My first Afreeza shipment is supposed to arrive tomorrow.
I’m Type 1 and on a Tslim pump. The use I envision for Afreeza are those occasions when my BG just keeps creeping up and gets really high (over 240) especially in the evening or night when corrections for highs lead to lows hours later.
Any advice for an Afreeza newbie? I’m a little worried that I’ll see double down arrows, freak out, eat and end up back on the roller coaster. I’ve always hated hypos. Are double down arrows the norm with Afreeza? I realize I’ll probably have to figure it out with trial and error, but I’d appreciate any descriptions of what an Afreeza correction is like or any other advice.
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I used affrezza for about a year 2015-2016…i had insurance that covered afrezza, but not the pump or cgm at the time…it works very quickly, and could create hypos with the iob on the tandem…i would try a 1 hour pump suspension if you recently ate and took affrezza, also figure out your correct afrezzz to carb ratios and drink lots of water to help the cgm catch up…at the time, i received 8u+4u packs as well as 12u+8u packs, but trying to get 4s and 12s didn’t work, and after a year i started coughing a lot…just like most of the people in the trials…i found if i inhaled before a meal, i would often go very low especially at a restaurant, so be careful and hopefully you have a watch linked to your cgm because your glucose will change quick and might take some adjustments
It’s a very fast drop for an hour, and it’s pretty much all done in an hour and 15 minutes, like this:
In my case, that is an Afrezza 12u dose, but the dose you need depends on how sensitive to insulin you are. Provided you have a supply of glucose right with you, and you started Afrezza cautiously to find out how much your body needs, the fast drop should not cause a problem. I like it except for the mild irritation I get when I inhale it.
Roger5 gave a useful caution: if your t:slim has given you lots of insulin to try to fix rocketing BG, and then you fix the BG with Afrezza, all the insulin from the t:slim is still there. So watch for a low after 2 or 3 hours. I don’t have that problem much, because if my BG is rocketing it generally means the infusion set is failing so I didn’t actually get all the insulin the pump thinks it gave me.
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Thanks so much for that! It sounds like just what I want. A strong correction without the long tail.
I took my first dose this weekend. It seemed like a good situation. I had very little insulin in my system because I had been exercising but then started eating because I was dropping a little low and right at the same time my T:slim actually shut down because of lack of power. When my BG started going up from the food there was basically no insulin in my system.
Anyway, I took 4 units of Afreeza and it didn’t really cause any drop at all. Not sure how much of that was because of my technique. I never had any training just watched a YouTube video and I’m not sure I breathed in deeply enough or held my breath long enough. I was nervous about it. It felt sort of like I was taking illicit drugs which I’ve never done.
Anyway, next time the occasion arises, I think I’ll be more prepared and won’t necessarily expect a massive drop from 4 units.
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won’t necessarily expect a massive drop from 4 units.
In my body, it seems that Afrezza is about half the strength of injected insulin, so 12u Afrezza is comparable to a rage bolus of 6-8u Novolog for me. But start cautiously (as you did, with a 4u Afrezza) and increase to larger doses as you learn how much your own body needs in order to get a good response.
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I think the units throw me. 4 units is more than 10% of my TDD so getting all that in about an hour would be mighty powerful. I’ve taken Afreeza for a second time and it had an effect but no double down arrows or anything. I think I have to get used to the fact that 4 units means 2 units (if that) and be a little less cautious.
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I’m wondering… what did your doc say about Afrezza dosing?
Like @bkh said Afrezza units are not the same as rapid acting insulin units. Dosing might be one of those it’s different for everyone so you’ll have to titrate up to find out how much you need. Here is a video on Afrezza from a couple of endos who are T1D, if you don’t like videos the page also has the full transcript.
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One last question: with liquid insulin, I don’t worry too much about refrigeration. I keep the vial I’m using at room temperature and, if I’m going on a trip for a week or two, I don’t bother about keeping the backup supply I bring with me refrigerated. Any feeling about Afreeza being different in the refrigeration category? I notice that you’re supposed to have it out of the fridge for at least ten minutes before using it so I’m thinking about leaving one of the little three dose bubble packs out at all times so I don’t have to wait.
I use Afrezza (4-unit cartridges) for corrections only. My supply seems extremely forgiving to long term (many weeks or months) unrefrigerated storage. I wouldn’t worry about this aspect of Afrezza use but your close observations should be your ultimate guide!
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Storage starts on the bottom of page 16 including
In Use: Room Temperature Storage 25ºC (77ºF), excursions permitted 15-30ºC (59-86ºF)
Sealed (Unopened) Blister Cards + Strips Must be used within 10 days
Opened Strips Must be used within 3 days
Do not put a blister card or strip back into the refrigerator after being stored at room temperature.
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