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Post by dmb247 on Mar 17, 2015 15:22:46 GMT -5
dmb, surely you know far better than I, but please consider telling your doc what you're doing, all that mixing and matching strikes me as worth discussing with a good doc. Good luck. I must respectfully disagree with you. The combinations that I have used/am using are very commonplace. Lantus/Humalog, Lantus/Humalog/Afrezza/, Lantus/Afrezza/Metformin, etc, etc. If I was taking a sulfonyulrea with these combos, there might be cause for concern. I firmly believe it is MY responsibility to get my blood sugars in check, and my Dr's responsibility to give me the tools that I need to do just that. When I need to talk to my doctor, which is a routine appt next month, I will. Until then, I check my BG 10-15 times per day. I know what's happening with my numbers better than anyone, even my doctor. No one knows better than me right now. if I was listening to my Dr, I would be taking 60U of Humalog at one time (per the dosing on the Rx box) and 18U of Lantus a day. That's obviously stupid. My doctor knows that I know what I am doing, that I am responsible, and I'm not going to try anything that might hurt myself. He was fine with me figuring out dosing on my own, and even gave me Novolog sample pens to use until I was able to get my Afrezza a few days later.
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Post by babaoriley on Mar 17, 2015 16:19:29 GMT -5
Godspeed, dmb!!
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Post by BlueCat on Mar 17, 2015 17:59:47 GMT -5
Just on a lark, dmb - are you filling your scripts through the same pharm?
I ask because while you navigate between the scripts and established combos, as Afrezza is new, should a contraindication suddenly get identified, the pharm computer **should** alert you to it .... possibly much faster than the next visit to the Doc.
This in fact, would be a good idea for any user of a new drug! Though I wouldn't necessarily count on it ....
Good luck - and glad to hear you were able to enjoy that mecca of FAST - the Bell!
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Post by dmb247 on Mar 17, 2015 18:07:40 GMT -5
Lol.. Nope. My pharmacy never notifies me of anything. I filled 120 tablets of Metformin the day after filling 120 of Janumet. i thought for sure they would say something... not a thing lol. And yeah, it's all at the same pharmacy.
But I know how to mix and match. I practically tell my doctors what to treat me with lol.
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Post by dmb247 on May 5, 2015 23:54:09 GMT -5
Hello all. It's been a while! Just thought I would come post that I am now super stable (Using Humalog and Lantus only), and my Dr. also managed to get me a Dexcom. The force is truly with that man. I have no idea how he got my insurance who I was told never gives T2s CGMs one just a few days after I asked my medical supply company about it. I just thought I would post here that I haven't been using Afrezza at all the last month or so. Partly because Humalog is just so much more potent, and me being as resistant as I am (1:3 breakfast, 1:4 lunch, 1:5 dinner), I have to take 3-4 cartridges of afrezza sometimes when a simple shot will do. That along with the breathing difficulties swayed me away from ever considering Afrezza as my main meal time insulin. For me, the potency, and by that I mean the duration of Humalog, being longer actually helps me rather than do harm. I've only gotten low 2-3 times and I just drank some chocolate milk and all was well. Tomorrow I am going to use Afrezza all day. I am going to eat Mexican for lunch and I will compare my last graph eating this same meal with Humalog, to using it with Afrezza. I'll likely need 5 of the 8U Afrezza cartridges. 3 to start the meal, then 2 around the 2 hour post meal mark to combat a sure 3 hour post meal spike that ALWAYS occurs when I eat this meal. Here is my graph since I got my Dexcom 13 days ago. I wish I could say it was using Afrezza, but sadly I don't think that will ever be the case. Nonetheless, I still want to test it for fun. Will post results tomorrow.
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Post by liane on May 6, 2015 4:25:39 GMT -5
dmb,
I can't recall if you have posted more about your Afrezza trial, but have you been able to use it (even at a very high dose) for any length of time? I guess I'm wondering if you were able to tolerate it for say a week or more and if you noticed any changes in FBG. Now that you have a CGM, maybe you can experiment more in real time.
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Post by dmb247 on May 6, 2015 13:58:45 GMT -5
This entire thread was about my Afrezza use . I was just dropping back in to say hello. Since I know what to expect from RAAs now, it makes it easier to truly test Afrezza, at high doses, to see how it really compares with my use of Humalog. I am eating a Mexican meal that I normally dose around 25U of Humalog for when I start eating, and another 10U about 2hrs later to stop the hour 3 spike that always happens with this meal. I took 24U Afrezza at start, and I'm going to take 16more at the 2 hour mark and compare it to a chart my last time eating this meal.
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Post by babaoriley on May 6, 2015 18:53:57 GMT -5
Hey, dmb, I'm curious as to what this Mexican meal consists of and just how large a meal it is.
