Marilyn, thanks. Good to know and be prepared! Thinking about maybe a cough drop to coat the throat beforehand…
@dogramma I absolutely love it. However I am having some issues with it. Sometimes things don’t make always sense for us lol. YDMV!
I love the decide to have iced coffee? (1/2 ratio of soymilk in it) drink a glass and take a Afrezza and no rise in BG levels…Another glass…just more Afrezza, no timing or waiting involved. That’s how it works with most foods for me so it was a hit!
I started using it a lot during the day and I’m on a pump. For some reason my after I’m in bed need for basal dropped in half. I kept reducing and had to keep reducing it more. Even though my last bolus was 7-8 hours before bed. Okay fine. Adjust.
But I could swear I was also having to use more of my Humalog in my pump. Humalog does have a tail that had been annoying but turned out useful to take care of any slower absorbing food. Afrezza wears off and I would start a slow climb about 3 hours after I used it. So the Afrezza worked great. But it wears off and it felt like it was making my Humalog ratio go up?
Next that dropping at night at half the dosing? Watch an astronomical climb of DP, Sometimes. Which sometimes I have sometimes not, but not a climb to over 200 in 60 minutes, no.
So I stopped and I went back to my normal. Didn’t use it at all or rarely for 2-4 weeks. So lets just try to use it off and on…maybe works that way, but yea I like it…so then two days in a row I ended up using a bunch. The second night 3 temporary reductions of my basal rate needed and a huge climb of DP at 6:50 am. In two hours 85 to 205.
So yea, I love Afrezza, but I’m not quite sure my body does? I haven’t heard of anyone else having these issues. I was thinking about asking everyone.
I had talked to my endo and she hadn’t heard anything. But it’s new to her. The only explanation she could think of is we all can vary in our metabolisms. I am one of those allergic to a ton of medications, why who knows? Lol…I am still hoping I can use it some!
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That may have been me. I tried everything to stop or at least calm the coughing. Over the years I’ve used plenty of other types of puffer/inhaler for asthma but without coughing, so it may be Afrezza’s type or size of particulate that is the culprit, rather than the inhaler or the inhaling. But I would lose most of a puff due to coughing, so in the end it was more trouble than it was worth.
I did like Afrezza’s speed and the way it had of leveling out in my range. I’d still be using it if the coughing wasn’t a problem.
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Thanks again, everyone! At doctor appointment today, he said he hadn’t heard of Afrezza (he only has type 2 patients), didn’t feel comfortable prescribing it because of no experience with it, and prescribed Basaglar basal insulin for me, instead. Will have training session with nurse next week on how to use it. In the meantime, I’m going to see what I can find out about it. Any of you happen to have experience with Basaglar or other long-acting insulin?
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I am not familiar with Basaglar. I used to use Lantus, but it is sort of known for hypos. Tresiba is supposed to be the best out there I think. It helps prevent hypos more. I didn’t notice anything different when I tried it over Lantus. But I started when I was still misdiagnosed and I was taking too much.
Unfortunately being misdiagnosed in my case meant I was handed Lantus and told to start at 10 units and increase it 2 units every couple of days until you find the dose that works. That’s all I was told. For me since I was running too high during the day, that meant the dose would crash me at night half the time.
The US likes to start people on slow acting insulins at first, But if you take enough to help enough during the day, you can crash at night when you are not eating. A way to help offset that is to split the dose into twice a day with a lower dose for the night. The different insulins have different timings. Basaglar and Lantus are both insulin glargines, but they still each might vary. Tresiba seems to be generally preferred and has a longer life and I think usually not split? I would suggest keeping a fast acting hypo treatment by your bed and with you at all times. It is just needed when you use insulin and our lives can vary.
PS I like the usual UK approach better where they have a tendency to give fast acting insulins first, then add a slow acting. In the US GP’s a lot of the time are only comfortable with using slow acting insulins if they have access to refer you to an endo or maybe even an internist to prescribe anything else.
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I split Lantus but don’t find a need to split Tresiba. Tresiba is better than any other long lasting insulin I have used. I have never tried Basaglar.
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Thanks ever so much, Marie, for the tip on splitting the dose, and also the great reference guides. I don’t know if I’ll ever be able to catch on to all this new stuff, and since you and Marilyn like Tresiba so much, am wondering if I should’ve requested that, or even Ozempic. This is all so new to me after 24 years of managing with diet and exercise for the first half, assisted with Glipizide and Metformin ER the second half. Before this latest 2% rise in my A1c, I always felt that I was able to get it back down again – but I’ve had a a string of difficult (mostly family-related) circumstances over the last 9 months, from which I’m just now able to attempt bouncing back to my normal exercise routine.
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Interesting, Marilyn. Thank you! I’ll try to investigate Tresiba along with Basaglar, so I can discuss both with doctor next time I see him. Maybe the nurse I see next week will know something about those two insulins, and/or Ozempic (but I’m a little leery of its side effects!) Previously, I’d only researched Afrezza, which ended up being a waste of valuable time.
An update on my Afrezza use. A third times a charm …no more dropping at night, instead this time round of using it a lot…I am now starting to climb at about 2 in the morning lol…go figure. That usually never happens to me until about 5 am if DP hits, but I have made the adjustments to include extra insulin at 2 am and it seems to be working… for now lol…
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I was looking for experiences with Mounjaro and came upon your post.
Al Mann developed afrezza primarily for T2s. He was looking for a faster insulin for his pumps. He always believed it should be the first medication prescribed for T2s, even before metformin. Its been on the market for 8 years and it has clinically performed beyond what most expected, maybe even Al. When it got approved by the FDA many thought it would only get T2 approval and not T1. Now more T1s are using it. Its been a marketing disaster but I think Al thought it was the greatest advance in diabetes care in 100 years and that was coming from the guy who developed the insulin pump.
