Hey Jen - this is a perfect example. With Afrezza, that high would literally be taken care of in 60-90 mins max for me, with no fear of a tailing low.
I hope you get the chance to try it out.
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Jen, apparently there are people in Canada that have managed to get Afrezza to try on. See the following post from Twitter:
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@Jen This used to be exactly what I struggled with as wellā¦ (if I was lucky!) not until dinner time would I be anywhere close to back in range and feeling better. Orā¦ even worseā¦I would get so mentally frustrated, there were times where I just gave up. Not good.
We shouldnāt have to feel this way if there is something out there that can support our feeling better and better physical health within minutes. Often itās such a quick blood sugar recovery that I forget it even happened and continue on with my day and life as such. I wish everyone could get their hands on it to try!
Andā¦with getting back into range quickly, I never feel that awful groggy, tired eyed, sluggish 1000 pound body feeling that lingered from a day or two of high bg.
Me. After a high bg day.
P.S. @Canadaā¦weāre just slower processors maybeā¦good things take time. lol!
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Cynthia, you are the Queen of Visuals on TuD; you seem to have a million of 'em, and you never fail to post an image that strikes me as right on the money! 
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Especially considering the little one is really Cookie Monster!
Maybe Sesame Street should do a Diabetes awareness skit WITH Cookie Monster?
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I think the reason Afrezza is struggling to take off is because only 10% of all diabetics are type 1. Type 2ās are not showing as much interest because they have many alternative drugs and healthy lifestyle choices unless theyāre severe type 2ās which are fewer. Also, if not fully covered by medical insurance, Type 2ās require even more insulin than Type 1ās, so it would cost and arm and a leg with Afrezzaās high cost. Being a Type 1 diabetic myself and just starting Afrezza a week ago, Iām hoping just the Type 1 Diabetics will keep MannKind afloat. Also keep in mind MannKind plans to use this patent for other conditions like allergy shots breathed in to reach the bloodstream quicker for deathly allergies. Like a breathable epi pen. So I doubt MannKind will go bankrupt. Are there any Type 2 on here using Afrezza? I also have a question for Type 1ās that use Afrezza only as a correction tool but still take their regular Humalog/Novolog/ or Apidra shots. Does that cause low blood sugars a few hours later? Humalog stays active for 6 hours. If your blood sugar is high 2 hours after a meal and you take Afrezza, thereās still 4 hours more of Humalog overlap which can now turn your blood sugar low. I tried Afrezza in combination ratios with Apidra with no success. I was thinking about using Afrezza as a correction factor when Apidra doesnāt do the job, but it mathematically doesnāt sound viable. You quickly bring down the blood sugar 2 hours after a meal just to turn low in blood sugar 4 hours after the meal with Apidra still in the system. My conclusion is that Type 2 diabetics can use Afrezza as a correction factor only using it sometimes, but it will cause lows for Type 1ās. For Type 1 diabetes my experience is that one should go All-In and use only Afrezza as a bolus or not at all.
Iāve done this repeatedly with very consistent success. How long have you been dealing with T1D? When were you diagnosed? What is your current treatment regimen? Do you use a pump? What is the status of your education about diabetes? Have you read any of the more popular books about diabetes treatment, like Sugar Surfing?
Since you donāt live with T2D, what is the basis for this conclusion?
Living with diabetes in the real world has taught many of us that theory is fine but the real world, if you pay attention, can teach you the art of dosing insulin.
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Good luck on the new market, but my problem is my Doctor. I have a major problem on days I change my infusion set for my pump. Run away blood sugars. I want to desperately try Afrezza to control the spikes and cover meals. I have a few friends who āpuffā now and in the past and they rave about their control. Soooo, I sent my Doctor an email and requested we try Afrezza and set up the required lung test!! The reply was he is not comfortable prescribing this medication. So I sent another message to go to the JDRF One Walk in Sacramento cuz I had a heads up the Afrezza table would be there. One of his patients was the JDRF head of the local walk, but no reply. How do we get the info to the Doctorās to join us in better management of OUR disease?
Tell him to research the drug or youāll find a more progressive Dr. whoās willing to seek out better treatments.
Iād also say that your life does have enough time to wait for him to get educated on drugs that are already approved by the FDA and are on the market with many successful users. Be tough on him, heās not God, nor can he give you demerits for being critical.
Checked my insurance and the local Doctor who does prescribe Afrezza is not in my plan. Afrezza is not either, but getting a medication approved is easier than getting a Doctor on board to really help ME manage my diabetes.
