I just inhaled a 4 unit (with my pizza and Arnold Palmer) and afterwards opened it and saw powder still in it. Did I not inhale hard enough or is that normal? I have 147 on Dex with an up arrow so either my timing was off or I didn’t get get enough, or maybe both! Still dialing in…
Is the powder in the cartridge itself or just in the inhaler? I think there just ends up being some powder caught/left in the inhaler sometimes, despite best efforts to properly inhale. I doubt that is the reason behind your BG rise, though - personally I have to start with an 8u for just pizza (and have follow up doses and/or Novolog), never mind adding a sugary drink - I rarely drink any drinks with added sugar because the spike just isn’t worth bothering to figure out the dose for me. I would go ahead and do another 4u now, if you can.
ETA: timing does matter, too. I dose anywhere from 10-30, sometimes 40 mins after I start eating because otherwise it drops me first, then runs out before my food really hits.
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The powder is in the cartridge, I thought we didn’t need to inhale really hard? I did wait until I was almost done, probably seeing the rise from the sugar in the lemonade.
Maybe you didn’t inhale long enough, then? I try to get in a good, deep ~5 second inhale. No idea if that’s overkill; I just rarely have any powder left anywhere, so not going to change what’s working!
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Hmmm that could be, I didn’t really try to inhale long or hold my breath. Just took a deep breath.
I have heard that you technically don’t need to inhale hard or for a long time, but…I think what’s considered hard or a long time is variable from person to person, so it’s hard to really put a definitive “inhale this hard for x seconds” on it.
If you notice powder still in the cartridge again, maybe just close it up and inhale the rest?
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That would have been smart but I tapped it on my plate to see how much was left! My guess is I got half of it, I opened one to try and split it into a two unit dose so I know what a full cartridge looks like, that was difficult to do so probably won’t bother. Side up arrow and 170 on Dex but meter keeps reading around 140. Going to take time to figure this out;)
Yeah, it takes a bit of experimenting to figure out (but the kinds of food I use it for are fun to experiment with 
). I haven’t bothered trying to split into 2u doses because I find 4s adequate (or not enough) for most of my meals. Definitely not equal to 4us injected.
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Just see what your bg does and if you need more, take more. That’s the beauty of afrezza is it’s real time management…
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Sam, are your cartridges completely empty after inhaling?
Ive never bothered to look in the cartridges… the inhaler definitely builds up some powder deposits
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I notice some residual powder in the inhaler but don’t have any left in the Afrezza cartridge anfter taking a dose.
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Thank you @Millz I’ll try to inhale a bit more forcefully. I did bring it to room temp and tapped it gently to loosen things up so must be my inhale technique.
@Lilly, diabetesmine actually raised that question a bit ago, here is what they said:
"Leftover Powder – I was also very worried about seeing some residual white powder left in the cartridge after most doses: was all the insulin really getting into me?
But Boss [Sanofi Senior Medical Director] reassures us that a little leftover powder in a used cartridge should not cause concern. The manufacturers [of] Afrezza cartridge[s] don’t expect 100% absorption, which is also the case with injected insulin, he says. “It’s OK if about 8% still seems to be in the cartridge afterwards. That’s calculated in. You lose some in the mouth, some in the cartridge. It’s such a fine powder that most of it absorbs in the lungs.”
(from https://www.healthline.com/diabetesmine/six-things-know-starting-afrezza#2)
If you read this thread we had in October, users say they sometimes cough some up but don’t see a difference in behavior afterwards:
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I’ve been breathing in a little deeper and longer, and making sure I have the inhaler tipped down slightly, and no more powder left in the cartridges so problem solved. This is only my first week and I’m doing really well so far with the Afrezza. I was a little nervous (okay a lot nervous actually!) trying it the first few times. I use it about ten minutes after starting a meal and I’m amazed at how gentle it is. That may sound like a strange way to describe an insulin but that’s what comes to mind. It stops the spikes and no surprise lows hours later like I had with other mealtime insulin’s
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