All about Afrezza – everything you need to know about inhaled insulin

Processed with RNI Films. Preset 'Fuji FP 100C v.4'If you have been following along on my Instagram (@icedcoffeeandinsulin), you may have seen me talk about Afrezza. Now, what is inhaled insulin, and how can it become apart of your diabetes routine?

Here is the website’s official tagline on http://www.afrezza.com.

“INSULIN YOU INHALE AT THE BEGINNING OF YOUR MEAL.

Afrezza is the only rapid acting insulin available that can be inhaled. Other mealtime insulin options are delivered through injection. Afrezza can potentially save you about 1,000 needle sticks per year.”

Afrezza Lungs Inhaler2

Here are a few key highlights of the insulin below.

  • Inhaled, not injected.
  • Fast-acting insulin (think of an alternative to Novalog/Humalog)
  • Works instantly, so it can be taken immediately at the start of eating a meal/snacks
  • Only comes in 4 unit, 8 unit, and 12 unit cartridges…BUT important to note that these units to not equal what you would dose for Novalog and Humalog
    • Example: 4 units of Afrezza = 2.5 units of Novalog, 8 units of Afrezza = 4 units of Novalog
  • The cartridges are placed in a chamber within the small inhaler, and then inhaled through the mouth.

How do I use Afrezza in my insulin regiment?

I have used Afrezza when I was on an Omnipod (from February 2018 – November 2018) as well as with [MDI] Multiple Daily Injections (November 2018 – Present).

On a pump, I was using Afrezza in specific situations.  If I was eating a high-carb meal, or having a stubborn high blood sugar, I would use the Afrezza to complement the Novalog corrections on the Omnipod.

Before Afrezza, I was finding myself stuck in the 200s, and constantly adding more and more Novalog to lower my blood sugar. This was where I was running into problems with correcting with Novalog. It would either…

  •  Not work AT ALL
  • Work slowly, stay in my body for so long that I couldn’t work out/do physical activity for hours without crashing
  • I would continue to correct and correct, stacking my insulin until I saw some change in blood sugar…and then I would be in an downward spiral of lows, correcting, etc.

I was so frustrated, and my endo recommended Afrezza as a solution. From there, Afrezza has changed everything for me.

It worked quickly and efficiently. I had never seen my blood sugar fall so quickly, and it was in and out of my system so fast that I never experienced dangerous lows. The insulin covered what it needed, and was out of my body soon. It immediately corrected stubborn highs and instances where I was about to eat a high-carb meal.

Soon, I was using Afrezza as my only form of fast-acting insulin. I was only using my pump for the Basal settings (constant flow of insulin throughout the day), and relying on Afrezza for my Bolus (fast-acting insulin used for meal-time, corrections, etc.).

My success with Afrezza was one of the key reasons that I decided to go off of my insulin pump and return to MDI. With how I was using Afrezza, there was no point (in my opinion) to have a pump latched on my arm for strictly Basal settings.

Currently, I am on Multiple daily injections. I use Afrezza for all of my fast-acting insulin needs, and Lantus (split dosage twice a day) for my long-acting needs. I am currently in the process of changing from Lantus to Tresiba, which I have heard works better (with less insulin).

If you are considering Afrezza as an option within your current insulin regime, I strongly suggest connecting with your endocrinologist to discuss how it would benefit you and your routine. If you are still wondering more, here are my top pro’s and con’s of Afrezza.

PROS

  • Less injections. I only take 2 injections per day (2 doses of Lantus).
  • It looks like an inhaler, so it’s not this daunting needle that you have to pull out.
    • The inhaler is so small, that the “embarassment” factor goes away here. People think that its an inhaler for asthma, and even a type of vape or tobacco pen! Haha!!
  • FAST. I have never had to “insulin stack” with Afrezza. I take the puff and know that my BS will go down.

CONS

  • Expensive.
    • I currently have a copay of 50+ for a 3 month supply (which is pennies for other medicines), but it will depend on the type of insurance that you have. Many insurances don’t cover it.
  • You have to inhale it properly, or it won’t work.
    • You have to inhale the insulin at a specific angle for the insulin to properly go through your system. If I’m rushing, the insulin doesn’t go into my system and I have to redo it.
  • You have to take double dosages for super high-carb meals.
    • Because the insulin works so rapidly, and is in and out of the body in a short amount of time, I find myself having to take an initial Afrezza dose, and then taking a second dose 30 minutes to an hour later. This isn’t necessarily a “con”, but it’s something to think about.

In conclusion, I would highly recommend Afrezza. If you are experiencing difficulties with stubborn highs and find yourself “stacking” your bolus to correct, Afrezza might be the perfect solution for you. Bring it up at your next endocrinology appointment!

As always, don’t hesitate to comment here or DM me on Instagram if you have any further questions about Afrezza. I’m happy to answer them 🙂