Fiasp (Novo Nordisk) is a faster insulin aspart with an earlier onset of action. In contrast to NovoLog, which is recommended to be dosed within 5-10 minutes before meals, Fiasp may be dosed immediately before meals and up to 20 minutes after starting a meal, providing added flexibility for more accurate dosing in children who may be variable in their food intake. The FDA approved the use of Fiasp for children with diabetes mellitus (no age restriction) in January 2020 based on an international multicenter randomized study involving 777 children (age 2-17), showing non-inferiority of both mealtime and post-meal dosing of Fiasp compared with NovoLog, and slight statistically significant superiority with mealtime dosing of Fiasp regarding HbA1c and 1 hour postprandial glucose excursions. It is approved for use in subcutaneous injections, insulin pumps, and IV infusions.