@Duck_Fiabetes may know a good doctor in the area
Thanks
I am living in the real world with T1D myself for 27 years. But my conclusion on T2D is based on the ones not taking insulin. My theory is that a drug to lower blood sugars would have a smoother overall effect 2 to 6 hours after a meal because a type 2 on a drug is using such a drug like a basal and pancreas still able to function somewhat to handle meals. Since a T2D is not shooting up a basal insulin after a meal like Humalog. ā¦ a type 2 does not have the large drop in blood sugar 2 to 6 hours after a meal and injection. So that type 2 can take a breath of Afrezza 2 hours after a meal for a correction without turning low between 2 to 6 hours after the meal because they have no Humalog in the system like a T1D after a meal has Humalog which is slow to start and peak but lags and stays in the system for 6 hours after the meal. T2D with a basal drug would not need a bolus shot of Humalog. So there is no 2 to 4 our turning low after a meal. With a Type 1 Diabetic I cannot see taking Afrezza as a correction working unless you take it to correct fasted periods 6 hours after a meal where both food and Humalog is completely out of the system. For a T1D to take Afrezza as a correction 2 hours after a meal when they already took Humalog for the meal is thinking very shortterm because itās using Afrezza as a crutch for the slow action of Humalog. ā¦ but not thinking about the overlap of Afrezza with Humalog still working even up to 6 hours after the meal. SPEAK all Type 1ās that had success using Afrezza only as a crutch correction if gave too little Humalog and find out 2 hours after the meal and take a breath of Afrezzaā¦ are you turning low in blood sugar 3 to 6 hours after the meal with Afrezza overlapping with Humalog still in the system up to 6 hours post meal? Overlapping Afrezza with Humalog or Apidra has not worked for meā¦ and Iām a Type 1 Diabetic. Iām looking to use only Afrezza as my bolus. ā¦ but not insured for it and costs an arm and a leg. I am not on a pump and not on CGM. T1D for 27 years and very good at trends. I tried every ratio possible of combining Afrezza with Apidra and no success. Afrezza on its own is working better. Im taking Tresiba as my Basal and I split it injecting twice per day to smoothen out itās action. The reason I mentioned Afrezza would cost an arm and a leg for T2Dās without insurance is because I spoke to a few endocrinologists that told me Type 2 Diabetics that require insulin require much more units of insulin per day than a Type 1 Diabetic. Just because their cells donāt absorb insulin as well combined with insulin islets dying off from being over worked. I also read some analysis of Afrezza and they said thatās one of the things deterring severe type 2ās that require insulin. ā¦ that their units of insulin per day are much higher than a Type 1 diabetic and would cost an arm and a leg for Afrezza with it costing so much and needing so many units of insulin per day and if not covered for it. Alsoā¦ for those of you not on Afrezza. My experience after you include follow up Afrezza doses an hour after the meal, is that your total daily Afrezza units would be 1.66X your Apidra or Humalog daily units needed. Almost twice the dose needed with Afrezza verus Apidra in a day. ā¦ when you factor in follow up doses. I start with 1.5 X a dose of Afrezza of what I would have taken with Apidra and then follow up with 4 units to 8 units to cover prolonged carb release from a meal. Afrezza is costing me a lot with no insurance even after the promo card off 48% off Iām going through 2 to 3 large packs per month. Apx. US$6,000/year. Then CGM on top of that not covered. Afrezza is not taking off because it costs damn too much !!!
Thanks for the suggestion to read āSugar Surfingā though. It sounds good and will read it.
I donāt consider any insulin a crutch. Youāre not revealing any secrets to tell me about duration of insulin action and the notorious āstacking.ā I get all that stuff. As long as youāre doing it with your eyes wide open with a plan rooted in reality, then I say ā stack away!
Something tells me you are more interested in the business side of Afrezza, MNKD, than you are about its clinical function. I no longer wish to communicate with you. Good day.
