# How to be unlimited **URL:** \ **Category:** Afrezza\ **Created:** [August 16, 2017, 6:16pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608 "2017-08-16T18:16:58Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![Pianoplayer7008](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/pianoplayer7008/32/1507_2.png) [@Pianoplayer7008](https://forum.fudiabetes.org/u/Pianoplayer7008)\ **Post date:** [August 16, 2017, 6:16pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/1 "2017-08-16T18:16:58Z")
So I talked to the Afrezza rep today, and I meet with her tomorrow to go over everything and get a voucher for a month’s supply (and start the process to get things straightened out with insurance to get it covered). Here’s the thing…I get that 4us of Afrezza is not like 4us of Novolog, but I am still having trouble wrapping my brain around this. My I:C ratio is anywhere from 1:25 to 1:35 depending on time of day and type of carb, and with how I still restrict my diet (thus the desire to be more unlimited…), I only use .5-2us for almost everything I eat. Anyone who uses Afrezza have any advice or experiences to offer? I really want to get back to as close to my pre-diagnosis way of eating (minus most of the sugary sweets, haha). When first controlling with diet during pregnancy, I was eating 80-100g carbs/day, NOT anywhere remotely normal for me, and, since having the baby, I’ve gradually relaxed more and more and now eat more closely to my original diet, coming in around 250-300g carbs/day. I’m still struggling some with postpartum anxiety, so my stress level is shooting up right now trying to reconcile in my head that I WILL be able to be more relaxed, but still need to be mindful of what I eat. I can’t seem to find that balance. ---
**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\ **Post date:** [August 16, 2017, 6:26pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/2 "2017-08-16T18:26:50Z")
You will have a great time with afrezza… don’t worry about them being called “units” and liquid insulin also being called “units”. I assure you they behave very differently. Do you have a cgm now? The cgm makes it real easy to see what’s happening and you’ll figure it out very quickly. You may need to tweak your dose timing to make it work best for you… particularly you’ll notice that fattier foods digest much more slowly and also slow down carb absorption and this becomes more obvious with an ultra rapid insulin. Keep us posted I bet you’ll love it. ---
**Author:** ![Pianoplayer7008](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/pianoplayer7008/32/1507_2.png) [@Pianoplayer7008](https://forum.fudiabetes.org/u/Pianoplayer7008)\ **Post date:** [August 16, 2017, 6:30pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/3 "2017-08-16T18:30:43Z")
I don’t have a CGM yet, unfortunately. I need to check up on that, as my doctor was supposed to send a letter of medical necessity to my insurance as the next step to getting it covered. I do eat higher protein/fat than most (partially to make up for the lack of carbs), so I’m interested to see how it works for those high fat meals that take a couple hours to peak with Novolog on board. ---
**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\ **Post date:** [August 16, 2017, 6:32pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/4 "2017-08-16T18:32:45Z")
You may find yourself adjusting your diet as you go… I didn’t use a cgm while I was learning afrezza… it’s not necessary but it makes it easier… just test a lot ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [August 16, 2017, 6:34pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/5 "2017-08-16T18:34:07Z")
> [@Pianoplayer7008](#): > > I don’t have a CGM yet I know that YDMV – for us, a CGM has represented a lifeline, an extraordinary difference in how we deal with diabetes. With a CGM we feel we have a good bit of control, we sleep longer and without as much angst, our numbers are MUCH better. A CGM has made an incredible change to our lives. For us, with a CGM diabetes is a different disease, one that you can almost control. I can’t even put into words what it means to us. ---
