Inhaled Insulin: My Experience Using Afrezza

Do you know that inhaled insulin is commercially obtainable within the US and has been since 2014?! It’s in all probability one of many best-kept secrets and techniques within the diabetes neighborhood which, for my part, is a disgrace.

Afrezza has been part of my diabetes toolbox for a couple of years now and on this article, I’ll offer you an summary of what inhaled insulin is, the way it works, and why I’ve chosen to make use of it.

What’s Afrezza and the way is it completely different from different rapid-acting insulins

Afrezza is a rapid-acting insulin just like the rapid-acting insulins you inject (Apidra, Humalog or Novolog), however you inhale it reasonably than inject it. Similar to the opposite rapid-acting insulins, it’s a mealtime insulin (bolus) so you continue to want one other background insulin within the type of long-acting insulin (basal). 

Inhaled insulin passes by way of the lungs and straight into the bloodstream, which implies that the insulin begins to work considerably quicker than injected insulin. It’s so quick that it’ll seem within the bloodstream inside a minute of being inhaled and you’ll see the primary measurable impact in about 12 minutes.

As a result of it really works so rapidly, it solely stays within the physique for about 90 minutes versus the 3-5 hours that injected rapid-acting insulin stays within the physique.

Dosing Afrezza

One other manner Afrezza is completely different from injected rapid-acting insulin is that it is available in set doses of 4, 8, and 12 items. While you obtain your Afrezza from the pharmacy, it comes with a set of inhalers and also you then choose the dose cartridge, load the inhaler, and inhale the entire dose.

The Afrezza items aren’t the identical because the items for injected insulin. One unit of injected rapid-acting insulin is similar as about 1.5 items of Afrezza, which implies that the smallest Afrezza cartridge (4 items) equals about 2.6 items of injected rapid-acting insulin.  

Potential negative effects

Afrezza has the identical potential negative effects as injected insulin however shouldn’t be utilized by folks with sure lung issues, comparable to COPD or bronchial asthma, or individuals who at the moment smoke or have stopped smoking within the final 6 months.

You may learn extra in regards to the potential negative effects right here.

I haven’t skilled any persistent coughing from utilizing the product, however research present that 27% of individuals reported growing a cough from utilizing Afrezza.

Why I exploit inhaled insulin

I’ve used Afrezza for years alongside my basal insulin and injected rapid-acting insulin, and I discover that it’s good for sure conditions.

I predominantly use Afrezza for resistant excessive blood sugars and higher-carb meals. Everyone knows these conditions the place our blood sugar is “caught” at a excessive degree and plainly it doesn’t matter what we do, it received’t come down. Afrezza is a good resolution for that.

If I’m caught at 200 mg/dl (~11 mmol/l) or above, I’ll attain for a 4-unit Afrezza cartridge and my blood sugar will get down into vary VERY rapidly. A 4-unit cartridge drops me about 100 mg/dl (5.6 mmol/L) however how a lot it’s going to lower your blood sugar will depend on your correction issue.

Observe: I discovered that Afrezza would lower my blood sugar a little bit extra aggressively the primary month or so after I began utilizing it. I’ve heard the identical from different customers, but it surely’s solely anecdotal info at this level since I haven’t seen any knowledge to help it.

One other scenario the place I actually admire gaining access to Afrezza is once I get pleasure from a higher-carb meal or a excessive glycemic meal. Since Afrezza hits the bloodstream so rapidly, I don’t should pre-bolus for the carbs, and I discover it simpler to match the height of Afrezza to the meals than I do with injected rapid-acting insulin.

The way it interacts with train

I needed to make use of Afrezza once I eat earlier than doing cardio because it’s out of the physique in 90-minutes (bear in mind, having rapid-acting insulin energetic within the physique throughout cardio will enhance the chance of low blood sugar). Sadly, the truth that Afrezza solely is available in fastened doses implies that I hardly ever have entry to the precise dose and I’ve to stay with injected insulin.

One other remark I’ve made is that the impact of Afrezza appears to get intensified much more by train than common rapid-acting insulin. Which means I’m very cautious if I’ve to do any sort of train inside a 90-minute window of inhaling Afrezza.

One of many first occasions I used Afrezza was to carry down a excessive blood sugar simply earlier than biking dwelling from having brunch. It made my blood sugar drop far more than I anticipated and I needed to cease after lower than 10 minutes on the bike to deal with a considerably low blood sugar. 

Studying to make use of a brand new insulin

Studying learn how to use Afrezza is a bit like studying a brand new language, and simply as we don’t all the time get the doses proper for injected insulin, you received’t get the dosing/timing proper each time for Afrezza both.

It takes time and a few trial-and-error to determine how a lot Afrezza to take, when to take it, and when NOT to take it.

And for full disclosure, I’ve had a number of the scariest low blood sugars of my life utilizing Afrezza. As a result of Afrezza is so efficient, having an excessive amount of on board can rapidly lower blood sugars considerably. What I’m making an attempt to say is that that is NOT the insulin that you simply “rage bolus” with.

There are upsides and disadvantages to utilizing Afrezza and I nonetheless advocate utilizing it in the best way that’s best for you.

Other than the occasional lows and restricted unit sizes, I feel it’s a superb product. It truly is a really efficient manner of reducing blood sugars rapidly

The best way to get Afrezza

Afrezza was authorized by the FDA in 2014 and is at the moment solely obtainable in the USA and some different nations. For those who stay in the USA, your physician can prescribe Afrezza simply as he/she will prescribe every other form of insulin.

Your physician may not find out about Afrezza and if that’s the case, you’ll want to teach and push for a prescription. For those who don’t really feel snug having that dialog, you’ll be able to all the time refer your physician to the Afrezza web site.

Earlier than prescribing Afrezza, your physician ought to do an FEV (compelled expiratory quantity) respiration take a look at to achieve an understanding of your lung operate. It’s a reasonably easy take a look at, you simply have to breathe right into a mouthpiece. Your physician ought to then have you ever carry out the take a look at once more after 6 months and yearly after that to make sure there’s no change to your lung operate.

After getting your prescription, you’ll choose up Afrezza on the pharmacy similar to you do with any of your different insulins.

If in case you have personal insurance coverage, Afrezza is almost certainly coated because it’s obtainable on 70% of personal insurance policy. It is likely to be an thought to name your insurance coverage firm or learn up in your advantages plan to study in the event you’re coated and what your co-pay is. Most individuals pay about $45 out-of-pocket per prescription, however that may, in fact, differ by plan.

I’d extremely advocate utilizing the Afrezza co-pay card. For me, it implies that my co-pay will get decreased to $15 per prescription, which makes Afrezza a really inexpensive insulin choice.