Thursday, May 24, 2018

What I Learned About Afrezza

At the end of April, I attended a meeting with Mannkind, the company who manufactures the inhaled insulin, Afrezza, with a small group of Diabetes Advocates and .Orgs at their HQ in Danbury, Connecticut. There we had the opportunity to meet with senior members of the company, including engineers and scientists and discuss Afrezza and Social Media.
I went in not knowing much about Afrezza, but was curious to learn all I could. 
I have friends (both on the pump and MDI,) who are fiercely loyal to Afrezza and I’d tried it once with positive results - more on that later. 
I went in with an open mind and hoping for another diabetes option for us.
Here’s what I found out. 
Afrezza is a crystallized, inhaled, powdered form of Regular insulin that works quickly via the lungs and the bloodstream and is used for mealtime dosing.

Afrezza works fast - as in wicked fast. As in it starts working in 3 to 7 minutes, reaches its peak in 30 minutes, and out of your system within 1 to 2 hours. 
Basically, the short time in the system helps to prevent low blood sugar hangovers - my words, not Afrezza’s. 

Other short acting insulins (Apidra Novolog, Humalog), take 20 plus minutes before they start to kick in.
WHY? Because being injected through skin has a slower turnaround time than inhaling.
Injectable insulins peak in 2 hours and exit the body somewhere between 4 and 7 hours.

As far as the Billing Code, Afrezza uses the same billing code as an insulin pump - so check your Durable Medical Equipment clauses in your insurance policy. 

FYI: Exercise activates Afrezza.

Clinical Trials
Clinical trials for Afrezza have shown no evidence of long term lung 
damage to patients. Our group was told that the reason why people have lung tests be
fore starting Afrezza is to rule out any unknown/underlying lung issues like COPD. 

Bitch Lows and preventing them 
Afrezza has been shown to reduce severe hypos by more than 30%. THAT"S BIG.
Dosing: Afrezza inhalable insulins are currently available in packs of 4, 8,12. 
Afrezza’s unit amounts differ from injectable insulin units -HealthCare Pro's help 
with the learning curve.
Friends who use Afrezza say it wasn’t difficult to get with the Afrezza program.
User Breakdown
Afrezza users are evenly divided into type1s - some of whom combine Afrezza with 
using their insulin pump. Using their pump for basal rates/correction boluses and 
dosing Afrezza for meals.  
The other 50% are type 2s.
Some users on both sides of the diabetes fence have experienced weight loss. 
Sidebar: There is currently no info re: LADA1.5 users at this time.

Is there a Patient Assistance Program? 
YEP. Go to Mannkind Cares Start Out Program and here's the link to the Patient Savings Card.

My Own Experience with Afrezza
My one experience with Afrezza was 3 years ago and it was a positive one. 
I was attending the Diabetes UnConference in Atlantic City and was out with some Diabetes Online Community friends who came to town early the night before the conference began. 
After copious amounts of Crab Nachos and bolusing multiple times - I could tell something was wrong. My numbers kept going up - even with an increased temporary basal rate of 40%. 
It turned out that my Medtronic infusion site had crapped out.
I had another infusion set with me, but low and behold that new site didn’t work either.

Yep, I was screwed. My blood sugar was well over 300 and I felt it.
I had two choices: Go back to the hotel a few miles down the boardwalk and change out my site, or take my friend M’s advice and try his 4 unit Afrezza and inhaler.  
I went with the Afrezza, inhaled, and 2.5 hours later (plus 1/4 of a turkey club,) my blood sugar was 167 - and I was happy.  

Closing Thoughts
I was impressed with what I learned about Afrezza, and while I don't want to give up my Omnipod, I would consider using Afrezza with my Omnipod therapy - and I'm going to discuss that with my Endo at my next appointment.
Also: Your diabetes is different from mine and collectively, people with diabetes need as many viable and beneficial diabetes options on the table as we can get!
Afrezza is an option. 

Disclosure – My expenses including travel, food, and lodging were covered by Mannkind,  and I was paid an honorarium - which I appreciated. 
With that being said, all thoughts are my own and I was not asked to write about Afrezza - but I did because I wanted to share what I learned with you - and now you know ~ 

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