I know a lot of type 1s have waxed poetic over the amazing effects of Afrezza-particularly it’s quick onset and just as quick exit from the body. That always appealed to me, but I couldn’t fathom how I could use it when the smallest dose it comes in, in its little colored blister packs as seen above, is 4 units. Eating low carb I rarely take more than 1 unit of rapid acting insulin for a meal.
That said, when I went to my endo last month something made me ask him if he had any samples he could give me so I could just try it. And, with unusual foresight, I packed it last night into my luggage for a two month trip I have just embarked upon overseas. While my blood sugar is pretty predictable when I’m home sticking to my routine, it’s all but that when I travel and have little influence over what I eat, jet lag, what my body’s biorhythms are doing, etc, etc…
So right out of the box, or I guess I should say gate, landing in Amsterdam at 9 AM Dutch time, 3 AM NYC time, being met by the husband, we sat for a cappuccino. Boom! My blood sugar began climbing from 102 to 194. I got out my insulin and began dosing single units until I’d taken 5. I daren’t do more. Even though my blood sugar was 264 and didn’t seem to be budging, I knew eventually it would. And that’s the crux, it takes so dang long to come down. Two hours later it was slowly sliding back down.
Now 1:30 PM Dutch time, 7:30 AM NYC time, we went for lunch. I had mushroom soup and a stir fry with just vegetables and beef. I didn’t take any insulin because I figured I had enough on board to cover this meal. I didn’t. Boom! It started climbing again. Now, at 200 again, I took one unit of insulin and we walked around the corner back to our hotel so I could try Afrezza. No way I wanted a repeat of the morning’s runaway blood sugar train and wait hours to come back down.
A short search through my knapsack revealed the little box. A quick video on YouTube showed me how to load the inhaler and take a drag. Then I put Pinkie’s (Dexcom CGM), receiver and my iPhone both, in my pocket, and said a little prayer. I had no idea if I’d inhaled properly and would see results and I was scared if I did, how low would I go?
The darn stuff works! Within 15 minutes my climb reversed and I was coming down. Within 45 minutes I was at 120, In an hour and 15 minutes Pinkie was telling me I was at 84 with the arrow going straight down, then 70, arrow still straight down, then 55. I felt fine, but who knew. Checking on my meter I was 86. I remembered when your blood sugar’s going up or down rapidly, Pinkie needs time to catch up and straighten herself out from the roller coaster. I took 2 glucose tablets to create some cushion. Within 2.5 hours I was 105 and I felt Afrezza had left my body
If I hadn’t already taken the 1 unit for lunch, and just taken the Afrezza, I think it would have worked just great. As I’ve been told, 4 units of Afrezza, the smallest dose, works like 2 units of rapid acting insulin in the body. I can definitely see the value of heading off skyrocketing highs and getting back in target range much faster than with injected insulin. That is always my frustration, how slow insulin is to get working.
While I can’t use Afrezza often because I am insulin sensitive and do eat a low carb diet, I’m going to want to have it around when what’s around me is not my norm.
So, listen up everyone in Copenhagen, London, Abu Dhabi, Singapore, Sydney, San Francisco and Portland where I’ll be coming through, Afrezza is in my backpack and if you see me taking a drag I’ll probably have a smile on my face. Rest assured, it’ll be the insulin I’m toking on, not a souvenir from Amsterdam ;-).
Reva, I too was very concerned about small unit dosing with Afrezza. You can’t “dial down” to 1, 2 or 3 units. But I tried it and I am a convert. I rarely bolus with Humulog anymore. I too try to maintain a lower carb way of living and Afrezza works fine. Also I’ve noticed (and heard other users say) Afrezza really isn’t 1:1 with Humulog or Novolog. It is more like 2:1 for me, meaning if Humulog was 1:20 dose, Afrezza is more like 1:10. I am still fine tuning Afrezza but so far I am sure glad I have it! I sure hope enough people start using it to keep the brand around! Take care.
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