Do you know that inhaled insulin is commercially out there within the US and has been since 2014?! It’s in all probability one of many best-kept secrets and techniques within the diabetes neighborhood which, in my view, is a disgrace.
Afrezza has been part of my diabetes toolbox for a number of years now and on this article, I’ll provide you with an outline of what inhaled insulin is, the way it works, and why I’ve chosen to make use of it.
What’s Afrezza and the way is it completely different from different rapid-acting insulins
Afrezza is a rapid-acting insulin just like the rapid-acting insulins you inject (Apidra, Humalog or Novolog), however you inhale it fairly than inject it. Identical to the opposite rapid-acting insulins, it’s a mealtime insulin (bolus) so you continue to want one other background insulin within the type of long-acting insulin (basal).
Inhaled insulin passes by way of the lungs and straight into the bloodstream, which implies that the insulin begins to work considerably quicker than injected insulin. It’s so quick that it’ll seem within the bloodstream inside a minute of being inhaled and you’ll see the primary measurable impact in about 12 minutes.
As a result of it really works so shortly, it solely stays within the physique for about 90 minutes versus the 3-5 hours that injected rapid-acting insulin stays within the physique.
One other approach Afrezza is completely different from injected rapid-acting insulin is that it is available in set doses of 4, 8, and 12 models. While you obtain your Afrezza from the pharmacy, it comes with a set of inhalers and also you then choose the dose cartridge, load the inhaler, and inhale the entire dose.
The Afrezza models should not the identical because the models for injected insulin. One unit of injected rapid-acting insulin is identical as about 1.5 models of Afrezza, which implies that the smallest Afrezza cartridge (4 models) equals about 2.6 models of injected rapid-acting insulin.
Potential unintended effects
Afrezza has the identical potential unintended effects as injected insulin however shouldn’t be utilized by folks with sure lung issues, similar to COPD or bronchial asthma, or individuals who presently smoke or have stopped smoking within the final 6 months.
You’ll be able to learn extra in regards to the potential unintended effects right here.
I haven’t skilled any persistent coughing from utilizing the product, however research present that 27% of individuals reported creating a cough from utilizing Afrezza.
Why I take advantage of inhaled insulin
I’ve used Afrezza for years alongside my basal insulin and injected rapid-acting insulin, and I discover that it’s good for sure conditions.
I predominantly use Afrezza for resistant excessive blood sugars and higher-carb meals. Everyone knows these conditions the place our blood sugar is “caught” at a excessive degree and plainly it doesn’t matter what we do, it gained’t come down. Afrezza is a superb resolution for that.
If I’m caught at 200 mg/dl (~11 mmol/l) or above, I’ll attain for a 4-unit Afrezza cartridge and my blood sugar will get down into vary VERY shortly. A 4-unit cartridge drops me about 100 mg/dl (5.6 mmol/L) however how a lot it is going to lower your blood sugar will depend on your correction issue.
Notice: I discovered that Afrezza would lower my blood sugar somewhat extra aggressively the primary month or so after I began utilizing it. I’ve heard the identical from different customers, but it surely’s solely anecdotal info at this level since I haven’t seen any information to help it.
One other scenario the place I actually recognize gaining access to Afrezza is once I take pleasure in a higher-carb meal or a excessive glycemic meal. Since Afrezza hits the bloodstream so shortly, I don’t should pre-bolus for the carbs, and I discover it simpler to match the height of Afrezza to the meals than I do with injected rapid-acting insulin.
The way it interacts with train
I needed to make use of Afrezza once I eat earlier than doing cardio because it’s out of the physique in 90-minutes (bear in mind, having rapid-acting insulin lively within the physique throughout cardio will improve the danger of low blood sugar). Sadly, the truth that Afrezza solely is available in fastened doses implies that I hardly ever have entry to the suitable dose and I’ve to stay with injected insulin.
One other remark I’ve made is that the impact of Afrezza appears to get intensified much more by train than common rapid-acting insulin. Which means that I’m very cautious if I’ve to do any sort of train inside a 90-minute window of inhaling Afrezza.
One of many first occasions I used Afrezza was to carry down a excessive blood sugar simply earlier than biking house from having brunch. It made my blood sugar drop way more than I anticipated and I needed to cease after lower than 10 minutes on the bike to deal with a considerably low blood sugar.
Studying to make use of a brand new insulin
Studying use Afrezza is a bit like studying a brand new language, and simply as we don’t all the time get the doses proper for injected insulin, you gained’t get the dosing/timing proper each time for Afrezza both.
It takes time and a few trial-and-error to determine how a lot Afrezza to take, when to take it, and when NOT to take it.
And for full disclosure, I’ve had among the scariest low blood sugars of my life utilizing Afrezza. As a result of Afrezza is so efficient, having an excessive amount of on board can shortly lower blood sugars considerably. What I’m making an attempt to say is that that is NOT the insulin that you simply “rage bolus” with.
There are upsides and drawbacks to utilizing Afrezza and I nonetheless suggest utilizing it in the best way that’s best for you.
Other than the occasional lows and restricted unit sizes, I feel it’s a superb product. It truly is a really efficient approach of reducing blood sugars shortly
How you can get Afrezza
Afrezza was accredited by the FDA in 2014 and is presently solely out there in the US and some different nations. If you happen to reside in the US, your physician can prescribe Afrezza simply as he/she will be able to prescribe some other form of insulin.
Your physician may not find out about Afrezza and if that’s the case, you’ll want to teach and push for a prescription. If you happen to don’t really feel snug having that dialog, you possibly can all the time refer your physician to the Afrezza web site.
Earlier than prescribing Afrezza, your physician ought to do an FEV (compelled expiratory quantity) respiration check to achieve an understanding of your lung perform. It’s a reasonably easy check, you simply must breathe right into a mouthpiece. Your physician ought to then have you ever carry out the check once more after 6 months and yearly after that to make sure there’s no change to your lung perform.
After getting your prescription, you’ll choose up Afrezza on the pharmacy identical to you do with any of your different insulins.
When you’ve got personal insurance coverage, Afrezza is most certainly coated because it’s out there on 70% of personal insurance policy. It could be an thought to name your insurance coverage firm or learn up in your advantages plan to study when you’re coated and what your co-pay is. Most individuals pay about $45 out-of-pocket per prescription, however that can, in fact, differ by plan.
I’d extremely suggest utilizing the Afrezza co-pay card. For me, it implies that my co-pay will get lowered to $15 per prescription, which makes Afrezza a really inexpensive insulin possibility.