Start up help with Afrezza

[Jattzl]

@Thomas

We use Fiasp in the X2 and have zero issues with occlusions.

I don’t follow those rules lol. When I first started pumping 28 years ago humalog wasn’t approved in pumps. That’s what I started with.

I’ve had no problems at all with Fiasp in X2!

[Thomas]

Fiasp is Novolog with two extra ingredients.

[Katers87]

@SFBob

It also seems to have a odd attribute of softening the drop once it crosses maybe 80. With Novolog/Fiasp it will just keep tanking hard, but with Afrezza is seems more likely to not cross past 70 which is a unusual attribute.

Agreed! One of my favorite things about Afrezza. The landing below is all Afrezza… no extra carbs.

[Jattzl]

Wow!

[JessicaD]

So you all use Afrezza along with Humalog (or Fiasp)? What sort of ratio between the two (for meal bolus, e.g.)? And I am assuming Afrezza solo for corrections? Thanks! Jessica

[Sam]

It really varies with what you’re eating… for a long time I very successfully used afrezza alone with all but the highest fat meals… really will depend on your own metabolism. I think experimenting is the best idea

[Millz]

FFor me, it all depends - what is carb count being consumed, is BG already high, am I treating a stubborn high BG scenario.

Higher carb meals - I often use a pump extended bolus but will supplement with Afrezza if I underestimated the pump bolus. Tonight I was a bit high right before dinner (a rare meal out for pasta and I knew I needed to be proactive with my insulin), took an 8u Afrezza dose along with an extended pump bolus. And there are times when I NEED to add a shot via syringe to the pump + Afrezza… it all depends.

Regular to lower carb meals, several things go into my choice which insulin to use for a bolus and/ or correction:

1. Units of insulin left in my pump?
   a) If I need to use the remaining units for basal before changing the POD, I’ll use Afrezza and/or an injection.
   b) If I have a lot of units left and want to use them up before changing the POD, I’ll use the pump.

2. If I need insulin late at night, before a long drive alone, before I know I’ll be otherwise occupied (in a long meeting, shopping, walking, etc.) I opt for Afrezza.

3. Sometimes it’s what’s been working best in the past few days.

Having a plethora of insulin options available definitely helps when I’m dealing with the inevitable day to day ups and downs.

[MM2]

@Millz

For me, it all depends

Ditto for me. I started with just the 4 unit size, but now using 4s and 8s. With 4s, often for meals with more fat, protein, so also do pump insulin for longer duration.

Due to some color blindness, I used a 8, thinking it was a 4. But with Dexcom, noticed the quicker drop, and then noticed the color (blue=4, green=8). So now I double check the number on pkg.
In good lighting, I can distinguish the colors. You wouldn’t believe how many card and board games there are, that I have similar issues with colors.

[Millz]

@MM2

I used a 8, thinking it was a 4

I’ve made the same mistake too (I really wish one was white or red).
Tried a number of ways to prevent this from happening…finally just decided to keep them in different areas of my little D bag I carry around. It works now that the 8u cartridges are always in the outside zipper pocket!

[Jattzl]

I saw my Dr yesterday and she contacted MannKind for a rep to come out with my samples! Customer service told me to call after I get the samples and they will set up a copay savings card for me. They were very helpful. Didn’t get good news from Medicare but it’s a process. I’m in another fight with them to cover the Fiasp in my pump so soon they will know my name.

[Jattzl]

@Millz

Having a plethora of insulin options available definitely helps when I’m dealing with the inevitable day to day ups and downs.

Great help! This is how I look at my management. It’s a toolbox. I think the more complicated variables you are dealing with, the more tools you need. I wish insurance was more helpful. I think they would prefer us on one injection/day, two strips/day and then pay for the emergency and complication care Makes no sense.

@MM2

color (blue=4, green=8)

the worse two colors to distinguish, even for me with no color blindness

[Jattzl]

I hope you give it a try, too! It would be great to have someone to learn with and from and share the experience.

[Jattzl]

@MM2

But with Dexcom, noticed the quicker drop, and then noticed the color (blue=4, green=8).

A good example of what you guys have talked about as far as the difference in measurement/dose and it being more forgiving that a bolus. Inhaling twice the expected amount compared to injecting twice the amount of units.

[TravelingOn]

@millz that was such a good reply! I think we forget to use it as often as we could. These were good reminders! Thank you!

[TravelingOn]

@Jattzl

I’m in another fight with them to cover the Fiasp in my pump so soon they will know my name.

Good luck! It’s worth the fight! I believe in you!

[TravelingOn]

@MM2

You wouldn’t believe how many card and board games there are, that I have similar issues with colors.

I totally would! We once took a heavy sharpie marker to a new board game because two of the guys in our gaming group are colorblind. And two are T1 diabetic. (All guys we’ve known since high school and we are almost 40 now.)

EH has a hobby of board game design and now in the Component Studio/Game Crafter website he uses to make his parts has a 9 way colorblindness checker!!! But many games are awful!

And he agrees - low light, not colorblind, he can’t see the difference between 4 and 8 unit Afrezza.

[Jattzl]

I’m really struggling to get my samples. MannKind has sent me a list of a few local doctors that have samples. They are not close and I need to bring them a script from my Dr which I am getting. But it’s been so frustrating.

[Chris]

Sorry this isn’t easy. Nothing it seems around diabetes is as easy as you want it to be.