Last week we made mention of a new series, Afrezza in the Real World, that will share the views of various folks now taking this new inhalable insulin from MannKind and Sanofi.
(Speaking of Afrezza news: the FDA just approved 12-unit cartridges of Afrezza in addition to 4 and 8-unit cartridges.)
Today we're excited to kick off these patient testimonies by featuring Brian Sharp , in Oregon City, OR, who describes himself as: Dad, Pilot, Diver, Trouble Maker and Type 1 Diabetic Afrezza user. Here is his story:
A Guest Post by Brian Sharp
I was a very thirsty 30-year-old male, pilot, diver, working in a factory manufacturing bike frames. Life wasn’t easy, but it wasn’t hard either. I had only heard the word “Diabetes” in passing from time to time. I never paid attention to what it was.
As the thirst increasingly got worse, I decided to get it checked. I was sent from an urgent care to the emergency ward of a diabetes care center. In just one short day I learned that I was a diabetic, and I was no longer a pilot. I was crushed.
Over the last 16 years I have constantly struggled with my type 1 diabetes. When I was hospitalized I learned I was needle-phobic. Every day, every shot has been a struggle. My A1C’s reflected my hatred of shots with numbers over 12%.
One day I heard that the first inhaled insulin Exubera was in clinical trials. I started using it as soon as it was launched. It was a big inhalation device that many people made fun of, it did however work fairly well. I noticed a big benefit to inhaling insulin. I could just throw it in the car and go. It was easy to use and convenient. I could now take insulin, eat, test, and take more insulin, and so on, as often as needed to keep my BG in check. For the first time I was able to lower my A1C to around 8, but Exubera was pulled from the market due to lack of sales. My wife secured a large supply the last week they sold it, so I was able to use it for another 2½ years. During that time I heard that a new inhaled insulin called Afrezza was starting trials. Once again, my hopes were lifted.
I was spring-loaded with my endocrinologist, my insurance, and my pharmacy all set to go at Afrezza’s launch. My A1C was 10.1 in November. Not good, but I was certain I could get it down in the 8’s again by getting back onto inhaled insulin.
I received my first Afrezza Rx on February 12th, nine days after launch. I got it home as fast as I could and was totally excited! I was surprised at how small the inhaler was. It just pops open and the tiny cartridges just drop in to place. I’m not a directions reader, and I wasn’t about to start, but they do have a pictogram that shows you how to use it when you open the inhaler box. My training was now complete, it is so simple to use.
My first day using Afrezza was good; I kept my BG average below 200, which I could rarely do with Humalog. My 2nd day using Afrezza, my BG average was 127. As the days moved on, my BG average fell every day. By the second week of using Afrezza, my highest daily reading would be 150. My third week I averaged less than 120 every day, and I continued to improve every week. I don’t even count carbs. It has just been too easy.
As it turns out, there was more to the Afrezza than I had originally realized. All I had cared about was not taking shots. All I expected was to get my A1C down to around 8, but I realized after the first week that I could achieve an A1C below 7. I met other people using Afrezza with similar results like Sam Finta (@Afrezzauser). Sam told me he didn’t care about taking shots -- he takes Afrezza because it works at the same rate you digest food, and at the same rate as insulin delivered from a healthy pancreas. People are using Afrezza simply because of its incredible ability to control your BG levels. As I write this, I can eat whatever I want and maintain total control, and I don’t count carbs.
I have met people who are worried about the 4 unit dose being too large. If they took 4 units of Humalog for a correction, they would crash. First, you cannot compare other insulins to Afrezza. The speed at which Afrezza works and then leaves the body is its secret sauce. Because of Afrezza’s speed it works great in two ways: safe controlled corrections and the ability to stop BG’s from rising. Four units of Humalog is active in your system for over two hours. But Afrezza is active for such a short period of time, your BG can only fall so much. This makes corrections safe, easy, and gentle, the exact opposite of what everyone predicted.
The second advantage of Afrezza works is also related to its speed. You can take it at the same time you eat and it works at the same pace that you’re digesting the food. This makes it incredibly powerful at stopping your BG from rising in the first place. In short, Afrezza stops your BG from rising, and if you do let your BG rise, it will lower it gently, safely, and controllably.
Something else started to happen during my third week that I didn’t expect. My insulin resistance started to drop. So I needed to reduce my two daily doses of Lantus.
I’ve been asked a lot if I’ve experienced any side effects, and I can honestly say no. I don’t have a cough, and it doesn’t have a taste. I believe exercise is a diabetic’s best friend. I ride my mountain bike for exercise and do a fairly grueling uphill ride regularly, and I still have great lung function. I have accidentally pulled the inhaler out of my pocket trying to get a golf tee. I’ve never tried to tee a golf ball up on it, which might be hard. That’s the worst thing I can think of.
I have also started using a Dexcom CGM, which has helped me gain even greater control, although I was able to achieve excellent results with test strips.
I am also an avid scuba diver and underwater photographer. With Afrezza, I don’t have to dive with high BG levels or be in fear of crashing. I don’t need to take Afrezza three hours prior to a dive to assure that it’s all gone from my system before I get in the water. I am an experienced deep water diver, cold water, high-altitude, cave diver, wrecks, and night dives. Getting low on any of those types of dives could be fatal and endanger others, so control is paramount.
As far as flying, I hold a Commercial Glider license, which doesn’t carry the medical requirements that powered aircraft pilots must meet. I am rated to fly high-performance sailplanes that test the bodies’ limits with aerobatics and high-altitude flight. Low BG while flying is not an option. BG levels must be checked frequently prior to flying and during the flight. Afrezza is great because if I haven’t taken Afrezza for two hours prior to flying, I know my BG will not be dropping. It’s well-established that diabetics can fly safely, and Afrezza makes it even safer.
Currently I’m considering producing a video in which I will explain how to use Afrezza and demonstrate it while I perform extreme aerobatics in a stunt plane. Any Afrezza enthusiasts out there who would like to see something like that, email me at firstname.lastname@example.org with the title it "Aerobatics" to let me know.
One more item on my soapbox: Diabetics can fly aircraft safely, and should be allowed to obtain a medical and fly. I urge readers to please support the Private Pilot’s Bill of Rights 2. This bill is currently in Congress. You can read about the advocacy push here and easily send a message to your Congressman by clicking here. This could help diabetics to follow their dreams of flying.
In all, Afrezza has been a life-changing drug for me. I’m still a diabetic, but my BG levels don’t reflect that. Furthermore I’m not trying very hard to control it. I just take the Afrezza however often I need to keep my BG between the lines. It’s just that easy now.
Wow, thank you Brian. We can only hope that others can replicate your results.