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Fiasp can be administered up to two minutes before or, if necessary, up to 20 minutes after starting a meal.
In pharmacokinetic studies in patients with type I diabetes, the onset of appearance of insulin in the bloodstream was twice as fast with Fiasp as with NovoRapid insulin aspart (4 minutes vs 9 minutes).
In a 26-week study involving 1,143 patients with type I diabetes, Fiasp administered at mealtime provided significantly greater improvement in HbA1c from baseline to week 26 than mealtime NovoRapid (-3.46mmol/mol vs -1.84mmol/mol [-0.32% vs -0.17%]) and significantly lower 1-hour and 2-hour post-prandial glucose increments than mealtime NovoRapid (-0.84mmol/L and -0.29mmol/L vs 0.34mmol/L and 0.38mmol/L, respectively).
Fiasp has also been studied in patients with type II diabetes. In a study involving 689 patients, mealtime Fiasp met the primary objective of non-inferiority in HbA1c reduction at 26 weeks compared with mealtime NovoRapid (-15.10mmol/mol vs -14.86mmol/mol [-1.38% vs -1.36%]).
Hypoglycaemia may occur earlier with Fiasp than with other mealtime insulins because of its earlier onset of action. The time to onset must be taken into account when prescribing to patients with concomitant diseases or treatment that may cause delayed absorption of food.
