Could not agree more.
Beautifully written @Terry4
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From what the OP said:
âIâve been struggling with overnight hyperglycemia latelyâ
âŚthis sounds like it COULD be MORE than just a âdaily lifeâ situation.
âMy post said DO conclude that tiâs a known causeâŚâ? But you do NOT know the cause. You do NOT know the patientâs medical history. You do NOT know what other medications he is taking. You do NOT know his social situation â whether he lives with family or alone. You know next to NOTHING about the patientâs past diabetic history. That is why doctors keep medical records â so they can refer to them when a patient is developing something new and make an INFORMED judgement. ALL you know is what he is telling you and on that basis alone, presuming to judge what heâs doing to be okay.
âBecause we would be calling our doctors EVERY DAYâŚâ? As I said, this patient has elected to diagnose himself and treat himself with arguably potential significant risk â intramuscular injection of RAI and stacking RAIs. Before assuming such risks, the RATIONAL thing to do is speak with the endo or diabetic nurse. If the doctor/nurse doesnât want to hear about it, Iâm sure theyâll say so.
What I donât understand is why you find it so objectionable for the patient to communicate with his primary care physician.
And Iâve spent almost as long dragging type 1s unconcious with hypoglycemia or DKA from the back seats of cars, beds of trucks, backs of ambulances, etc, into my ER! And, curiously enough, almost invariably around 3-4 am! Always amazes me how diabetics always manage to crash between 3 and 4 am!
And once theyâve regained conciousness, Iâve had to listen to some variation of the line about âmost doctors and many other medical staff do not have the depth of experience that I doâ more times than I can count! And THEN Iâve had listen to their endos gripe and refuse to admit them because theyâre non-compliant and the endo doesnât want to mess with them anymore! So do all the ER docs in the world a really, really SMALL favor and call your endo! Canât HURT, can it?
How many of those hypoglycemic comas youâve dragged into your ER have been caused by afrezza? Which is the topic of this and every single other thread youâve chosen to join?
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Ok, back to the topic of Afreeza for corrections. I have meet a few people at different meetings/conferences who are using Afreeza both as their meal bolus insulin and as correction bolus. But my question is about 4 units? My correction level is 1:100. A dose of 4 units would send me into a tail spin. Is 4 units the smallest dose? Or can you adjust for 1 or .5? I would love to give it a try mainly because itâs quick and doesnât hang around.
My understanding is that because Afrezza is so fast it triggers a natural process where your kidneys âclearâ extra insulin. This makes you less sensitive to dose size and lows. Injected insulin is slow enough that it doesnât trigger this clearing process.
My endo just gave me a sample box of Afrezza. I havenât tried it yet.
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This comment reeks of condescension and self-righteous judgment! You are obviously not here to participate in a peer support group. You choose to frequent our forum and come off as somebody who might bestow diabetes pearls of wisdom from someone who doesnât know squat about living with diabetes. Why donât you take your offensive and patronizing remarks someplace else?
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Great that he was willing to do that, did it take any persuasion from you?
I can assure you itâs nothing like taking 4u of injected bolus. IC ratios arenât really near as relevant with afrezza as they are with injected. Just get to know how your body reacts to it under controlled circumstances. Timing is everything. I hope you like it.
Donât fixate on the number of âunitsâ I know those are the rules we live by all day with injected, but this is a different animal. Instead just think of it as a small dose or a large dose would be my advice.
I donât take my afrezza for a full 45 minutes after I eat currently. But am takingn a PPI that seems to slow down carb digestion. Even before that though I was doing 25-30
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So that means a dose of 4 units would help a high but not send me the other way? Iâm sure my doctor could get me a sample but just not sure if itâs something I could use without ending up with a low.
Very cool. I am so very thrilled that there is something new for type 1âs. Doesnât happen very often does it? Letâs see, it was insulin and Smylin. And yes this is another type of insulin so I guess not really new, but the way itâs used is very new. I see my endo in 2 weeks and we will be taking about many different drug possiblilties out there. So thanks and weâll see if the lungs can handle it. That might be a deal breaker for me due to some breathing issues but I can hope.
It didnât take much persuasion, she has had a number of patients try it with good experience. She has also been seeing an actual Afrezza rep, I asked.[quote=âSally7, post:53, topic:56490, full:trueâ]
So that means a dose of 4 units would help a high but not send me the other way? Iâm sure my doctor could get me a sample but just not sure if itâs something I could use without ending up with a low.
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The experience of users I have seen suggests that even with a dose that would guarantee a hypo with injected insulin Afrezza results in a smooth landing. I believe Afrezza studies reported lower levels of hypos (even with crude dosing) than with comparable injected insulin.
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As Samâs and Terryâs experience has shown that, the fast-in and fast-out nature of Afrezza makes it much less likely to cause a hypo. I recall the studies showed a 30%/50% (canât recall exactly as I can not get access to the full report any more) plus reduction in hypo rate.
Interestingly, in the this video of Al Mann (the discussion regarding the hypo events starts at around 11 minutes of the video), it appears in the main study (I assume it is the study for Type ones, study 171), Al Mann mentioned that in that study, there is one person who accounted for more than half of all the hypo events in the study. So if you take out that person (an outlier), the hypo events would have dropped another 50%. This seems to be consistent with the observations shared by the Afrezza users (that Afrezza is less likely to cause a hypo in the first palce and even if it causes a hypo, because its fast-in and fast-out nature, the hypo event would be less severe).
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I know that some people have report issues with coughing, but thatâs due to dry powder hitting a dry throat, its only natural to have the urge to cough. Iâve heard that drinking water before and after your dose helps considerably. Good luck, hope youâll report back if you do try it.
Sorry, but dealing with the consequences of seizures, vomiting, and failed sphincters can do that to some people after 30 years.
Your failed sphincter has nothing to do with afrezza. Stay on topic please. Still never heard why youâre posting on these threads.
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