Amy Tenderich

I can’t wait to get my next A1C test done (who says that?! but it’s true). I am now two-plus months into my use of new inhaled insulin Afrezza, and frankly I’m blown away by how well it performs (ooh, pun!)

I’ve been hesitant to be too much of a cheerleader for Afrezza, because I thought maybe I was experiencing beginner’s luck – the thrill of any shiny new diabetes treatment can wear off pretty quickly – and given how controversial this drug is, I didn’t want to stir the pot unnecessarily.

But sorry Naysayers, Afrezza is the bomb. At least for me.

{I’d like to take a moment here to thank Sam Finta, aka @afrezzauser, for this insightful post warning investors off hounding us patients as we test the waters with this new drug – “Your financial good intentions to spread the message have blinded you to seeing there is a real person who will only trust and listen to a fellow warrior in the battle, and they (along with everyone they come into contact with) might reject or miss this “life-changing” drug based on your inappropriate behavior – can you blame them?”}

I’ve written about the advantages of using Afrezza for all your bolus needs while on an insulin pump, and I continue to enjoy those.

Today I’d like to share a little more detail about my own success with Afrezza. And we are hoping to share the experiences of other patients using it here at the ‘Mine soon, in a new series we’re calling “Afrezza in the Real World.”Afrezza in the Real World - DiabetesMine

No, I’m not a marketing shill for MannKind or Sanofi; my use of this drug was strictly the choice of my doctor and I, and I’ve had no dealings with those drug makers other than interviews we’ve done with company execs in the course of reporting the news.

I’ve simply become convinced that this first-ever operative non-invasive insulin has incredible potential to help everyone with diabetes.

The Joys of Rapidity

As I’ve noted, the rapid-on/rapid-off function of this insulin is a real game-changer, IMHO. I’ve heard people saying for years that our so-called “fast-acting” insulins are too slow, but I never realized how much that fact is the crux of struggling with the glucose roller-coaster until now.

When you suddenly have something that peaks within an hour, and is out of your system almost immediately thereafter, you become keenly aware that most of the highs and lows of the past were caused by peak insulin action not matching up with peak glucose absorption, and by the insulin lingering in your bloodstream long after you needed it.

In this 2009 interview I did with Al Mann, he explained that Afrezza essentially "turns off glucogenesis" so no glucose is secreted from the liver in reaction to food. For that reason, people with type 2 can use a set dose of Afrezza for meals and run essentially zero risk of lows no matter what the meal size, whereas type 1s “will still have the issue (of lows) if they dose and don't eat anything… and if they eat a large meal, they'll need a larger dose.”

“The advantage for all patients is that they won't have to do carb counting or anything, because Afrezza does not have to be so precisely matched to food intake,” he adds.

This, my friends, has proven 100% true for me, and it’s a HUGE life improvement to be relieved of all that math (and S.W.A.G. guessing).  

More Time in Range

Simply put, Afrezza is helping me spend more time in range. My CGM screen now rarely shows the little dotted line going outside the borders of yellow for too-high and red for too-low. I’ve had whole days that remained in the white zone. And I’ve managed to do both a spin class and aerobics class starting at a “normal” blood sugar (100-ish) and ending there as well! 

For these morning workouts, I’ve learned that it’s best to take my regular Afrezza breakfast dose, and then just shut off my pump (basal insulin) for the hour-long workout or use a deeply reduced temp basal.

I’m also using this tactic now to avoid going low when I need a small correction (from, say, 150-160 BG) and have no choice but to take 4 units of Afrezza.

My BIGGEST WISH with Afrezza is that there were a 2-unit option – which would be perfect for type 1s like me in need of correction doses, I believe.

On the flipside, I’ve found that when you are low(ish) after a meal or before a workout, you don’t need to panic as much as you did with subcutaneous insulin, when you just knew you were headed for a crash. Rather, I find it’s best to treat very mildly (tiny amount of sugar intake) and briefly (reduced temp basal for just half an hour) because that Afrezza will be out of your system in no time, allowing your BG to level off.

For the first two weeks of April, you can see that 73% of my glucose readings were between 70-160, which is a big win for me:

Glucose Data using Afrezza


A Background Dilemma

One question other users have asked me – and I’ve been trying to work out myself – is what to do when your glucose level remains ideal or even a little low after an Afrezza-covered meal but then starts to slowly rise thereafter. I find that when this happens, it usually it peaks at about 185, so still not the crazy 200+ spikes I often experienced in the past, but what to do here, when you’re pretty darn sure that another full 4 units will drop you too low?

The only solution I’ve found so far is the one mentioned above: you go ahead and correct with the 4u of Afrezza, and then use a temp basal setting on your pump to dial back the full amount of insulin you’re getting in order to avoid a low.

But if you’re not on an insulin pump? I have no idea how you would handle this.

Some folks, including my own endo, have asked if it might be possible for folks like me to forgo using an insulin pump in the near future if Afrezza works so well. Based on what I just described, my answer is No. I still have the need to manipulate my background basal dose, to account for overcorrecting, exercise, and periods of higher insulin resistance, like PMS.

Frog in My Throat

One endocrinologist acquaintance of mine has been making skeptical faces at me whenever I say how much I like Afrezza; he’s still very concerned about the long-term effects on the lungs. And of course only time will tell how much this is an issue!

Back in 2009, Al Mann told us they’d been following some patients who’d already been using Afrezza for up to 5 years, and saw no change in their lungs. (They did high-definition CT scans on the 600 patients in their study.) That seems encouraging.

But I didn’t tell my endo friend that I’ve been experiencing a frog in the back of my throat and a bit of a cough. Since my nose has also been runny lately, I honestly can’t tell if it’s related to the Afrezza, and I hope with a passion it isn’t.

If anything else is giving me pause about this drug, it’s simply the concern that uptake seems to be slow among doctors.  That’s what I’m hearing, anyway – about endos who are ‘meh’ about offering it to their patients. Which makes no sense to me.

Here we have the first-ever viable non-invasive insulin, that couldn’t be easier to teach or use, and that’s producing amazing results among early adopters. I know there’s some trepidation based on the past failure of Exubera, but Afrezza really is a whole new ballgame.


Tried Afrezza yourself? Please reach out so we can help others learn from your experience too.

Disclaimer: Content created by the Diabetes Mine team. For more details click here.


This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.