Managing diabetes 24/7/365 takes a lot – a lot of energy, knowledge, and resources. We’re all about ensuring that every person with diabetes knows about every existing tool that might be able to help. There’s one tool that is increasing in popularity and can help increase time in range: inhaled insulin!
What is inhaled insulin and how does it work?
Inhaled insulin (currently, Afrezza is the only brand available in the US) is an ultra-rapid acting insulin that works differently from the insulin you inject into your body. The inhaled insulin is actually a powder that is delivered through an inhaler, so the insulin passes through the lungs and goes straight to the bloodstream. Fasting injectable insulin on the market takes at least 15-30 mins to start working after a person injects—inhaled insulin starts working within 12 minutes, which can decrease the blood glucose spike from mealtimes, correct when levels go above target range, help when the stresses of illness and life impact glucose levels, and more. You can learn more about Afrezza here.
How does it affect time in range?
Inhaled insulin can be an incredible tool for individualizing your care to what works for you. If you’re struggling with things like pre-bolusing, stubborn highs (prolonged high glucose levels), or are just tired of injections, Affrezza can provide major relief. Because it lowers glucose levels quicker than injected insulin, it can help you spend more time in range and less time rage-bolusing. In fact, recent research found that using inhaled insulin led to lower post-meal glucose spikes compared to bolusing for the same meal via an injection or pump.
So, what does using inhaled insulin look like in real life…and how can it affect time in range? We had real people with diabetes try using Afrezza on one of the toughest foods we could think of…deep-dish pizza!
The Question:
Can Afrezza help me keep my glucose in range after a meal that is difficult to bolus for?
The Process:
We had three people with diabetes use Afrezza to bolus for their pizza. Each person uses a different AID system, but used Afrezza as their primary bolus insulin for this meal. They watched their glucose levels 30 minutes, 1 hour, and 3 hours after the meal to see how their daily time in range was affected.
The Results:
Person 1:
Our first participant found her experiment successful! This graph represents the 3 hours after she ate her pizza—the highest her glucose reached was 160 mg/dL, the lowest it reached was 76 mg/dL.
Participant 1 attributes this “win” to the use of Afrezza before and about 1 hour after her meal. Through CGM metrics and patterns, she finds that when she has a meal that’s particularly carb and fat-heavy (like deep-dish pizza) she sees a spike in glucose levels 1-2 hours after eating. Afrezza was able to mitigate this spike by having the insulin enter her bloodstream quicker, so the glucose that comes from the carbs breaking down was broken down into energy faster. In simpler terms, there was less time for the glucose to sit around and crowd the bloodstream.
Person 2:
Our second participant started their dinner and took Afrezza at 150 mg/dL. After initially rising to 195 mg/dL about 15-20 minutes after eating, their glucose came back into range for the next hour and a half. This is because inhaled insulin starts working more quickly than injected insulin—people might not notice the initial drop in glucose levels until an hour or so after injecting themselves.
Participant 2 dropped to 55 mg/dL (carb miscalculation!), and was then able to have a small snack and ended their night in range! When asked, the participant called this experiment a “win” as well, and felt that using the inhaled insulin helped avoid a stubborn high and potential insulin stacking.
Person 3:
Participant 3 had their leftover pizza for breakfast…something we always agree with!
He ate his pizza around 9am, and took his Afrezza right after, this graph shows the 3 hours after dosing and eating. Similarly to Participant 1, Participant 3 avoided the initial glucose spike, as the inhaled insulin was able to start working quickly. They stayed in range the entire time!
Participant 3 does not use Afrezza for every meal, but likes to use inhaled insulin for “more complicated” meals—things that he enjoys eating that are a bit out of the norm for him and his schedule.
At the end of the day, everyone’s diabetes is different. What works for one person might not work for the other—but it is important to know what tools are available to help keep yourself in range and feeling good. Inhaled insulin might work for you!
If you’re interested in learning more about if inhaled insulin could help you, you can talk to your healthcare team, or even a doctor online.