We’ve been n the road to visit family and had a really difficult day (storms, road closures, missed dinner, etc.) and overslept the next morning. We wanted to grab breakfast before service closed and I was over target so I used 4 units, ate 35-40 g carbs, started to go high and took a 25 minute walk, dropped, then started going high again so another 4 units. No joy!
My husband drove first, BG did not go down per CGM, did 1 unit of Humalog, ditto, tried 1 more Afrezza cartridge an hour later. Finally dropped!
So after thinking this over, I realized that I coughed a lot all 3 times I used the Afrezza–my husband wondered if I need to inhale it fast (not slowly like I was doing) to make sure I got the full dose. Timing was probably an issue, too. I haven’t been sleeping well so that’s another factor (insulin resistance higher) and am not getting my usual amount of exercise. (Maybe I need to increase my basal on driving days?) The samples are close to their expiration date so that might be an issue, too. Lots of confounds!
So right now what I am thinking is just trying it for corrections in order to eliminate some of the other variables. I haven’t given up on Afrezza and more reports will be forthcoming!
While Afrezza can be a star performer while traveling, starting it while traveling may be difficult. As you say, there are many confounding factors. One observation may be that you need more Afrezza to cover the carb load that you ate. Only personal experimentation will inform you about that. Timing is also important. Some people inhale the Afrezza after their mealtime. Keeping track of all these factors is harder while traveling. Maybe you should postpone this until you return home. Just my two cents.
I pretty much don’t use the 4s to cover any carbs at all, only for corrections… to cover a meal requires at least an 8 even if it’s a relatively LC meal for me
I do find the 4s to be very effective for corrections though
Hello @CatLady06 !
Don’t give up! It took me about 3 weeks of using Afrezza before I felt it got used to me and I got used to it! The technique really does have an impact and even now I can tell if I “off” puffed of let some of it back out of my exhale. You can always open up the capsules and check to see if any remains inside.
A 4 unit cartridge offers me the same coverage or correction as about 1.5 units of humalog. It took me some time to really trust the the 4 unit dose was not really 4 units of injected insulin ( I rarely use that munch).
Another thing I have noticed is that one 8 unit cartridge is much more powerful than puffing two 4 unit cartridges which intuitively one would think would offer the same coverage. Just not the case for some reason.
One of the best things about Afrezza is that you can sort of seemingly “play around” with it much more comfortably than with injected insulin…it is in and out of your system so quickly…it never seems to drop me into a low and if not getting the desired result you can always puff again!
It is a new package that Mannkind introduced to the market this summer (available since August). It contains 180 cartridges (instead of 90). 90 four units + 90 eight units in one package. Since it has more cartridge in one package, it gives you more flexibility to play around with the dosage in the titration/dial-in period.
See the NDC number (47918-880-18) for the titration package and other existing packages in the following tweet from Mannkind:
For me a 4-unit Afrezza works for 20 grams of carbs. Maybe a little more but only if I am exercising or moving a lot after I eat. Like others have said, one unit of Afrezza is not one unit of insulin. I do find that sitting after a carb heavy meal makes things a little more challenging. For breakfast I stick to greek yogurt with a 1/4 cup granola. That’s always safe for me. (The right granola of course.)
I am now pretty much completely on Afrezza and only use an additional hit of insulin if I will be eating a long slow big meal.
Afrezza is in my system and out of my system so much faster than anything
else on the market. With sports or an active lifestyle this is totally the
way to go. Traditional insulin is better for a high carb diet, but that’s
not the greatest for me or for any diabetic. Goal is to have low insulin
needs.
I think I am getting the hang of using Afrezza for corrections (it’s so hard to estimate the carb load in restaurant meals sometimes!) and have really appreciated the fact that it has such a short tail. Also yesterday I really needed a caffeine hit but didn’t want another Coke Zero. ((We’re on a road trip and I started feeling sleepy while driving.) We made a pit stop and I got a chilled espresso drink in a can–10 g carbs. I inhaled a 4-unit cartridge, watched my CGM for the bend in the curve, and…enjoyed my drink! No BG problems afterward!
^^ That seems to be the untold advantage of Afrezza for people that just go by studies and label.
you wanted something, drank it, puffed and moved on with your life.
You didnt plan for it, didnt have to prebolus for it…( even if in case of a meal you dont have to Afrezza)…
And for the carb load in restaurants, T shirt sizing may be? small , large, x tra large reading here.
I would tell you in November/December
I’ve been using Afrezza for about 18 months. I also use insulin pump and Dexcom. Today,while helping some family members move, BG was dropping fast, and I over corrected, estimating that the continued activity would also be covered. However ended up at 257 dexcom 267 meter BG.
So decided to record the numbers this time,
I took 4U Afrezza at 7:20, and here are the following results on dexcom.
7:20 257 straight arrow
7:50 233 45 degree down
7:56 218 down arrow single
8:03 188 down arrow double
8:27 135 down arrow single
8:35 120 45 degree down
8:56 98 45 degree down
9:06 86 straight arrow
9:20 79 straight arrow
I reviewed changes to the formulary for my insurance and found that Afrezza now requires prior authorization and a statement of medical necessity. Formerly, it was at the highest co-pay only but otherwise available. Here’s hoping my doc can keep getting the samples!
