I usually update on twitter but have much to say so I thought I would give this forum a try to better articulate our results. I am highlighting my G/F’s results, (together almost 8 years now) she is a type I diabetic since the age of 10. Before starting Afrezza she used humalog with the pump (medtronic) and her last A1c before starting Afrezza was a 7.8 which was pretty typical. Her best reading was a 7.5 on the pump, in the time I have known her.
Her first A1C was after 2 months on Afrezza and it was a 7.4. Her next two readings came in at 6.9 and 7.0 respectively. Our goal is to be at 6.5 or below so we are now in the process of obtaining a CGM to better monitor her blood sugar daily.
I am a scientist so I have been curious to see if her better results were caused by user input (new treatment better self monitoring) or if afrezza really is better. I can safely say at this point that afrezza for us, is truly a better prandial option. I have come to appreciate that our diet is a very challenging diet for a type I diabetic to effectively treat. She never limits her food choices and has decided, for better or worse, not to let diabetes limit her experiences in life. We eat some of the most challenging of foods (pizza, mexican, Indian etc). Not constantly mind you but more than many of you I have been reading about do. I would say it is a typical amount for any american diet, and even with such challenges she is still achieving far superior results with afrezza.
The one thing I really want to highlight here is that w/out a CGM she does have spikes. Over the course of her treatment with Afrezza she has had many spikes in the 200’s and even one or two in the 300’s, but her time in range, due to Afrezza’s faster action, brings her back into range much more quickly. It is this time in range that has improved her A1C as much as it has. In addition to her better A1C’s her hypoglycemic events have all but disappeared with only one, coupled with exercise, really achieving anything close to an “oh ■■■■” moment. The amazing thing about Afrezza is even when she has a spike, even as high as 300, she can bring it down quickly have a soft landing and not go low. I have witnessed many times with the pump (and many of you can attest) that getting out of range that far almost always results in a low (at best) from over-correcting and at worst a day long battle (insulin roller coaster) trying to get back to normal. I can say without hesitation she has not had one single day battling an insulin roller coaster since starting afrezza.
We have over the course of her treatment become more vocal, reluctant if you will, advocates of afrezza. When she learned that SNY was exiting their agreement she was literally brought to tears at the thought of having to go back on the pump. It was at that point I decided to do everything I/we can to support Afrezza and share our experiences with as many people as we can, because we truly believe this product can and will prevent not only her suffering but the suffering of many in the future. I am her surrogate story tell if you will because she has an aversion to social media and honestly after battling diabetes day after day the last thing she wants to do is talk about it. Good luck to all diabetics.
Everything you have said is on point with my experiences. Especially being able to stop a high in its tracks and come back into range very quickly with no worry of a low. It truly is an amazing feeling.
I experienced a cough for a bit but rarely experience it anymore.
There is nothing on the market that comes even close to controlling those post prandial spikes.
This is a good plan. The CGM info is a game changer. Combined with Afrezza and a commitment to “eat to your meter,” I have no doubt your girlfriend can radically change her health for the better. The eat to your meter idea is to note what you eat and then measure the blood glucose at mealtime and +1 and +2 hours later. The CGM is even better at this exercise.
You’re basically letting technology inform you about the effects of the food you eat. Many people choose to limit or even give up some foods that they have repeatedly tried to successfully eat with relatively reasonable post-meal excursions. Once you become accustomed to better blood glucose, it often provides the motivation to change eating habits. No one wants to change their eating habits! People generally adhere more to their eating style than they do to their religion. Good luck.
I would be interested in knowing if the pump is still being used to provide a basel supply of insulin, or was there a switch to a long-acting insulin. If so which one?
Is Agrezza the only fast acting insulin being used for meals, or is some Humalog still being used as well?
We have more patients using Afrezza as an occasionally insulin rather than an every day. One patient loves eating deserts and she uses inhaled to balance while still using a pump for all other needs.
I use Afrezza for meal and correction bolus. I use an OmniPod with Humalog for my basal. I tried Tresiba and loved it, but need an increased basal in the 12pm-4pm time frame that only my pump can accommodate.
Sam Finta / afrezzauser maintains a list. Not sure where he posts it but I don’t imagine it’d be hard to find. He’s on Facebook and has a website I think.
Thanks Mike! We are lucky to have each-other of course! She had a very mild reflexive cough at first that she dealt with, with water. She does not have any cough now and in fact were are pleasantly surprised how well afrezza continues to work right now with the cold she has.
I completely agree Terry. She has been reluctant to go on the CGM simply because she loves being unconnected so much, after years of being connected to the pump. I believe she now sees a bit of a ceiling her treatment and accepts that the CGM is her next logical step toward better control. To us it seems like the upper limit W/out a CGM is in the 6.0-6.5 range while Afrezzza plus CGM is 5.0-5.5 We will keep you posted on her progress with the CGM. As you all know Endo’s offices are busy so not sure how long it will take to get one. She just inquired about it today.
To get a cgm I’d recommend contacting Dexcom directly. They have sales reps who will bundle up all the paperwork and have your doctor just sign the dotted line and submit it to your insurance. They make it pretty simple.
Hi Mark. Initially our plan was to dabble with Afrezza in much the same way you describe, but our insurance would not cover two prandials at once. She ended up taking the leap right into toujeo + afrezza, which was scary to say the least for the first 10-12 days. It takes that long for basal to get into the fat pad and really start working correctly, so her numbers were all over the place. Toujeo was good but it had a gap mid morning around 9-10am and her morning numbers were not always that great. She has since switched to tresiba and she much prefers it. No morning gap and better fasting morning numbers. I have often thought that the pump + afrezza offers the greatest versatility, for handling complex meals especially, but we didn’t get a chance to try. I am also of the opinion, as you suggest, that afrezza simply for correction of spikes is also of great value.
If you decide to try it, don’t hesitate to ask for advice here and on Twitter. Many were helpful to us during the transition period. There is a learning curve but for us it has been so worth the effort.
On balance, if there’s a desire not to be too “connected” with stuff, but also a desire to enjoy lots of bg-challenging food I think you’ll both agree the CGM is a relatively easy way to track things for good health. As a scientist, you’ll appreciate all that data and the clear trends.