**Author:** ![TiaG](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/tiag/32/594_2.png) [@TiaG](https://forum.fudiabetes.org/u/TiaG)\ **Post date:** [August 16, 2017, 6:35pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/6 "2017-08-16T18:35:24Z")
So I have no experience with Afrezza but I’d just say that it helps to take an experimental mindset and think of it as a work in progress to get there. Are there certain foods you still don’t eat and you’d like to incorporate? Just add them back into your diet one by one and then besystematic to figure out how to dose the Afrezza to make it work. Get a cute notebook or a good app, and just try different dosing and record everything, testing BG maybe more often than usual for those particular foods. This is something @daisymae’s swimming thread has really driven home for me – if you keep trying and experimenting, you can find a system that works pretty well! A lot of her early tries at swimming (and even some later ones) aren’t technically “success” in terms of ideal BG outcomes but over time by testing out a new approach and then successively tweaking she hit upon something that really worked, and more and more of her swimming days look like great BG control. She is achieving great control during activity without a CGM I believe. However, one of the major perks of Afrezza seems to be that it’s a lot more forgiving on all the little details, so you probably won’t have to do 20 experiments to make it work. Probably more like 4 or 5 per food you’re interested in. Over time that may translate to returning to your normal diet. And don’t be afraid to tap the collective knowledge on here, which I think is really helpful! Good luck! Sam’s the resident Afrezza expert. > I’m still struggling some with postpartum anxiety, so my stress level is shooting up right now trying to reconcile in my head that I WILL be able to be more relaxed, but still need to be mindful of what I eat. I can’t seem to find that balance. Postpartum is such a rough time. Having a baby, getting no sleep – it’s all really really hard. Add to that the paranoia that the care teams typically place on moms with diabetes – it’s not surprising you’d have trouble letting go of that vigilance. I don’t have any advice except to keep an eye on it and maybe talk to someone if it’s becoming difficult to manage the feelings of anxiety on your own. Good luck! ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [August 16, 2017, 6:40pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/7 "2017-08-16T18:40:44Z")
> [@TiaG](#): > > and maybe talk to someone if it’s becoming difficult to manage the feelings of anxiety on your own. And talk on the forum here! Obviously, I don’t have what you have (I am a parent of CWD). When my son was diagnosed, my own psychological state became difficult to deal with – I had a hard time accepting my inability to help him. I filled with rage and anger. Much of this has gone now, in great part thanks to FUD. Sharing what happens to us here makes a great difference to me, and I think to many others too. ---
**Author:** ![Chris](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/chris/32/382_2.png) [@Chris](https://forum.fudiabetes.org/u/Chris)\ **Post date:** [August 16, 2017, 6:48pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/8 "2017-08-16T18:48:48Z")
One thing I gleaned from reading about Afrezza is that it is not an all or nothing thing, in that you don’t need to stop using Novolog to start using Afrezza. I like to think of it as another arrow in your quiver. If a particular meal is best handled with Novolog, use it. If a different one is better solved with Afrezza, go for it. Hopefully you can keep access to all the tools and match the best tool with each meal. It looks like a great tool once you figure out how best to use it, and I am looking forward to the day I can convince our current medical team that we can add it. ---
**Author:** ![Eric](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/eric/32/9209_2.png) [@Eric](https://forum.fudiabetes.org/u/Eric)\ **Post date:** [August 16, 2017, 7:09pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/9 "2017-08-16T19:09:02Z")
> [@Chris](#): > > One thing I gleaned from reading about Afrezza is that it is not an all or nothing thing, in that you don’t need to stop using Novolog to start using Afrezza. Yep, it is another tool in the toolbox. Great point, thanks for bringing it up. You can use it alone or with injectables. It also makes a great emergency insulin for big spikes. I think everyone should have some on hand, just like a glucagon shot. I don’t use it much, but I have it available if the situation fits. ---
