I started using Afrezza inhalable insulin a few months ago. Often use it as quick “rescue” when my blood sugar is rising fast. I also take Tresiba and use Humalog MDI. I’m also using Dexcom G6, so it’s easy to track what’s going on. I love that it works for about an hour or 90 minutes and then it’s done. My A1c is down to low 6’s from high 6’s and my time in range is way up into the 80 percents.
I wonder why more people don’t use Afrezza. I’m not sure I want to use it all the time - sometimes I cough a little - but it really works when I need it.
I’ve been using it for corrections when my BG is about 200. Anything less and even a 4u cartridge is too much. I recently started making my own 2u cartridges (thanks @Karin7 for help!) but I can’t make them consistently.
I talked to my endo two weeks about about using it for mealtime boluses in addition to corrections. The thinking is that insulin requirements to cover a meal will be more demanding than correction only and that the 4u cartridge won’t be overkill. He wrote a script and I just got them. I’ll give it a try.
It’s complicated. I started using Afrezza when it first became available in the US in March 2015. I first used it for meals and corrections but transitioned to primarily using it for corrections. On average, I use 4 doses/day of 4-units. It works wonderfully for me.
I can correct in the middle of the night without fear of overdoing it. I will correct BGs as low as 120 in the right conditions. Afrezza is another tool in my diabetes toolbox.
Mannkind, Afrezza’s producer, emerged as a renegade in this field and market. Al Mann, the company’s founder was an engineer, not a medical doctor or researcher. He designed and built MiniMed insulin pumps back in ‘80s before selling the company to Medtronic in the early 2000s.
The FDA delayed introduction of the product three times but Al Mann persisted, often solely funding the enterprise. I believe that the medical/research/academic members of the status quo took an undue degree of skepticism toward Afrezza.
As a result, to this day, most doctors are unfamiliar with it. The FDA certified its use only with a “black box” warning about potential breathing problems and a required periodic respiratory test. Four years in the market with little, if any, respiratory incidence has still not quelled clinician’s uncertainty about this product.
I think it’s a wonderful product that I wouldn’t want to live without. Sometimes when I forget to prebolus for a meal, I use Afrezza instead and it works very well.
I hope your experience is just a good as mine has been.
I believe Mannkind has run into issues mass marketing Afrezza, in part because the other insulin manufacturers - Eli Lilly, Novo Nordisk, and Sanofi - exert significant pressure on the both the FDA and physicians across the USA.
Add to that the perplexing doubts many doctors express regarding the loose dosing model, and the fact many docs hate the idea of inhaling anything, it just hasn’t reached critical mass.
That said, Afrezza has still not been approved for use in Canada, even though Mannkind applied to our Federal government early in 2018. I’d love to try / use it.
I asked my endocrinologist to prescribe Afrezza to correct unusually high BGs and was advised that Afrezza has been shown to intensify existing lung conditions. Accordingly, he felt the risk was not worth the reward.
I have been using it for about 4 years on and off depending on what clinical trial I am doing. But I first started out using it for stubborn highs but have started using it for some meals. For high fat/protein it is more work vs an extended bolus on the pump. I find with those high fat meals, I have to take another dose because it wears off so quickly.
But I think many don’t use it because they think it is too new. They just don’t realize it has been around for a long time with plenty of research behind it. I also get a slight cough once in awhile after I inhale but I try to always drink water before and after to help minimized it.
I think it is another tool in my growing tool box of new things I use to help with my treatment plan.
I use Afrezza as my primary bolus insulin. I use Lantus 2x a day for my long-acting insulin. I have Humalog on hand for certain occasions, but I use Afrezza most of the time.
My A1c has decreased substantially over the 1.5 years I’ve used Afrezza. It’s amazing stuff, and I find it frustrating and mind-boggling that it is not more popular (either as a primary bolus insulin or simply as a tool for corrections).
I do some intense swimming a couple times a week and hike 8-10 miles every other week or so. I don’t feel like Afrezza has had any impact on my lungs. I feel more fit and capable now than I have at any time since my diagnosis 25 years ago at age 8 (I need to give my cgm partial credit for that though ).
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