at what dexcom reading do you take affrezza? how do you decide whether to take 4 or 8 units first?
As with injected, it takes practice, there is no magic formula. I am on my 8 month now. My CGM range is at 70-120 during the day and 60-140 at night. Here is the basic protocol I started with (now I fined tune it and go mostly by feel)
- How much Afrezza I need to keep my BG steady for the next 60 min after I start eating? Small plate usually goes with 4, but the typical for a carbo meal for me is 8. After the 60 min you check BG, trend, how you feel, what you are going to do next (walk or take a nap), and give your dose based on that.
The cool thing though is that because the IOB clock resets every 90min or so, its ok if you donāt nail it. You just keep trying and learning from it. Flexibility!
PS: For example, 20 minutes after finishing a big plate of pasta, I realized I had forgotten to give my Afrezza before eating Oops. CGM beeped at 120, showing 147 going up. Checked BG to confirm I had forgotten the Afrezza, yep, 205 (If I hadnāt forgotten to do my Afrezza dose, I would never have 205 post prandial). Blasted 12U, now I will see where it lands and adjust as needed.
When this happened to me with injected, it would have been most probably that my sleep is ruined, and my next day too.
Cheers
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With injected insulin I had about 100 āmagic formulasā. And I had very small liklihood of guessing the right one when I needed it. With afrezza there truly is no magic formula at all and none is necessaryā you take enough, you donāt take way, way too much, and for me you have a very basic loose idea of how fast different types of meals digest and you time the afrezza accordingly, and your bg stays at totally normal non diabetic levelsā¦ Itās literally 1/10 the effort and 10x the resultsā¦
Just read this from Matt Bendal down under, heās in Australia and somehow has managed to get hold of Afrezza. Seems like a helpful explanation of how Afrezza works. Pretty cool. http://afrezzadownunder.com/2015/09/afrezza-units-insulincarb-ratios/
I have to admit when you posted this at first I rolled my eyes thinking āoh great a layman user like me explaining a complex physiological process way beyond our graspā
I actually agree with a lot of what he says completely though. I donāt claim to be any expert on physiology or metabolism so I canāt exactly say his physiological explanation makes sense or doesnātā but I agree 1,000% that they should have never labeled them as ā4 unitsā or ā8 unitsā etc and tried to draw parallels to injected insulinā because it simply isnāt the same thing and the same concepts really do not apply very well at all. I agree that this misguided dosage labeling did far more harm than good and that weād all be far better off and better able to conceptualize this in a more effective way with simple āsmall, medium, and largeā dose labels or something like this
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Yeah, I guess they felt they needed something to equate too. Maybe 4U, 8U, 12U should been in the smaller print under Small, Medium, Large, with something explaining this is not a true 1 to 1 equivalent. Iām sure someone can think of the right words to explain it.
Another good article on using Afrezza. The good part is Dr Pettusās experience and thoughts.
Enjoy.
http://www.healthline.com/diabetesmine/afrezza-focus-group-feedback#1