Moving from Tslim/Dexcom to Dexcom G6, Toujeo and Afrezza

I have posted links to podcasts in the past and people had a difficult time accessing them. I hope you can listen to this one. I am in the process of moving from the Tandem X2, Dexcom G6 (which are the BEST PUMP AND CGM) out there in my opinion) with Afreeza > Dexcom and Toujeo and Afrezza. It’s a big change and I am taking it a step at a time after 30 years of pumping. It is a hard thing for some people to absorb, especially medical professionals and insurance companies. I feel like I am forging my own battle to educate them and get them to come along with me. Let alone finding a way to pay for it. Anyway, this podcast talks about using Afreeza and many aspects of diabetes and the consumption of our mental energy and focus and in turn how much we have left to spend on actually living life. In his life this change from the pump helped him to balance that.


@Jattzl, I was not able to play it for some reason, maybe because we are in Europe right now :frowning:

But your post resonates with us. I wish it was possible for us to get good control on MDI. I look forward to when our teen peaks and basal variations moderate and make it possible to go back to MDI.


First of all Michael, Europe!! Yay!! Enjoy!

Darn. I’m sorry you can’t get the podcast. Hopefully when you get back. I’m wondering if anyone has been able to listen. When I click on the link it opens right up in the Apple iPhone podcast app.

Teen years are such a difficult time for us. In the old days of insulin and BG testing when I was on MDI it was a nightmare. No matter how hard I tried it was futile.

I’m crossing my fingers regarding the long acting insulins available now being able to handle my significant dawn phenomena. Afrezza is a major pivotal factor for me making this change. But having Dexcom is really what makes it all possible.

As more and more monitoring and management tools have become available, the more obsessed and consumed I’ve become living with T1. It is out of balance. I’ve slowly moved towards viewing and living my life through the filter of diabetes. I’ve lost the perspective that I used to have of being a person first who happens to have diabetes. Now it feels more like a “Diabetic” trying to fit in a life.


Agree… I’m looking forward to trying tslim w/G6 next year, and continue Afrezza too.
What specifically do you think will improve with your switch?


It’s good to see Afrezza gaining some traction as an alternative way to manage diabetes.

The host talks a lot about how fast Afrezza works, but it also kind of felt like he was saying he was actually controlling his diabetes less since he made the switch. Perhaps his control was sooooo tight, that that was a natural consequence of moving to Afrezza. It doesn’t seem like there are many people who are achieving control so tight that using Afrezza would be a step down. Perhaps part of it is that he transitioned off a pump at the same time, so he can no longer vary his basal rates as he did before.

I’ve never been a big fan of pumps, so I probably have more in common with the female host in the podcast. Though I try to control my D as much as I can.

I think the pump consumed a lot more mental energy for me. I love not being attached to something. After listening to the podcast, I am wondering if it might be better to spend less time perusing diabetes-related forums/stuff. It’s also really important to me that diabetes is merely a part of my life, not the focus of my life.

Anyway, it’s great to see Afrezza being referenced in popular diabetes podcasts. Thanks for sharing!! :slight_smile: I think most people’s control would actually improve with Afrezza though. Their control may even improve if you replace a pump with Afrezza and a long acting insulin - not everyone’s control of course. But a lot of people.

I’m excited to read your thoughts on Afrezza after you start.


This was so multi-faceted it took me a long time to respond.

First of all. It is a big move for me and is going to be a lot of trial and error which is really what all management is about. But I don’t know anything BUT the pump! I can’t really compare my past MDI experience as it was 30 years ago and so much has changed. And I may find that the pump/cgm with Afreeza as a supplement is the best for me and adjust other aspects of my feelings about diabetes overwhelming my life and regaining a healthy perspective.

These are my thoughts on Afreeza.

I’m using these quotes from @Sam because they are representative of what I have heard from other users and also described by Craig in the podcast. My thoughts on Afreeza is my personality needs a… less not… precise but less obsessive attention. Watching each dot on G6, constantly adjusting basals, extended bolus, temp basal. All GREAT tools and work! But mentally and as a quality of life I’m want to lighten that burden. I think that can be done with adjustments to my tools and my mindset. I tend to strive for perfection which will lead to insanity if you have T1 :exploding_head:

Regarding long acting insulins, as I said I have no experience and hope I can find one that helps with significant dawn phenomena which was not possible 30 years ago.

Regarding the pump itself - As a long term pump user and being thin I struggle with scarring and absorption. I also have developed sensitivity to multiple adhesives and infusion sets causing inflammation and absorption issues. The constant adjustments and supplies to deal with these is overwhelming.

And if we just get down to a basic bottom line that isn’t a reason exactly but I am just tired of having something hanging from me 24/7. This has become more cumbersome and more annoying since acquiring other auto-immune diseases requiring me to have other attachments too.

Part of my feelings that T1 has consumed me began when I moved to the 670. It was so horrible and began a nightmare of searching for answers and help for something that ended up being defective in my opinion and experience. But this in turn lead to -

I agree 100% with this comment. I have made a concerted effort to back away from what began with the 670. I now try to read and listen to things that help me and support that is uplifting. I’ll address this in my response to @Katers87 below.

