I follow all of the instructions, doing all of the math calculations and carb counting and I just can’t seem to have control of my numbers.
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Best strategy for me was to forget everything you’ve ever known about carb counting and all of that. Consider the doses as small, medium and large and pick the one that corresponds to your meal. Focus on timing more than dose. You will need more “units” of afrezza than you will of injected bolus. Forget that they’re called “units” they’re not the same thing it’s unfornate that the fda required them to be called “units”
Your body doesn’t measure its needed insulin in “units.” That’s just a necessary tool they developed for how to measure liquid insulin. It does not apply well to regular insulin absorbing quickly into the bloodstream like afrezza.
To do well with afrezza requires breaking free of the box we’re taught to think inside with injected insulin.
I don’t dose with afrezza until after I eat, sometimes well after with fatty foods… sooner with more simple carbs.
With slow digesting foods it’s not uncommon to require a follow up dose after about 2 hours
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Hi @sturonasbrown! I’m also new to Afrezza and have spent some time thinking about the dosing. I definitely agree with @Sam’s response, but what kind of problems are you running into? When you say you just can’t get control, does that means lows? Highs? Both?
Also, is Afrezza your only insulin, or do you do other kinds of boluses? I ask because I’ve learned how to use Afrezza as a supplement to my pump boluses in order to get better coverage. I’m just curious what you’re current arrangement is and also what type of control you feel you had prior to starting Afrezza. So a whole lot of borderline personal questions. 
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Hi, Nickyghaleb.
I am on Afrezza only as my short acting and Tresiba for long acting. No pump but I do have a CGM, which is a godsend. For example, I will carefully calculate my carbs I am about to eat. I go through the supplemental dose first and then for the meal. I’ve read an article to wait 10 minutes to take Afrezza after starting my meal. My numbers usually rise. I’ve even tested it by eating the exact same meal. I’m also frustrated that they don’t make 2 unit cartridges. I’m having to redose after my initial but sometimes 4 units is too much. Do you ever have to redose after your initial meal dose and how long do you wait to redose?
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Try not carb counting… waiting for your cgm to start showing a rise… then if still elevated or rising after 2 hours take an additional dose… gotta let go of the carb counting thing to have success with afrezza. It’s a necessary evil with liquid insulin for a totally useless concept with afrezza… try only carb counting to the extent of “this is a small, medium, or large amount of carbs for me”
It’s almost like the less you try the better results you’ll get… it’s crazy
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I would mirror Sam’s advice and he was a great help to me when I started. I would add that I split cartridges almost all the time and I have posted videos and tools so you can search for those. If not I can resend them. I almost always do a follow up dose due to gastroparesis. I monitor my cgm for the timing but it almost always is about 1 hour after the first dose. That’s where the split 2u cartridge comes in for me.
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They make 2 unit cartridges??
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No they don’t make 2u cartridges, but if you search for Jattzl’s posts, you will see links to video’s on how to make your own.
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Here is the YouTube on Splitting cartridges.
I split 12u’s into 4 3u’s and then yellow are always my 3u cartridges. I split 8u’s into 4 2u’s and then greens are always my 2u cartridges. I use the 4u as they are.
I have found for me the dosing with Afreeza is mostly based on timing, my BG at the time and what the food is that I’m eating rather than the old carb ratio/carb counting.
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