**Author:** ![Pianoplayer7008](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/pianoplayer7008/32/1507_2.png) [@Pianoplayer7008](https://forum.fudiabetes.org/u/Pianoplayer7008)\ **Post date:** [August 16, 2017, 8:07pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/10 "2017-08-16T20:07:41Z")
> [@Sam](#): > > just test a lot LOL Anyone who has asked about how much I test seems shocked I test so much, so I think I’m good. 😉 > [@TiaG](#): > > Are there certain foods you still don’t eat and you’d like to incorporate? Just add them back into your diet one by one and then besystematic to figure out how to dose the Afrezza to make it work. Ohhhh, good point. Baked sweet potatoes, mmmmm… > [@Michel](#): > > Sharing what happens to us here makes a great difference to me, and I think to many others too. Yes, I process through things better by sharing or just writing them down…I’ve been intending to write out my story here at some point, when I’ve got some free time (ha!). And great point, @Chris and @Eric about it just being another tool in addition to the others. While I’d like to just have one type of bolus insulin for financial reasons, I really don’t see how I would be able to do JUST Novolog or JUST Afrezza at this point, particularly when I still only eat 10-20g carb snacks, which I don’t think Afrezza is best used for. Im really excited about trying it for the higher (and faster acting) carbs, though. ---
**Author:** ![Beacher](https://avatars.discourse-cdn.com/v4/letter/b/a6a055/32.png) [@Beacher](https://forum.fudiabetes.org/u/Beacher)\ **Post date:** [August 16, 2017, 8:12pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/11 "2017-08-16T20:12:40Z")
> [@Eric](#): > > It also makes a great emergency insulin for big spikes. This is what makes Afrezza attractive to me. I probably wouldn’t be able to take it regularly, because I have asthma and mildly compromised pulmonary function. (Compromise can be difficult for me, but for my lungs, apparently, no problem. Nice of them to ask first.) I can only correct so much with Humalog (or, currently, Fiasp) before there’s a danger of stacking, and I have only so much patience. I’d dearly love something that worked now, or now give or take an hour. And I’m too chicken to try IM shots. Of course the ideal would be to not have the spikes or the stubborn highs in the first place. ---
**Author:** ![cardamom](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/cardamom/32/2622_2.png) [@cardamom](https://forum.fudiabetes.org/u/cardamom)\ **Post date:** [August 16, 2017, 8:20pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/12 "2017-08-16T20:20:54Z")
I’m tempted to try Afrezza myself as an adjunctive tx for the occasional carb-heavy foods and for corrections (although I’m torn re: corrections, bc while coming down quickly in nice in some obvious respects, I find crashing too quickly makes me starving and feel some of my low symptoms, which is not great, especially when I’m trying to lose or at least not gain weight). Planning to ask my endo about it next appt and try it anyway though if he’ll hook me up. ---
**Author:** ![Pianoplayer7008](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/pianoplayer7008/32/1507_2.png) [@Pianoplayer7008](https://forum.fudiabetes.org/u/Pianoplayer7008)\ **Post date:** [August 16, 2017, 8:28pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/13 "2017-08-16T20:28:16Z")
> [@Beacher](#): > > Of course the ideal would be to not have the spikes or the stubborn highs in the first place. Too bad ideal and reality are two different things. Yesterday I thought I figured out the perfect dose for breakfast, but then…I’m guessing I went on autopilot and gave myself my usual dose instead. That 1 hr check was not so fun. > [@cardamom](#): > > I’m torn re: corrections, bc while coming down quickly in nice in some obvious respects, I find crashing too quickly makes me starving and feel some of my low symptoms, which is not great Yes, this! I really hate the starvation mode I go into when my BG drops quickly; it’s so hard to resist binging on all the carbs. 🙁 ---
**Author:** ![TiaG](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/tiag/32/594_2.png) [@TiaG](https://forum.fudiabetes.org/u/TiaG)\ **Post date:** [August 16, 2017, 9:13pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/14 "2017-08-16T21:13:57Z")
I think this is an absolutely underused indication for Afrezza for sure. In fact, I spoke with an endo who absolutely didn’t like the idea of kids taking it chronically because of the lack of study on lung impact, but when I suggested it as a quick treatment for things like bad sites or the occasional pig-outs, she seemed to see how useful that could be – and presumably the risk associated with taking a drug once every month or so is a lot less. Highs above 300 take hours to bring down… with Afrezza you could just get back to your ordinary life. ---
