using those 2 insulin together a problem.

[@Dorito230]

Lyumjev?

[@sugarhighchannel]

Great observation. Lyumjev hadn’t been released when I made this video. I did make an update news flash on Lyumjev when it was approved and how it performs. Here’s a link if you’re interested: m.kzbin.info/www/bejne/iF6skKygj9eeZ5Y

[@larryc1964]

Why not just cut out or way back on carbohydrates? No such thing as essential carbs. I believe I’ll be off insulin within the next 6 months. Been eating very low carbs for a year now

[@sugarhighchannel]

Diet modification is the BEST way to manage type 2 diabetes. I’m glad you’re doing so well. Some people absolutely need insulin supplementation, though (like type 1 diabetics, for example). This video is intended to explain the differences between the various insulins options available.

[@larryc1964]

@@sugarhighchannel yes, agreed

[@mightyd463]

You forgot Humulin R U-500