I always demand a discount. But that may just be religious preferences. (Probably should have taken that to a PM)
1 Like
Here is the 10 foot pole I’m not gonna touch that with.
2 Likes
Thankfully that pole is swaged on one end, which clears up all the horrible connotations. /sarc
2 Likes
Saw my endo last night. She basically grimaced when I asked to try Afrezza, but then I started talking about how I knew all these people that were using it and wanted to try it. I felt like a teenager asking their parents for the next new gadget coming out. After that she responded pretty positively, but she said that because it’s contraindicated for people with asthma she wants the full PFT (since I had asthma as a baby). I’m okay with that as long as it’s covered well by my insurance. I’ll have to look into it.
My A1c came back as 5.4. This is a great A1c, but I’m actually surprised it’s so low. My last one was 5.7, and I expected it would’ve gone up by .1 or so (because my average has gone up a bit). According to my cgm, my average glucose level is 130, and my standard deviation is around 40. I’m spending consistently 2% or less time in the urgent low glucose range and 4-6% in the low glucose range. I don’t think lows are skewing the A1c. Based on those stats, would you guys think so?
Whenever I hear about A1c discrepancies it tends to be from people who have higher A1cs than you would expect based on their glucose levels on their meter/cgm. I’ve read online that the VerioIQ tends to test a little high so maybe I need to invest in a new meter (even if it’s not covered by insurance). I was given the Verio Flex last night because I wanted a meter that doesn’t require the battery to be charged all the time. I’ll see if there are discrepancies between these two.
I’m just kind of confused about why my A1c is that low. My endo wasn’t concerned at all. In fact, she called me her model patient. Which is convenient so I ran with it, but I wish I knew why.
6 Likes
Congrats on a great A1C! That’s awesome!
It’s hard to interpret BG tests into an A1C result because you may only be testing BG at certain times, like before meals or after meals, or when you feel high or low.
Sometimes CGM’s don’t catch a full high (like if you correct and your BG comes down before the CGM ever got the full high), and sometimes a CGM will linger low. So you can’t always use CGM numbers to figure out your A1C.
But regardless, that’s great knocking some points off of it! Whatever changes you are making, it’s working for you.
Was her response because of asthma, or why do you think she responded that way?
1 Like
My impression after dealing with this and discussing it with a number of doctors and dozens of patients is that they grimace because it’s a little extra work for them. They have to have patients do a test that’s unfamiliar to them (even though there’s absolutely nothing to it) and they have to figure out how to prescribe in terms of quantities that are completely unfamiliar to them… it’s appreciably more complicated to rx a new patient afrezza than it is to rx “20u novolog daily”. Or whatever the case may be… and if they don’t understand the benefits they don’t see why it’s worth bothering with…
My personal opinion is that some of this complexity is deliberate and by design and behest of its competitors… but some of it is just the nature of its mechanisms as well.
Just be sure to tell your doc how much it changes your life…
4 Likes
I think @Sam’s response is pretty close to why. She didn’t seem to see the benefit of having insulin that kicks in faster. In fact, she mostly seemed to think that I wanted to inhale insulin rather than doing shots. I would consider that a side benefit rather than the reason I want to switch though. I’ve been doing shots for long enough that they hardly phase me. Her only concerns regarding lung function were specific to my history of asthma.
She did mention the dosing differences, and I think she was appeased by my response showing that I’d done some research beforehand on that topic.
2 Likes
In the A1c test you are measuring the amount of glycated hemoglobin, so rather than think of it as an average, in practice I like to think of it as a measure of how much time you spent above the point where glucose attaches to hemoglobin at a more rapid pace. This works better for me than a predictor of average blood glucose. I think they equate the two in the office so people understand what they can do to affect it, which leads to an oversimplification.
If your average glucose went up, but you spent less time in the highs, then a lower A1c makes sense. Also, the last 30 days carry more weight in the test than 31-120 days prior, so if you have had better control recently that can also explain why the test came back with a lower value.
6 Likes
That actually makes a lot of sense, and I could definitely see that being the reason. While my average has gone up a little, I think I might be spending less time in the “high” range. I’ll have to take another look at my cgm reports with this in mind.
1 Like
Also you joined FUD…
Ha! Just kidding! 
3 Likes
Might be part of it! You’ve all rubbed off on me!
2 Likes
@Katers87, what a wonderful number!
I certainly don’t think of the A1c as an end-all goal. But it is a very nice confirmation of everything you are doing right 
[EDIT] You should let us know how the test goes!
1 Like
Little late to the party, but EH likes to have it in the tool kit too.
Had the in-office test, was approved, got the samples and has been using it for really carby foods as well as an attempt to catch spikes before they’re out of control. No lung issues he’s noticed so far.
We got a sample pack shipped to us for free - check with your Afrezza rep in your area. Not sure if 2018 will still have the same deal but it’s nice to be able to get something for nothing. 
Congrats for sticking to your guns in the doctor’s office. That’s tough to do sometimes.
2 Likes
Thank you for explaining this. I wondered about this as well, as I’m hitting 200s more often than I used to (used to never…), yet my latest A1c was super low, considering. I have become more aggressive at correcting the highs, and with Afrezza, I spend very little time with high BG now, so this explanation makes so much sense!
4 Likes
The first time I saw Afrezza was from a Marketing “person” (lol) prior to it being FDA approved. The big focus was on no longer needing injections and it being a “cool” way to use insulin. Not a mention or hint of the functional differences.
I thought that was pretty stupid.
It was not until hearing about personal experiences on these forums that I came to understand (and believe) that the benefit of Afrezza is substantially different from my initial impression/information.
5 Likes
We all know that there are significant differences in endos’ perception of what is important in diabetes and patients’ perception. I can’t think of an area where this difference is stronger than with Afrezza.
Endos who are not T1Ds have no idea of what the flexibility, speed and lack of tail of Afrezza mean to us.
5 Likes
I will! I’ve had this lingering cold, so it probably won’t be for a week or so. I’d like to be at my best when I do the test.
1 Like
I’m starting Afrezza tonight, and despite all these posts and research…I’m pretty nervous. It was nice to read through this thread again and squash out my worry a bit 
I want to thank everybody again for their posts.
5 Likes
What’s for dinner?
2 Likes
Haven’t decided yet. I might try to eat something with less fat/protein… maybe pasta?
What was your first meal on Afrezza? Any recommendations?
1 Like