Jessica Ching, a long-time T1 and a whiz at all new D technology offered our adult T1 community as well as her Berkeley (CA) adult T1 group to participate in The Afrezza Challenge.  Sounded like fun and we could eat, indeed we were encouraged to eat a high carb breakfast!  Here’s Jessica’s report on the Afrezza Challenge and the results.

 

A series of experiences and observations led a small group of T1s to an Afrezza inhaled insulin challenge.

The background:  a coupe of us use a self-built Closed Loop Artificial Pancreas. However even with this amazing technology, T1 diabetes can still be a struggle.

The reason?  Insulin just works too slow and is often the weak link in diabetes management.  It takes around 90 minutes for Humalog/Novolog to hit peak strength, so it’s rare that food timing and insulin timing ever match.  As we know, that means blood sugars go high after eating.  And if you take a large dose of insulin up front or in advance, it is likely to drive you low in a couple of hours.

If you haven’t tried it, inhaled insulin is amazing.  Afrezza is available from Mannkind Corp.  It’s the company whose heaven-sent founder (the late Al Mann) also created the Minimed insulin pump. I think they are equally revolutionary.

Afrezza is human insulin (just like Humalog/Novolog) but in a powder form.  It comes in a pre-measured little cartridge and you take it by puffing it through a small “whistle.”  It starts to peak in around 20 minutes, which means that pasta dinners, donuts, desserts and other carbs can be eaten with much less penalty— not counting the “fatness” penalty from eating so many carbs!  But sometimes you just gotta do it; I use Afrezza on an occasional basis for higher carb meals/food, and for some corrections.

 

EXAMPLE 1 – Sugary Food

I had a meal replacement drink (41 carbs of sugar).  I inhaled just before I had the drink at 9am.  As a comparison, there were several of us drinking this drink and I think everyone went to 250+, except for one person who took her bolus 30 minutes in advance (but then had an ugly low 2 hours after).  Here was my result:

 

 

 

 

 

EXAMPLE 2 – Correction

I changed my CGM sensor and in 2 hours my BG went up to 259.  I inhaled Afrezza, and here was my result just 50 minutes later. Love love love the ability to come back to normal in such a short time!  Notice BG did not keep dropping:  

 

EXAMPLE 3 – Group Afrezza Challenge

After some experiments like Examples 1 & 2, a group of us got together recently to compare out BGs using Afrezza.  Six of us T1 girls met at a bakery cafe (plus a “T3″ spouse who was the non-diabetic comparison).  

Sunday morning cafe treats included a gluttonous assortment of pastries, muffins, bagels, oatmeal, and Belgian waffles.  Some took it to the limit and added a mocha to wash down the carbs.  No yucky sugar-free stuff; this was 100% the real deal.  

We ate.  We inhaled.  We were happy.

Here’s a summary table of results!

Overall results were very good, with a lot of desirable “green zone” readings and an average peak of 171 mg/dL.  This is notable because it would be hard to max out eating bakery food at only 171 mg/dL on Novo/Humalog without a low several hours later.  (Afrezza has no ‘tail’  as it’s a short duration of insulin).  The most successful T1 did as well as the non-diabetic control guy!  How awesome is that?? 

Carbs consumed ranged from a mere 50 carbs to a motherlode of 190 carbs.  In one sitting.  Most of us normally do not indulge with such gusto, but as one person said, “thanks for the opportunity to eat a bagel!”

Our challenge really highlights the value of having inhaled insulin on hand for a high carb meal (or a correction, with very quick results).  Hope you all get the chance to try it and maybe even keep it in your diabetes tool kit.  As you can see from my examples 1 & 2, you may get even better Afrezza results with practice.

See the data charts from the OC (Orange County, CA) Afrezza Challenge:

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