Maybe it’s just because I now have the Libre, so I’m seeing BG movement sooner and am more confident giving multiple corrections, but it also does seem like I’m having to use a lot of Afrezza to keep BG relatively in check whenever I stray from my usual diet.
Tonight, I ate turkey, boudin (only 1/2, but sooo worth it), veggies and hummus, and chips n salsa. Also ate a small cookie (my friend’s 7yo daughter made them - how could I resist?). 16u’s Afrezza and .5u Novolog later, and I’m still at the top of my range. Yes, I only went up to 180s, so not that bad, but spiking from a pre-meal in the 80s, I’d much rather it have been lower. I’ve been relying on Afrezza pretty heavily of late because I have been eating things that are difficult to count carbs, or don’t have time to pre-bolus because I’m busy with the kids, etc, and I feel like I’m spiking more than usual and having to do corrections more often. I’m ready to switch back to carb counting/using Novolog and just having Afrezza for corrections/eating out (which lately has also been disastrous). And go back to eating minimal/no grains (tortilla chips are so bad, but so good! ). Just not sure what/if I should change anything about how I’m dosing the Afrezza.
It seems that if you’re taking follow up doses of afrezza the .5u of novolog really isn’t likely adding much, if anything to the equation… for me the idea of mixing the two is to have a longer bolus coverage, because as the afrezza is wearing off the novolog is just getting up to speed, so If I know I’m going to take a secondary dose of afrezza after some length of time (or more) then the novolog really has no point… and I’d think based on the amount af afrezza you take that .5u of novolog isn’t likely adding much to the equation…
That said, yes I have noticed periods of needing to use a lot more afrezza. As with everything else with this juggling act there are a lot of variables… a big one with afrezza is how much fat you’re eating, it slows down digestion tremendously, so you’ll need more short bursts of bolus like afrezza provides if you’re trying to cover high fat meals with afrezza. Another big one, for me, is my overall physical activity level… when I’m generally sedentary for more than a few days I end up needing more insulin of all sorts…
Ha, yeah, I did the Novolog dose because I thought my BG had peaked and only wanted to bring it down a tad, as my Novolog corrections have been very unpredictable lately, so didn’t want to overdo (1 unit used to consistently drop me ~60; now it’s anywhere from 30-100, or sometimes more if my pancreas kicks in belatedly to “help”). Once I realized it was going up again, I decided to do the 4u Afrezza because, well, I was getting frustrated and didn’t want to have to stay up late making sure more Novolog didn’t send me low.
The last time I had to do a ton of boluses of Afrezza was a very fatty meal, which I understood being behind a sustained, stubborn high BG. This meal didn’t seem overly fatty - pretty much the only source of fat was the boudin, and I ate very little compared to everything else, so it surprised me that my BG kept going up as the Afrezza wore off. Live and learn…and yes, my activity level has been really haphazard lately due to being up and down with other health issues. Didn’t consider that.
And the hummus? The way I make it there’s lots of oily tahini in there. For me hummus is a slow carb.