Afrezza.... your doctor’s thoughts

Type 1 & LADA
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my dr said I was the only one who asked for afrezza 3 years ago, and she hasn’t met anyone else who has asked her to use it. I used it for about a year, but did notice more coughing eventually, and it often worked faster than my meals, which always created problems… also waiting until after I ate usually meant I was hyperglycemic for a few hours…still her main issues were that in the studies, most people stopped using it after a year, and the recommendations to not use it for ketoacidocis upset her.

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Yeah but the warning is completely misconstrued… risk of bronxhhospasm in patients who already have acute lung disease… and it was completely made up. The fda expert committee did not recommend that contraindication. It mysteriously appeared out of nowhere…
in other words one of their competitors pulled some shady bs.

(IPhone)

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She was concerned with the not recommended for ketoacidocis… so along with your glucometer, and affrezza, you are supposed to carry around insulin in case of ketoacidosis? Also at the time, my insurance would not allow insulin pens and affrezza… I has to choose… they also would not do 12, 8, and 4 units…either 12 and 8, or 8 and 4, so it was cumbersome.

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Yeah, I don’t think Afrezza is a good insulin for those who experience this problem frequently or occasionally. My understanding of ketoacidosis is that it occurs when you have not had basal insulin over a period of time or in times of illness. Afrezza is definitely not intended to replace basal insulin.

I’ve never been in ketoacidosis afaik. I need to carry my Lantus pen around with me anyway, so I just always carry a Humalog pen too. On rare occasions I might not carry my long-acting insulin with me, but I can’t remember the last time. I just always like to have my insulin, pen needles, and meter with me all the time. It all easily fits in my purse. I just use a makeup bag to carry the insulin and pen needles. The Afrezza is waaaaaay more bulky than either of the pens. I like it enough that it doesn’t matter though. Now that I think about it, I don’t mind carrying my D supplies around anywhere near as much as I used to. Maybe because Afrezza has made the rest of my life so much easier.

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It just means that if you’re already in DKA, you probably need something that will last in your system longer than Afrezza to help kick you out of it (i.e., you probably got there from absence of adequate basal insulin and need to slam both bolus and increase basal to get back there). But most diabetics shouldn’t regularly be going into DKA, and it’s easy enough to keep a little humalog or something on hand in the fridge at home for that if Afrezza is otherwise your only short acting. Also DKA is not the same as producing ketones, it’s a much more severe state when ketone levels are high enough to alter body chemistry in severe and damaging ways—the warning doesn’t say that Afrezza shouldn’t be used with low levels of ketones.

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I agree. But I also think that dosing with liquid injectable insulin is fuzzy. Sometimes a banana is not a banana, if you know what I mean. Sometimes a banana is more sugary, or you’re heading down but slightly, or whatever. I just feel like 1u of regular insulin certainly doesn’t provide the exact same results every time.

And EH likes Afrezza for when the injections are taking too long. Or he’s got a stubborn high. It’s a great option. No lung issues so far and he’s used it for over a year I would estimate. Also I’ve never ever had more help from a medication company getting something approved. They went to bat for us and are really on top of calling to refill the RX. We can now get it through our local Costco, which is nice. And it’s been easy to work with them too. We recommend.

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