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This article is about Ginger’s experience using inhaled insulin and is intended to give a firsthand perspective on a product about which many members of our community have asked for more information. This article is not published as part of any partnership, and it is not medical advice. Please consult with your healthcare provider before making any changes to your medications.
Can you imagine using insulin that doesn’t require an injection or an infusion site? An insulin that corrects high blood sugars in less than 90 minutes, landing gently in your target range? And it’s out of your system just in time for your 3-mile run or afternoon dog walk?
It sounds too good to be true, but it’s real. And yet so many people with type 1 diabetes are still skeptical and reluctant to try it. I’m sharing why I love Mannkind’s inhaled insulin—Afrezza—so darn much because it truly lightens the day-to-day burden that comes with taking injected rapid-acting insulin all day long.
And I think you might really like Afrezza, too.
What is Afrezza?
Administered through your mouth, Afrezza is an inhaled insulin that enters your bloodstream through the cells in your lungs. Afrezza is the only inhaled insulin on the market. It was FDA-approved in 2014 and had a lot of work to do to repair the reputation of its predecessor—Exubera. (Exubera came out in 2006 and it was a massive failure.)
Afrezza is not Exubera. Afrezza struggled to gain traction at first, but it is becoming increasingly popular amongst people with type 1 and type 2 diabetes for a variety of reasons.
Of course, everyone reacts differently to any medication. The following statements are from my personal experience using Afrezza inhaled insulin for the past year:
- It’s safe—and has been studied extensively.
- It’s very compact and easy to administer.
- It enters my bloodstream within a few minutes.
- It starts noticeably affecting my blood sugar within 15 minutes.
- The smallest dose is out of my system within 60 to 90 minutes.
- The next largest dose is out of my system within 90 minutes.
- It doesn’t require precise carbohydrate counting! Seriously!
- It doesn’t require pre-bolusing for a meal because it acts so fast.
- It can replace most of my rapid-acting insulin needs for meals and corrections.
- Please note: Afrezza cannot replace your background insulin needs.
At the end of the day, using Afrezza has changed the daily game of managing my blood sugar. I honestly cannot imagine having to go back to taking rapid-acting injections. If Afrezza were no longer available tomorrow, I would cry. A lot. I would be furious and heartbroken—because I love what it’s done to my daily life with this disease.
Using Afrezza has been truly freeing. It provides freedom from the worry about low blood sugars and the frustration of high blood sugars. Allow me to elaborate.
How Afrezza changes my day-to-day experience of type 1 diabetes
A few of the things it has specifically changed in my day-to-day life with type 1 diabetes:
- I have far less anxiety or frustration about high blood sugars—because I can correct them back to 100 mg/dL within an hour in most cases.
- I can seriously correct a blood sugar of 225 mg/dL within 60 minutes, landing at 100 mg/dL without any worry of crashing. There is no need to “rage bolus” because I have a tool to correct highs so quickly.
- I have far fewer low blood sugars during daily jogs and dog walks because I don’t have mealtime boluses of Novolog/Humalog active in my bloodstream for 4 hours after eating.
- Instead, Afrezza is out of my system within 90 minutes, making it easy to plan my daily exercise for when I have only background insulin active in my bloodstream.
- I have zero anxiety of timing insulin with my meals because even if I forget to dose while I’m eating, Afrezza is so darn fast that I can stop a rising blood sugar level within 15 minutes.
- Low blood sugars from getting too much Afrezza aren’t very scary because I know that it’ll be out of my system within 60 to 90 minutes depending on the size of the dose. When the click hits that mark, it’s simply out. This means most low blood sugars require tiny amounts of carbohydrates and don’t take an hour to recover from. These lows don’t come with unbearable hunger or the urge to overeat. They just get over with quickly.
- I enjoy the freedom of not having to take 6+ injections or wear an infusion site in my skin.
- It’s easy to take in the middle of a grocery store, on an airplane, in a restaurant—wherever. I don’t have to find a patch of skin to inject into by pulling down the edge of my jeans or peeling off a thick jacket in the middle of Vermont winter. Afrezza is just easy to take—anywhere and everywhere. Is it noticeable? Sure. It’s not silent when you inhale. But it’s easy.
