I have many requests to update my Afrezza status. This article describes only my health status related to using Afrezza. Later, I will write another article to describe community views I collect.
Afrezza Status After 8 Months of Use
In March of 2016, my Hemoglobin A1C was above 8. My diabetes was “uncontrolled.” Since then, I am using Tresiba for my basal insulin, and Afrezza for my mealtime insulin.
My last A1C reading is 5.6, from September of 2016. This is in the “normal” non-diabetic range.
I do not have coughing from inhaling Afrezza anymore. This is a complaint many diabetics report at first. I stopped coughing about 1 month after starting Afrezza. As such, it is possible to get over this “negative” side-effect.
Afrezza Status on Daily Glucose Levels
Many Afrezza users say that they have “flat line” blood glucose levels. They also say there is “no hypoglycemia” and “no difficult math to calculate doses.”
My experience with Afrezza is different.
Flat Line Glucose Levels
Afrezza users are known for their graphs with amazing blood glucose levels. But notice they are often 6-8 hour periods. I often show flat line sugar levels of my own. My overall levels are not that even though.
The most even levels I have are when I avoid carbohydrates. I am also learning how to time doses to avoid rising blood sugar levels. My readings do go into the 150-160 mg/dl range. Sometimes I have highs around 200 mg/dl.
Most doctors say a diabetic will be 180 mg/dl 2 hours after eating. I avoid these highs if I time my Afrezza properly.
One advantage I see with Afrezza is that it is quick and easy to get back to normal.
Overall, my sugar levels are good for a diabetic.
I am sure that people do not mean to say hypoglycemia is not possible on Afrezza. It does come across that way sometimes.
I sometimes over correct with Afrezza, and it does cause low glucose levels.
This is easy to do when you run your levels in the 60-130 mg/dl range, as I do.
For comparison, recommended ranges for diabetics are 80-180 mg/dl, and non-diabetic ranges are 70-140 mg/dl.
No Difficult Dosing Math
This is true, and this is false.
Many Afrezza users use a “t-shirt sizing” to dose their Afrezza. This is because Afrezza comes in 4 unit, 8 unit, and 12 unit does. Because of this, it is often more convenient to think of the carbohydrates in a meal as “small,” “medium,” or “large.”
This is also where one needs to learn the timing of follow-up doses.
I have tried to do this without the math, and have not been successful. Doing this format caused me to swing high and low often. As a data oriented personality, I need something solid to anchor my decisions on.
The other problem I found is that doctors want specific ratios of insulin doses to carbohydrates eaten.
I have landed on a hybrid mode for my dosing.
My need is about a 4 unit does for “roughly” every 16 carbohydrates I eat. I take 4 units for anything in the 4 to 18 carbohydrate range. That goes up to 8 units for 18 to 28 carbohydrates, and 12 units for above that.
If I see a glucose level rise of any kind after 30 minutes, I start follow-up doses. There is also some guesswork in what types of food, how much fat, and a variety of other factors. This is the wizardry that would take a much longer article to discuss.
So Will He Continue on Afrezza
I have a normal A1C of 5.6. This is a non-diabetic reading.
Therefore, I have no reason to switch from using Afrezza to another short-term insulin. Despite recent frustrations I tweeted about on other issues with Afrezza, I am a believer.
Yes. I have ordered a new Minimed 630g insulin pump. This is because I believe in insulin pumps for basal control, and I am a supporter of Artificial Pancreas technology. Therefore, I will try the 670G pump when it is available. The 630g order puts me in line to get a 670g first. I always try the new stuff. It is my nature. It is how I ended up on Afrezza, after all.
No, that does not mean I will abandon Afrezza. The pump will be my basal treatment. Though I like Tresiba very much, I have a difficult basal baseline and it is hard for me to meet a flat fasting glucose level. A dose that keeps me flat at night, causes lows during the day. A flat daytime basal gives me highs at night. My basal control is better on a pump, but sometimes one needs a break for the body to heal.