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Post by rockstarrick on May 6, 2015 19:39:30 GMT -5
So, admittedly, I haven't been super impressed with Afrezza. I am happy with it, but not with the 4U cartridges and needing to take so many to achieve the desired result. I was also not happy with the cough and constriction I felt after using Afrezza the first couple of days, but I stuck with it, and that improved drastically. I'm 6 days in, and I've used over half of my months supply due to my Dr. prescribing one 4-unit box, not being aware of my needs. That is not his fault, however. As long as he updates the Rx for me when I send him in my numbers later this week, all is good. Anyways, today I did a real test. I had about 75 carb lunch, and decided to take more than the previous maximum 3 that I've done at one time. My I:C is 1:4, so on Novolog I would need around 18units. On Afrezza, I took 20. At one hour I was at 130, and 1.5 hours 107. These are extraordinary results for me. I can't wait until the 12U carts come out this summer! If you don't mind, are you type 1 or type 2. I have a friend, type 2, who is starting tonight, I was hoping somebody could share how they went about getting started. How long before the meal to take Afrezza, and anything you could think of that may be helpful. Thanks
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Post by lynn on May 6, 2015 20:12:06 GMT -5
Ummm RSR , We do have Spiro here , why don't you ask him ? No offense but he has his own thread . He's our Type 2 Afrezza Super Star
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Post by mnholdem on May 6, 2015 21:16:53 GMT -5
Interesting thread on the complexity of controlling this disease. Thanks, dmb247. Your remark, "because Humalog is just so much more potent, and me being as resistant as I am (1:3 breakfast, 1:4 lunch, 1:5 dinner), I have to take 3-4 cartridges of afrezza sometimes when a simple shot will do" caused me to wonder if you have heard of at least two early adopters who are posting that continuous use of Afrezza is lowering their insulin resistance.
Something to think about. If that proves out to be one of the benefits of Afrezza, it would be an extremely important development.
Again, thank you. I wish you all the best.
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Post by dmb247 on May 6, 2015 22:00:56 GMT -5
So, admittedly, I haven't been super impressed with Afrezza. I am happy with it, but not with the 4U cartridges and needing to take so many to achieve the desired result. I was also not happy with the cough and constriction I felt after using Afrezza the first couple of days, but I stuck with it, and that improved drastically. I'm 6 days in, and I've used over half of my months supply due to my Dr. prescribing one 4-unit box, not being aware of my needs. That is not his fault, however. As long as he updates the Rx for me when I send him in my numbers later this week, all is good. Anyways, today I did a real test. I had about 75 carb lunch, and decided to take more than the previous maximum 3 that I've done at one time. My I:C is 1:4, so on Novolog I would need around 18units. On Afrezza, I took 20. At one hour I was at 130, and 1.5 hours 107. These are extraordinary results for me. I can't wait until the 12U carts come out this summer! If you don't mind, are you type 1 or type 2. I have a friend, type 2, who is starting tonight, I was hoping somebody could share how they went about getting started. How long before the meal to take Afrezza, and anything you could think of that may be helpful. Thanks First off your friend needs to understand how his body reacts to insulin. The only way to do this is test, test, test. Test before the meal, at 45 mins, at 1 hr, at 1.5 hrs, at 2 hrs, at 3hrs after meal and learn what varying levels of carbs do to his body. That is the only way to know. If your friend suffers much insulin resistance, as most T2s do, then Afrezza might not be that great a choice for him. If however he is a T1 or a T2 with little resistance, then I think Afrezza will work quite well for him. I take Afrezza at start or a few minutes into the meal. It just depends if where BGs are pre meal. Your friend will need to do a lot of testing to figure out all this on his own.
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Post by dmb247 on May 6, 2015 22:22:21 GMT -5
It's a large meal. I eat it rarely, but I wanted to do a test today, so this is my go to test meal. Tortilla chips and salsa. Serving of Spansh Rice and refried beans topped with queso, and a tortilla filled with seasoned chicken and held together with a slice of bell pepper, also topped with queso. It's a massive meal. And Afrezza didn't do well at all for me today. I took 3 8U carts, did well for the first hour, then at 1.5 hrs I saw the line trending up, so I took 2 more 8Us, and just kept rising to the point that I said screw this, I'm taking Humalog. I took 6U of Humalog and stabilized and started going down a little about 45 mins later. But not by a lot. Shortly thereafter I ate dinner, 7:30pm, dosed 8U Humalog for my meal, and another 8U to get me back to 100. Thus I didn't come back down to around 100 until right after 9pm 1-2 cartridges is fine, but 5 in that time span did a number on my lungs. I just can't handle inhaling that much, and then not having it work very well either. Had I used Humalog for this meal, I would have spiked higher than I like around 140ish, went down, then started going up again around hour 3, but not very much as long as I took a 2nd dose at 1.5-2 hours post meal. Mexican is difficult to dose for, but obviously, for me, Afrezza just doesn't work as well, which is unfortunate because I had the highest of hopes for this stuff. I still see a lot of use for it, and I want my T1 friend to get a CGM and start using it as well. This was my graph today. Note that had I not taken the Humalog around 4PM, I would have shot up above 200 for sure. Obviously, it's not what you all want to see, but it's what happens for me
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Post by mnkdd on May 6, 2015 22:28:58 GMT -5
Do you think being asthmatic has something to do with your results?
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Post by dmb247 on May 6, 2015 22:38:13 GMT -5
Do you think being asthmatic has something to do with your results? I couldn't count it out, but it's doubtful. It reacts this way even when using an inhaler before. It works the same either way. In fact, I don't even need an inhaler with 1-2 cartridges. I got used to it. But for anything more, it just feels unnatural. I am really curious to see what lung impact studies will show in the future. I was one of those that thought lung issues from Afrezza wouldn't be an issue but after using it, I am not so sure. Time will tell.
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