I think this one podcast may have been misleading and unfair to him as an example of Afreeza in his life. Without his history it does sound like he was controlling his BG less. But he was extremely tightly controlled and focused constantly like me. He is a runner and ran very low so the “less control” actually improved his management and improved his quality of life. He needed the change to sort of snap him out of it if that makes sense. I don’t mean to speak for him that is just my impression of why he made the change.

This is my hope!! On my way to meet with the rep and my doctor now. Thanks everyone!


Thanks for sharing your well thought out details, I appreciate it ! And YES to all Afrezza, I use it similarly.

You mention several items that aren’t a concern for me, and I also have many years on pump without issues with sites. I frequently use mini adjustment bolus throughout the day, rather than dealing with basal changes, because I never see a pattern. For this reason, I’m hesitant to give up my pump. Often use .2 - .8 units with the easy bolus feature, and don’t even look at the pump, much easier than using syringe or pen.

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Finally got my samples! Yesterday I forgot to pre bolus for my med carb low fat dinner and shot up to 234 fast. So I use my first 4. Immediate dropped fast to 81! Both excited and scared but it worked miraculously! Here’s my question. After about 1:45 it climbed again. I’m assuming it was slow digestion :woman_shrugging:t3:I gave a reg bolus because I was worried that BG wasn’t as high and I wasn’t eating. I was afraid it would drop too low if I took a second Afrezza dose. Also if the script is written for one/meal don’t you run out using repeated doses?

What do you think? Also it made me wonder. I’m searching through old posts from ‘17 some people use both a injection and Afrezza. How do you figure out the ratio for lowering the injection. Hope that made sense.


A lot of this is just trial and error. A drop from 234 to 81 is a pretty big drop. Were you active or walking around during that time? Afrezza is more sensitive to that than humalog IMO. I think I may have been a little more sensitive to Afrezza when I first started.

I’m comfortable following most meals up with another dose 2 hours later if it’s needed, and I base that Afrezza dose amount off of the arrow angle on my Dexcom. High fat/protein meals like pizza tend to benefit from some humalog instead of an Afrezza follow-up dose. I usually dose with humalog as I sit down to eat (no prebolus) and attempt to cover the carbs I estimate won’t have digested by the end of 2-3 hours (paired with an Afrezza dose for the carbs I estimate I’ll digest in the first 2 hours). It’s a guessing game! The difference is that if you mess up the estimate, you have a super fast-acting insulin on your side now.

My Afrezza prescription is written for the max dose/meal. If you end up using more than you expected, your doctor can revise the prescription so you have enough (hopefully covered by insurance!).

Edit: With a high fat meal like pizza, I usually dose the Afrezza after I eat.


Thank you that was very helpful! No I wasn’t active at all :flushed:. I’m insulin sensitive but I have already DIY some 2u doses :shushing_face:

I am on Medicare. The company is working with my dr and they have some programs that sound hopeful.

I’ll keep at it today!

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Smart!! Let us know how that works out. I’ve thought about doing that, but I guess I’m lazy :smile:


Just saw your reply @Katers87!

Does anyone else have feedback on the DIY 2u doses? It’s hard to tell if the amounts are equal but it’s so forgiving I guess it’s okay. It was very easy.

Also I’m curious why the Afrezza posts in search are so old. I’m surprised it hasn’t caught on. Is it the cost?

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I think the cost is probably the largest part. Some people are leery of Afrezza because we don’t have long-term history of people using it. While there’s no reason it should cause any problems long-term, we don’t have the history to back that up yet.

There are quite a few people that use it on this forum though. I think @TravelingOn’s partner, @MM2, @CatLady, and @Sam are using it. I’m trying to remember who else.

Here’s my thread from when I started: Afrezza & upcoming endo appt

It’s a year old though.

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It isn’t available to anyone under 18, we have tried to get our practice to prescribe it without luck. I think the cost is also an issue. Also, reading through the threads on this as people have started out with it, it would seem that reasonably quickly people get the hang of it and stop asking for advice, so I take that as a good thing.


Yes that all makes sense. I’m surprised but not surprised how resistant some people are to it. Especially providers. They seem to like to go with the easier way of what they know.

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Probably also because long-term safety is unknown. Its safety short-term is well-established (outside of people with pulmonary rule-outs), but it’s simply impossible at this point to know what the effects might be decades down the line of regular use. It’s why personally, I’d be hesitant to use it as a primary short-term insulin just yet, vs as an adjunctive one (although I can certainly understand people making other choices after weighing pros/cons for themselves). Pediatric providers are going to be way more cautious on that front, given that their patients have a lot longer to live still, so possible unknown long-term side effects are more concerning. I don’t think it’s about going the easier route, but the safer one.


I primarily use Afrezza for corrections and glycemic meals (such as Thai food). I don’t use it often enough, though, to have a good sense of timing or how many carbs a dose covers. I did self-pay for my 4-unit doses and got samples for the 8s from my doctor’s office.


The host in the podcast, Craig Stubing, does he talk about it in other podcast sessions? Do you follow him on social media?

I’ve never really gotten into the facebook, instagram, or twitter scene. It’d be interesting to see if Afrezza is being talked about there.

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Yes he does! And there are three different podcast under the BetaCell umbrella. I really like their outlook and information. He is not as active on social media as
Laura Pavlakovich who I think you related to.


This is what I’m starting with and have a feeling it may be how I end up using it. I would rarely use an 8u so I am splitting them to help me financially.

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