Marilyn – Does your insulin sensitivity factor remain the same during the day? Does it remain stable from day to day? Mine varies and when I see a pattern of glucose levels that resists the pump-delivered Loop basal rate changes, I’ll add a 4-unit Afrezza.
For me, a 4-unit Afrezza cartridge is equivalent to 2 units of liquid insulin. Did that 2.6 unit number you reference come from personal experimentation?
If you believe that one 4-unit cartridge delivers the equivalent liquid insulin dose of 2.6 units, then you can calculate how many carbs you would need to eat to offset at least some of that dose if you start to go low. I really think you could benefit from doing some experiments when you are at home and not distracted with other things.
I think our sensitivity to insulin, whether high, low, or medium, is not as stable as we like to think. I know you appreciate how much it reacts to adding and subtracting fat from the diet. It also varies with our circadian rhythm, especially in the early morning hours. I also think that it responds to hot and cold weather and seasonal changes. And we all know that stress can change our sensitivity to insulin.
Yet we are encouraged by the “pros” to use a single individually separate and distinct number for our calculations. I think each of our individual insulin sensitivities waxes and wane every day, much like the wind changes when sailing. If you react by using standard numbers, it may make your corrections too much or too little.
I think that it is this changing insulin sensitivity that makes managing insulin as difficult as it is. I have an ISF schedule that segments my day but I think of these values as nominal, not exact. I then, with Loop and Afrezza, add or subtract insulin to accommodate the changing needs.
I know this sounds rather inexact but this mental framework has worked well for me. My system is neither perfect nor precise. But, when I make a correction, I keep an eye on it and react if needed. It is not as erratic as I make it sound and I can keep a relatively low glucose variability measured by SD.
I think your Afrezza doses may be much more useful to you than you now appreciate. Good luck with whatever you decide.