The first thing all diabetics lose is post prandial control. When you eat your blood glucose rises and you pancreas is suppose to release a boat load of insulin to meet your body’s needs. With a non-diabetic they will make more beta cells and make as much insulin as the body needs to over come resistance and meet the body’s needs.
The ideal situation for the T2 is when eating take the afrezza and stop the post meal spike and get back to your pre-meal baseline. Afrezza is replacing what your pancreas is suppose to be doing. It also takes the stress off the pancreas which has huge benefits. Since afrezza is “human insulin” and its a monomer, as soon as it hits the lung lining its in your blood and working mimicking what your pancreas does. So much so, your liver will stop glucose release just like it does with a non-diabetic.
For a T2 on no other diabetic meds its pretty hard to get a server hypo with afrezza. The rule of thumb is go big on the dose. The biggest complaint has been “its not working”. The reason is the dosing on the label is wrong and people are underdosing. Its human insulin so its going to work or you have bigger problems. How much you need will depend on your needs. If you start to go low your liver will kick in with afrezza just like if you were non-diabetic.
If you can’t get a prescription for afrezza, the next best thing for a T2 would be an RAA. However, your doctor is going to follow the ADA’s SoC. This is a long list of non insulin things which over time usually fail or cause other issues. The SoC is a treat to fail recipe for doctors. It also has “insulin” as the last “steps” in the program and first its a basal and then add the RAA. The big concern with insulin is hypos and taking shots. These are not issues with afrezza.
As I mentioned I am trying to get user experience on Lilly’s Mounjaro. the preliminary feedback is some are saying this new GLP-1/GIP is more harsh than Ozempic which is a GLP-1. The interesting thing about Ozempic is near 80% stop using it after 2 years. The initial hype is the weight loss because it causes a loss of appetite. Its also a big thing now on TikTok for weight loss. It also does a lot of other things and has a pretty scary label. Personally, it’s a no-brainer to me, I would use the afrezza. There are also a ton of studies on the benefits of early insulin intervention in T2s. IMO afrezza would even do better as the studies were mostly done using basals.
With the Basaglar its better than the orals but its no afrezza. With afrezza if you dial in your BG and keep near non-diabetic numbers there is a good chance of stopping the progression. It will also work with your liver. The biggest issues with afrezza are under dosing and the cough. When the powder hits the back of your throat it causes the cough. The sip of water already suggested is good. When you inhale take a long slow deep breath. If you take the fast breath you will cough. If you can get a CGM do that too. Its the best way to dial in what you will need for each food type. Of course you will want to keep the food log for the first 2 -4 weeks.
The best place to get afrezza is from insulinsavings.com . I think there are some $10 coupons around and of course your doctor can get free samples. Getting the script may be your biggest challenge. Its not a step in the T2 SoC. Very few GPs have ever heard of it and its not taught in medical school. There is an afrezza facebook group for users that can provide some good advice. Afrezza | Facebook
Hopefully my info is not too late for you but as I said the basal is better than the orals. Its just not afrezza. I would still get the CGM if you can.
BTW - there was a recent article on Mannkind and the CEO who was just diagnosed as a T2. According to the article guess what he is using and its not metformin?
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Interesting info about that product.
I did a study for a product that came many years earlier. It was called exubera.
I had nothing but trouble with it. I was taking long acting but no other insulin.
The foil packs came in 1 unit, 3 units and 5 units that came out to 3 units 6 units and 20 units in similar units to liquid insulin.
It wasn’t possible for me to properly dose it… also if I coughed, I had no idea how much insulin I got. My control was terrible for 2 years.
I believe it is the same powdered insulin with a superior delivery device.
At that time it was only for type 1, and I was offered to join the study that brought us afrezza but I declined. It was 5 years after so I was eligible.
I think it is a good product for driving down high glucose if used with other insulin because there is no way to micro dose this product.
Most people I know who take it, love it.
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@George44 Very interesting! I did not know who Al Mann was, but he certainly sounds amazing! One of Al Mann’s companies was called MiniMed which developed an insulin pump that delivered insulin all day and then he sold it to Medtronics! I say one of his companies because he also developed a pacemaker, a cochlear implant, artificial retina and a few other things. Thanks for this!
I am glad you found it informative. Al also perfected the solar panel which was initially used to power space satellites.
Al was a great man and wanted to do good things. As I mentioned above he was trying to develop a faster insulin for his pumps. He knew the limitation was not the ability to develop algorithms but the speed and unpredictability of the RAA in the pumps/AP(artificial pancreas) with absorption.
Like everything else afrezza is not perfect for everyone. Some can never get over the cough, but most when shown to properly inhale can. A few get it up in their noses and they sneeze, again very few. The biggest issue is under dosing. Long term safety looks amazing which I can not say about most of the antiglycemics like the GLP-1s. Its human monomer insulin which everyone needs to live. Why its not listed as step 2 after or even before metformin in the ADA’s SoC is a mystery.
He teamed up with another guy Sol Steiner who was using FDKP for another drug and now we have afrezza. As the results from the test studies starting coming in Al could not believe the results they were seeing which was the ability to near mimic first phase insulin release - the holy grail in diabetes management. After 8 years the clinical results, especially the safety aspect is amazing.
As I had mentioned I am looking for user experience with Mounjaro. Here is an interesting study on Ozempic about user adherence. I expect Mounjaro’s will be worse based on the initial info I am hearing but we will see.
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