Here’s an example for me… I ate a small salad and an 8" tortilla with a small amount of rice and corn. The first square dot is my first dose of afrezza… it kept me perfectly level for an hour and a half and then wore off instantly while my food was still digesting. Second dot is second dose when meter alerted at 140 (meter said 210). Current bg by meter is 240.
This is from a tortilla and less han 1/4 cup of rice and about the same of corn…
Lately my bg has just been uncontrollable with virtually any carbs… basals are perfect though… afrezza not seeming to work as well for me as it used to with anything but the most simple carbs
But it’s down to 140 and headed down again again 2 hours after eating… hope this kind of spikes aren’t doing too much damage since at least I can keep them super short
I often wonder about this too. Been thinking lately about creating a topic about strategies for keeping standard deviation within a target (of, say, 50?) I’d love to read what sorts of tips or tricks people have with this other than doing the obvious.
So this actually ended up being a pretty interesting case study in an afrezza fail, where it kept my flat for about an hour and a half, then abruptly wore off and my bg skyrocketed very fast, reaching about 200 by the time I corrected it and peaking at about 240 (measured on meter, cgm never registered that high). I corrected as indicated on the cgm and you can see the quick turn around and the magical afrezza landing without hypos…
Notice the time stamps
Pardon all the sloppy annotating all done from an iPhone. I don’t own a computer.
Do you mean just pre and post prandial at a certain point or 24 hr sd? 50 pts is not a bad rise after a meal but SD of 50 throughout the day seems pretty high… like that’s the number a dexcom report shows
Looking at this example really makes me think of this way to phrase it—
Afrezza as a bolus really acts more like an on/off switch that keeps your blood sugar from rising, to some extent regardless of how many carbs, for a while… and then it turns off. If your bg is still wanting to rise at the point it turns off, it will do so rapidly sometimes because the afrezza effect truly does just vanish without a trace when it’s done-- but afrezza corrections are very effective.
Just works completely different from liquid insulins where you’re matching the exact amount to the amount of carbohydrate…
Had an experience similar to yours with Thai food. Did really well the first hour but turned out I really needed an 8 unit for my second dose, not a 4 unit. Sigh…kicked the spike with some yard work. Anyway your point about Afrezza “turning off” when that dose is done is spot on, IMO.
Yeah another point I’ve come to realize is that although the carb counts aren’t nearly as important as they are with liquid insulin… you’ve just absolutely got to take enough afrezza and every time something like this has happened it’s been due to a gross underdose. Had I really thought it through and figured that the tortilla was 24g, the rice was maybe 15, maybe the corn was another 15, and there were actually some beans in there too… maybe another 10 or so grams… then whatever the salad and fixings etc… I’m sure it was over 70g in hindsight altogether and I’m around 1:7 at lunch with liquid insulin… if I’d have actually taken the time to add it up and inject insulin I’d have actually counted and come up with that… knowing that it doesn’t have to be exact at all but you always need more afrezza than liquid I’d have probably realized right off the bat I would need 16 afrezza and could have “restarted” the afrezza right at 1 hour when I knew it was about done working…
Instead though sometimes afrezza makes me lazy where I just glance at a plate and think "yeah that doesn’t look like that much an 8 might do it… " which can bite you a couple hours later sometimes
I totally get what you’re saying. I measured my rice but the sauces…anybody’s guess. Will keep working on Afrezza for Thai food…it’s an experiment, after all.
I think if I had this experience on a regular basis I’d lower my CGM alert to 130 or even 120 to catch the spike sooner, especially since the CGM lags behind blood glucose. I currently have my CGM alert set to about 125 and I think it’s been a huge reason why my control has been so much better (well, that and I just don’t eat carbs, my body can’t handle them at all without massive spikes…if I ate 70 grams of carbs I’d spike to 300-400 even taking double the insulin my ratio would indicate…).
Yeah that’s generally good advice… with afrezza though it acts so fast and your bg can skyrocket so fast after its done that the cgm really can’t track it very well at all, so I think the potential improvement is small— the difference in tracking with a cgm with afrezza be liquid insulin is truly quite pronounced for me… … I’d have been better off if I’d just took the time to think about what I was doing in advance and dosed a follow up before it even started to rise-- though that kind of stuff is easier said than done sometimes
