Hmmm good question. I would assume a bad spike in a fully progressed diabetic would always be higher, because at least someone honeymooning usually is still producing SOME insulin, even if it’s not enough to cover the meal, so they have that keeping numbers lower than they would be otherwise. I’m guessing I still am producing some (or was as of 3 months ago), because I had labs drawn while not taking insulin after baby was born, and I had normal-low end insulin levels.
My guess is the one absolute with D is there is no always.
lol
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Update: wow! Had leftovers for lunch (minus the egg rolls), started at 82, and in the 2.5 hours Afrezza is supposedly active, never went over 111, and I made banana muffins with my toddler during that time (which means we taste tested them lol!).
12:00 - 82
1:00 - 111
1:30 - 107
1:40 - ate banana muffin, 10 carbs
2:40 - 100
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Can you say how that would equate (or has in the past) to what you would have used and done without the Afrezza?
(Wondering how the comparison is)
I’ve not made this exact meal before, so I don’t have a true comparison, but I did have something similar (same chicken with fried rice and egg roll in a bowl, all homemade so I know exact carb count) last week.
Pre-meal - 84, pre-bolused ~1.5u Novolog (covers ~52 carbs)
Ate 15 mins later, 80 carbs
1 hr post - 132, dosed ~0.75u Novolog (covered remaining 28 carbs)
2 hr post - 83
Another equivalent number of carbs in a fatty/carby meal I had recently:
Pre-meal - 75, pre-bolused 2u (covers 70 carbs)
Ate 60 carbs 20 minutes later (BBQ ribs, boiled sweet potato, asparagus, and salad)
1 hr post - 149, no correction
1.5 hr post - 98
- I struggle a little with reactive hypoglycemia that isn’t true hypoglycemia (don’t actually fall below 70, though partially because I eat a snack a lot of the time when it happens) - when I eat a lot of carbs and go over 140, I get a really fast drop because I think my body freaks out a little and overcompensates kicking out insulin too late, but at least it gets me back in range faster than I would otherwise.
- so basically Afrezza just helps keep me from a larger initial rise.
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It is absolutely a ‘wonder drug’ far more so than the surface has been scratched here amongst diabetes ‘enthusiasts’ in the DOC blogs like this…
Think of how many wildly out of control diabetics there are out there (the vast vast majority of diabetics worldwide)… then realize this makes pretty decent control damn near effortless… it’s hard to escape the realization that this is an invention that has the potential to change the course of the world. If only the disgustingly corrupt pharmaceutical and insurance industries don’t manage to crush it.
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My guess is that it’s YDMV. We are not in honeymoon any more, and have very good breakfasts with no spikes most days as long as we do low carbs for breakfast (12 carbs is standard for us).
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This is a good point. I stick to lower carb breakfasts (whatever my 1u covers, so initially 35g; now down to 25g). The majority of the time I have perfect numbers after unless I get crazy and eat oatmeal or cinnamon raisin bread or something. 
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I can say for sure that I am not honeymooning and I also use Afrezza. I use a pump, dexcom and moderate/ low carb. So only use Afrezza on exception meals out of my normal routine, or to make correction. I also pay out of pocket, but think I would do the same even if covered.
I think Afrezza can be used in combination with insulin very effectively.
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So how many carbs would you consider moderate carb, and at what point (or carb count) do you decide to use Afrezza instead?
First I have to a admit I haven’t counted carbs or used pump wizard in at least 10 years. I eat a lot of salads, veggies, fruits and various meats and nuts. Rarely do I eat breads, crackers, rice, French fries, etc, but on those occasions Afrezza is first choice. Occasionally I do frozen fruit+protein shakes for breakfast or lunch.
I use my dexcom CGMS as my guide. If I see sharp rise, I take some Afrezza. If it starts to drop fast. I pause the pump Basal or eat a little more carb or fruit. Some of this I learned from Sugar surfing by Stephen Ponder. On days I work from home, I can nibble all day if I want, otherwise it is a bit more structured.
Some times I think it is like using the gas and brake pedals in my car, and dexcom is my spedometer. Afrezza helps me slam on the brakes when needed !!!
My current pump history average for last 30 days shows 7 bolus, 13 basal per day.
My average may be 8-12 units Afrezza a week, but that varies a lot.
Best estimate is 50-100 g carbs per day.
Full blown T1D since age 5. Lower carb for past 8 years.
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This is a fantastic analogy! Thanks for this. I’m going to try to obtain some Afrezza at my next visit.
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Some doctors have or can get free samples.
I use a discount card and get best price at costco.
I don’t really carb count thoroughly anymore to be honest I would consider Moderat card for me to probably be less than 100 g per day
Most of my doses with novolog are based in carb counting experience… with afrezza I don’t even really correlate the doses in my head with a carb count, I just know what to expect and it’s pretty easy.
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…I’m going to have to stop saying I eat moderate carbs, then. 
I was eating 150-200/day. Since becoming more comfortable with dosing Novolog and now starting the Afrezza, it’s closer to 300/day this week. So that brings up another question - every time I talk to any t1s about diet/carbs, they either say they eat lower carb or look at me like I’m crazy for eating the carbs I do. In the long run, for minimal complications, etc, is it better to eat low/lower carb? Or does it matter more whether or not you have good control, regardless of specific diet choices (though I will say we eat a whole foods diet, lots of fruits/veggies/healthy fats, minimal processed foods)? Because part of the reason my doc prescribed Afrezza is, “you’re too young to be this restricted.” (food wise)
This is where I’m currently stuck. How do I look at a meal and figure out whether I’m going to need a 4 or 8 of Afrezza, unless I eat the same things again and again and don’t try anything new? How did you figure it out - trial and error, I’m guessing, but any tips?
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It will come with experience.
Yeah you eat what most diabetics would consider a heavy carb diet… I’m probably twice your size and couldn’t possibly eat anywhere near that many carbs with any semblance of control
Some do fine with a lot of carbs… many, in all likelihood most can’t
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I consider it enjoying all the carbs while I still can (while I’m still honeymooning). I know some people have prolonged their honeymoon period by going low carb, but…yeah. That’s just not for me. I have other health issues that require me to eat a fair amount of carbs, so that balance is going to be fuuuuuun.
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Given your carb ratio and what you just ate and had good results with a 4 I would think 4s would cover most of your bases for now…
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I think they were doing very serious carb restrictions, such as 12-24-24 or even less.
Exactly - that’s why that is not for me! I couldn’t handle that amount of carb restricting with my other health issue. 80-100g/day during pregnancy had me laid out on the couch for those last few months (more than just normal end of pregnancy stuff, haha).
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