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Nopeā¦ wrong. Iām type 1 diabetic for 27 years and not invested in MNKD. Stacking of Afrezza with Humalog or Apidra or Novolog is very tricky and I was unable to make it work. But it is possible with a CGM with alerts because if turning low in blood sugar 4 hours post meal, you can snack. But without CGM its not working for me. The whole reason I tried to combine Afrezza with Apidra is because Iām not covered with medical insurance, so was trying to save money. But after trying Afrezza Only as a Bolus, Iām finding it much better and this is without a CGM. With a CGM it would be amazingā¦ just take a breath of Afrezza everytime your CGM beeps trending high and eat sugar anytime beeping trending too low. But the problem for me without coverage is $6,000/year cost for Afrezza after the promo card savings and $3,000/year for CGM after cheating and wearing the patch for 14 days instead of 7 days. Thatās $9,000/year for the whole system! So without coverageā¦ my eye is now also on a new alternative. Medtronics new FDA approval of the Artificial Intelligence Basal Insulin Pump where the basal is automated. I have a feeling with automated basal that the worse insulins like Humalog will work when that new insulin pump is working away at the basal automatically 24/7. If I can get similar control with that new Medtronic artificial pump, Iām sure it will cost less than $9,000/yearā¦ then Iām ditching Afrezza for that. I forget the model #. Google Medtronic Artificial Insulin Pump. If you have medical coverage that covers majority of Afrezza and CGM then go for it. But my hope is that MannKind reads these posts and lowers the damn price! The new Medtronic Artificial insulin pump will be good for people that donāt qualify for Afrezza with lung problems or worried about longterm Afrezza lung effects.
I use afrezza without a cgm all the time. I also frequently combine (I donāt like he word āstackā in this context because it usually has a negative connotation and is used in explanation of an error chain leading to a hypo). But I frequently use afrezza and novolog simultaneously without a cgm and have never had a problem. Of course I check my blood sugar carefully when I get creative by combining two insulinsā¦ My a1c is 5.2 and have never had any profound hypoglycemia.
I do agree that ALL manufactures should lower their pricesā¦ but donāt the think mannkind deserves the finger pointing here. Theyāre trying to recoup billions in startup costs and are nowhere near turning a profitā¦ The big pharma injectable brands are the ones that have increased their costs hundreds and hundreds of percent for 25 year old technologyā that said, the percentage of people actually paying for their own insulin is so small in this country that there is no downward pressure on costs. The only example I can think of in the USA of insulin that is primarily purchased outside the insurance market is R and NPHā which by no small coincidence can be purchased for $25/ vial. When a third party foots the bill for something the costs will always rise. This is the same reason a vial of insulin that in most cases is covered by insurance will cost hundreds of dollars but one not generally covered will cost $25. Itās also the same reason the US Govt spends $500 on a toilet seat and $300 on a claw hammer.
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Sam19ā¦ thereās really no reason to combine Afrezza with other liquid rapids like Humalog, Novolog, Apidra unless not covered and for cost savings. Using ONLY Afrezza for a Bolus is much betterā¦ you need a follow-up dose to cover longer releasing carbs of course. But logical sense and other peoples stories are showing me CGM will make it way better control for most because you can simply take a breath of Afrezza if the high trend beeps or eat sugar when a low trend beeps on your CGM. Most are not able to get their HbA1C down to 5.0% like you. Especially without a CGM and if combining Afrezza with other bolus insulins to complicate things. You could be the Outlier diabetic. I want to see another 100 Posts on Here saying they were successful combining Afrezza with Humalog/Novolog/Apidra. Iād like to see a separate thread for T1Dās on Afrezza Only as a Bolus and everyone post their annual average HbA1C those on and not on CGM. I need to see the stats on the massesā¦ not just you Sam19. Everyone is effected differently too.
Disagree. Believe me my entire plan was to use only afrezza. However I have found that in many cases it is my most effective strategy to combine, for me. Iām not suggesting that anyone else do that. I am suggesting that for me, if Iām paying attention and not being reckless, it works fine and is effective. Terry and @mikep do the same thing. Maybe weāre all dummies.
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You Terry and Sam are 3 people. Thatās STATISTICALLY INSIGNIFICANT. I want to hear peoples results on that from hundreds of Type 1 Diabetics on here. Sam19 are you Type1? It doesnāt mean you 3 are dummiesā¦ it just means you are 3 people with body chemistries that it can work. I know T1Dās personally that use Only Afrezza as a Bolus + CGM and have near flawless blood sugars. So now its me and those I know versus you three that didnāt have good results with Afrezza on its own. The secret for those with body chemistries that can use Afrezza on its own as a bolus is the proper amount and timing of the follow-up Afrezza. Some are following up 1 hour after the first dose and some 75 min or 90 min. Keep in mind MikeP also ditched Tresiba saying it caused afternoon spikes for him. Many others are happy with Tresiba. So debating with one person on this is pointless. I want to hear hundreds of opinions on here to see the consensus experiences.