**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\ **Post date:** [August 16, 2017, 9:17pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/15 "2017-08-16T21:17:36Z")
it works great for corrections but it also makes life a heck of a lot easier for many other instances too… like when you’re eating food that you don’t know the carb count of… or spontaneously eating like a normal person instead of prebolusing well in advance… or you’re in a social setting… and the list goes on. It’s great for corrections but it improves quality of life well beyond that. I use novolog more often than not currently… but when I’m being ‘unlimited’ nothing even comes close to afrezza ---
**Author:** ![Thomas](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/thomas/32/1719_2.png) [@Thomas](https://forum.fudiabetes.org/u/Thomas)\ **Post date:** [August 16, 2017, 10:28pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/16 "2017-08-16T22:28:32Z")
> [@Eric](#): > > It also makes a great emergency insulin for big spikes. I think everyone should have some on hand, just like a glucagon shot. I like it. The anti-glucagon. I will bring it up with our NP endo at our upcoming visit and get her take. Being a Ped, it might not be something they want to do. No downside to discussing it. ---
**Author:** ![Pianoplayer7008](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/pianoplayer7008/32/1507_2.png) [@Pianoplayer7008](https://forum.fudiabetes.org/u/Pianoplayer7008)\ **Post date:** [August 18, 2017, 1:57pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/17 "2017-08-18T13:57:46Z")
> [@TiaG](#): > > the lack of study on lung impact I’ll admit, I’m a little apprehensive about that myself. > [@Sam](#): > > I use novolog more often than not currently… but when I’m being ‘unlimited’ nothing even comes close to afrezza I think this is going to end up being the approach I take, if I can get my doctor to prescribe Novolog in addition to Afrezza. I don’t see her until mid-October, so I should have plenty of time to show her how well the combo is working for me (I hope). ---
**Author:** ![mikep](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/mikep/32/149_2.png) [@mikep](https://forum.fudiabetes.org/u/mikep)\ **Post date:** [August 18, 2017, 2:14pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/18 "2017-08-18T14:14:46Z")
Hey @Pianoplayer7008 , I’ve been on Afrezza for over 2 years and here’s my reader’s digest after a tremendous amount of experimentation. Always remember YDMV. -I use it in conjunction with Tresiba and Novolog. -It is fantastic for stopping a spike in it’s tracks (literally stops it 15 minutes after a puff) -Same goes for bringing down a high very, very quickly with little to no worry of a low. Nothing stressed me out more when I was high and I’d take Humalog/Novolog (via pump or injection) and I’d wait and wait and wait and wait for the high to start coming down. Then I’d rage bolus and ultimately go low. Not good. -High carb foods don’t have a chance against it. Plus, the late spikes from high carb/high fat foods (pizza) are much easier to control with a puff about 90 minutes after eating. My best advice is that it’s so flexible that you should see what works best for you. Honestly, Afrezza helps me be Unlimited by freeing my mind and body of the stress that comes along with high blood sugar and the struggle to bring it back to normal as quickly as possible without inducing a low. ---
**Author:** ![Millz](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/millz/32/12204_2.png) [@Millz](https://forum.fudiabetes.org/u/Millz)\ **Post date:** [August 18, 2017, 2:33pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/19 "2017-08-18T14:33:36Z")
Ditto and ditto! I am so very glad Afrezza is one of my insulin options, to handle spikes or planned carb excursions. It eliminates stress about those issues. Right now I’m pumping with Humalog and use Afrezza as needed (my insurance covers it 🙃 ). ---
**Author:** ![Millz](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/millz/32/12204_2.png) [@Millz](https://forum.fudiabetes.org/u/Millz)\ **Post date:** [August 18, 2017, 3:46pm UTC](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608/20 "2017-08-18T15:46:59Z")
I used this post from @mentat to split Afrezza 4u cartridges into 2u doses for those times I need a small dose. [https://forum.fudiabetes.org/t/custom-afrezza-doses-making-2u-cartridges/1230](https://forum.fudiabetes.org/t/custom-afrezza-doses-making-2u-cartridges/1230) It works well for me! [Next page](https://forum.fudiabetes.org/t/how-to-be-unlimited/1608.md?page=2)