Do you know that inhaled insulin is commercially accessible 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 couple of years now and on this article, I’ll offer you 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 totally different from different rapid-acting insulins
Afrezza is a rapid-acting insulin much like the rapid-acting insulins you inject (Apidra, Humalog or Novolog), however you inhale it somewhat 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 means of the lungs and straight into the bloodstream, which implies that the insulin begins to work considerably sooner 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.
Dosing Afrezza
One other means Afrezza is totally different from injected rapid-acting insulin is that it is available in set doses of 4, 8, and 12 items. Once 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 items will not be the identical because the items for injected insulin. One unit of injected rapid-acting insulin is identical as about 1.5 items of Afrezza, which implies that the smallest Afrezza cartridge (4 items) equals about 2.6 items of injected rapid-acting insulin.
Potential uncomfortable side effects
Afrezza has the identical potential uncomfortable side effects as injected insulin however shouldn’t be utilized by folks with sure lung issues, equivalent 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 uncomfortable side effects right here.
I haven’t skilled any persistent coughing from utilizing the product, however research present that 27% of individuals reported growing a cough from utilizing Afrezza.
Why I exploit inhaled insulin
I’ve used Afrezza for years alongside my basal insulin and injected rapid-acting insulin, and I discover that it’s sensible 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 stage and it appears that evidently it doesn’t matter what we do, it gained’t come down. Afrezza is a good answer 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’s going to lower your blood sugar is determined by your correction issue.
Be aware: I discovered that Afrezza would lower my blood sugar slightly extra aggressively the primary month or so after I began utilizing it. I’ve heard the identical from different customers, however it’s solely anecdotal data at this level since I haven’t seen any knowledge to help it.
One other state of affairs the place I actually respect getting access to Afrezza is after 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 after I eat earlier than doing cardio because it’s out of the physique in 90 minutes. Sadly, the truth that Afrezza solely is available in mounted doses implies that I hardly ever have entry to the suitable dose and I’ve to stay with injected insulin.
One other commentary I’ve made is that the impact of Afrezza appears to get intensified much more by train than common rapid-acting insulin. Which means I’m very cautious if I’ve to do any kind of train inside a 90-minute window of inhaling Afrezza.
One of many first occasions I used Afrezza was to convey down a excessive blood sugar simply earlier than biking residence from having brunch. It made my blood sugar drop far 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 learn how to use Afrezza is a bit like studying a brand new language, and simply as we don’t at all times 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 attempting to say is that that is NOT the insulin that you just “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.
Apart from the occasional lows and restricted unit sizes, I feel it’s a superb product. It truly is a really efficient means of reducing blood sugars shortly
The best way to get Afrezza
Afrezza was accepted by the FDA in 2014 and is presently solely accessible in the US and some different nations. When you reside in the US, your physician can prescribe Afrezza simply as he/she will be able to prescribe another sort 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. When you don’t really feel comfy having that dialog, you’ll be able to at all times refer your physician to the Afrezza web site.
Earlier than prescribing Afrezza, your physician ought to do an FEV (pressured expiratory quantity) respiratory take a look at to realize an understanding of your lung perform. It’s a reasonably easy take a look at, you simply have to breathe right into a mouthpiece. Your physician ought to then have you ever carry out the take a look at once more after 6 months and yearly after that to make sure there’s no change to your lung perform.
Upon getting your prescription, you’ll choose up Afrezza on the pharmacy identical to you do with any of your different insulins.
When you have personal insurance coverage, Afrezza is most definitely lined because it’s accessible 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 be taught should you’re lined and what your co-pay is. Most individuals pay about $45 out-of-pocket per prescription, however that can, after all, fluctuate by plan.
I’d extremely suggest utilizing the Afrezza co-pay card. For me, it implies that my co-pay will get decreased to $15 per prescription, which makes Afrezza a really reasonably priced insulin possibility.