Learning how to use Afrezza certainly involves a bit of a learning curve, but all you need is an open mind and some sensible caution as you learn how to make it work for you.
The first month is definitely a science experiment—I tried to use as little Novolog as possible in an effort to see how much Afrezza could cover my mealtime and correction insulin needs. The next few months, I started experimenting carefully with taking Novolog for slow-digesting meals or when I needed a teeny dose (like a ½ unit) for dawn phenomenon hormones or minor corrections.
How to get Afrezza
Don’t let your doctor dismiss your request with something like, “Oh, no, you don’t want that, it’s bad for your lungs.” That’s the reputation of Exubera inhaled insulin clouding their memory.
They might also tell you it’s only for people with type 2 diabetes. It’s not. It works wonderfully in type 1 diabetes!
My experience of getting Afrezza started with an agreeable and open-minded doctor. He’d never had a patient use it, but he listened to me and wrote the prescription.
Once you have a thoughtful and willing doctor, follow the directions detailed here on getting Afrezza. MannKind has a fantastic patient assistance program for those who cannot get insurance coverage or have no insurance. Their customer service is top-notch! Give them a call before you start the journey of getting insurance approval—they will help you make it happen!
Give it a try
I’ve lived with type 1 diabetes for almost a quarter of a century! Using Afrezza halfway through “year 22” of this disease was like a breath of fresh air. It’s just different in a variety of ways that I mostly appreciate immensely. (And I’m the kind of person who resisted switching from cassette tapes to CDs because I didn’t want to give up my Rocky III soundtrack. I’m stubborn! If I’m open to new things, you can be, too!)
Before I started using Afrezza, my A1c was 6.1%. After about 9 months of Afrezza, my A1c was 5.7%. I don’t obsess over perfect blood sugar. I eat chocolate daily—and not the dark kind, I mean Hershey’s kisses. The only difference I made was that I started using Afrezza and I was able to keep my blood sugar under 160 mg/dL for a huge majority of the day.
Read more about Afrezza here:
I know some people on pump who still use Afrezza to correct high blood sugars.
If you were to ditch the pump altogether, your healthcare team would help you choose a long-acting insulin (Lantus, Tresiba, Basaglar) and fine-tune the best dose for your body’s needs. Then you’d use Afrezza for all meals and corrections. It’s really a trade-off of what kind of “diabetes work” you prefer: dosing via buttons or dosing via Afrezza/some injections. I still use Novolog 1-2 times per day for slow-digesting meals (like my protein smoothie) or tiny corrections where I only need a 1/2 unit.
Thank you sharing. Curious as to your handling of high protein (e.g., tuna sandwich; fish) or high fat (e.g., protein) meals where (in my case) BS kicks up after 90 minutes (protein) or 3 hours (high fat). Blessings!
There are a few ways I approach this:
1. For slow-digesting small meals (like my protein smoothie), I just take a small dose of Novolog and do not use Afrezza at all (unless I was high before I started eating).
2. For a treat like pizza or cupcakes or tacos, I would take Afrezza while eating + a small dose of Novolog for the slow digestion + potentially another dose of Afrezza 90 minutes later.
3. If I’m eating a slow digesting meal right before bed (cake, homemade cookies etc.) then I definitely take Afrezza while eating + a dose of Novolog to manage my BG while I’m asleep.
Some people just take more Afrezza after the first dose is out. I like to have a little Novolog on board to help prevent any spike if I forget/miss the timing with that second dose. But again, since Afrezza is so fast, I just don’t worry about rising BGs as much from more basic meals because I can turn it around SO fast with Afrezza. With those REALLY high-carb/high-fat meals (like pizza), I like have NOvolog in the background of Afrezza to help manage the slower impact.
My A1c Dropped from 6.1 to 5.7% Using Inhaled Insulin: Ginger’s Story Cancel reply
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I use a pump. So with inhaled insulin, I would have to give up my pump and start injecting long acting insulin again? Can you tell me about managing that? I am also in year 22 of my diagnosis. Was LADA at 42 and I’m 64 now. Thank you for the follow up.