Mike Joyce has an unimaginable kind 1 diabetes story. Four years in the past, he weighed 275 kilos and was chained to a desk in a soul-crushing company job. That’s when he modified his weight loss plan, began exercising, and customarily took life by the horns. Now he’s hiked each the Appalachian and the Continental Divide Trails, and is planning much more adventures (his Instagram web page is a nice comply with).
One of the keys to his outstanding change was Afrezza, the distinctive ultra-rapid inhaled insulin. Mike believes that Afrezza has been important to his life-style, each throughout adventures and between them, and needs extra individuals to learn about it.
This article goes to sound like an advert for Afrezza – I promise you that Mike isn’t a paid spokesman or influencer. He’s simply a man that’s actually dedicated to a drugs that he thinks has considerably improved each his diabetes administration and his psychological wellbeing.
“I think I first fell in love with Afrezza because my CGM showed how long it took my injected fast-acting insulin to work. On my CGM, Humalog or NovoLog wouldn’t stop lowering my blood sugar until 45-55 minutes after the injection.”
“And when I saw how quickly Afrezza would start affecting my blood sugar, I couldn’t believe it. Within 3 dots of the Dexcom reading – 15 minutes – I’ll see the line turn down.”
It works so quick, in actual fact, that it has fully modified the way in which he doses insulin for meals.
“I don’t pre-bolus because Afrezza works too fast for that. My body will not digest the food fast enough. Afrezza is so fast that I actually bolus after I’m done eating.”
“I eat, and I watch my CGM. As soon as I see the line start to bend down on my CGM – it might be soon, it might be hours – I’ll usually use an 8-unit dose. And then I keep an eye on the CGM. If my blood sugar hasn’t gone back down within 30 minutes, I can just take more.”
“It works so fast that I don’t really have to worry about stacking. With NovoLog, if I took more, three hours later I might be at 35 mg/dL and eating the whole refrigerator.”
If you need extra element on why Afrezza works so rapidly, Mike strongly recommends listening to this Diabetes Connection interview of Mannkind CEO Mike Castagna.
Mike principally sticks to a low-carb weight loss plan, which makes bolusing pretty easy, however his technique nonetheless works for heavy carb splurges like pizza and sushi:
“For higher-carb meals, I’ll use up to a whole cartridge (24 units) when I see the CGM start to trend up. It sounds like a lot – 24 units? – but in my experience Afrezza units are maybe half as powerful as injected insulin. So that 24 units is really the equivalent of 12-15 units of NovoLog, which is what I was taking for big meals before.”
He additionally doesn’t trouble worrying a lot about late spikes, whether or not from a huge protein meal or “pizza effect.” He simply takes it straightforward and responds with extra insulin when his Dexcom exhibits one other upward pattern:
“For any meal, I don’t have to predict, I just react. If it spikes again hours later, I just take another small dose. I stopped having to plan ahead. That was the game changer for me.”
“I’m gonna eat, and then I’ll take some insulin, and then I’ll take some more if I need it.”
The solely time this doesn’t work properly is in a single day – to take care of a late spike after a late meal, he’ll need to get up in the midst of the evening. But that’s not so totally different from what most individuals with kind 1 diabetes take care of.
More importantly, the unconventional change of mindset – “I can be reactive instead of proactive” – has additionally significantly alleviated the stress attributable to the fixed mindfulness that diabetes often calls for.
“I don’t think we talk enough about the psychological effects of diabetes. It takes up so much mental space. But with Afrezza, I have so much more time to live now.”
“With injections, you have to be proactive. You have to think ahead and make a guess. But with Afrezza, I can just react in real-time. That’s what I love about it.”
“I no longer worry about those other factors – whether or not I have rapid insulin on board, what I did a few hours ago. I’m no longer thinking about diabetes every minute of the day. If there’s an issue – oh, I’m trending up? – let me take some insulin and I go back to my life. It used to be more like, oh, let me take some insulin and see if it comes down in an hour.”
“Carb counting is a thing of the past for me. It’s so fast in and out I don’t have to have perfect calculations to stay in range.”
Mike’s therapy technique could be not possible to tug off with out a CGM.
“I think everyone with diabetes should have a CGM. Period. I don’t think I’d be able to do anything I do if I didn’t have a CGM. I don’t know how I survived without one! I’ve only been using it for three or four years, and I can no longer imagine life without it.”
The different huge blood sugar consider Mike’s life is train. Whether he’s strolling 20 miles per day within the mountains or simply jogging after work, he loves that Afrezza’s impact is so short-lived.
“I used to have hypos during exercise all the time. But Afrezza is out of my system so quickly. As long as it’s been two or three hours since my last dose, I know that I won’t go low.”
“Even if I were to go back on a pump, I would always want to have Afrezza on hand. When pump failures happen, you can go from 100 mg/dL to 400 mg/dL with ketones in an hour. It’s dangerous. Nothing will get your blood sugar down as quickly as Afrezza. If I could inhale some Afrezza first and then change my pump infusion second, my blood sugar would be back in range by the time the pump is on my body.”
“Given how common pump failures are, I wish doctors insurers would let people have an Afrezza prescription as a second short-acting insulin. We should have access to more than one fast-acting insulin, because they work so differently.”
Some readers could have problem having access to Afrezza. Doctors are much less acquainted with it, and never all insurers robotically cowl it. If that’s your case, Mike recommends merely not taking “No” for a solution:
“You can get something coated by insurance coverage, you simply have to take a seat on the cellphone for 5 hours! It’s annoying, however if you happen to’re prepared to advocate for your self and your physician is prepared to resubmit the request a number of occasions, they’re ultimately going to present it to you.
There has been some fear that often inhaling Afrezza may trigger unwanted effects, or worse. The drug isn’t beneficial for sufferers with lung points (or people who smoke), and sufferers often have to undergo some pulmonary testing earlier than they’ll get their prescription. Mike – who should have very wholesome lungs, gulping down that mountain air for months at a time – hasn’t had any points himself.
“The inhaler has by no means bothered me in any respect. The spray will get deep within the lungs in a short time and really simply. If I don’t have it angled the precise approach, I can really feel it hit the again of my throat, and I’ll breathe a few of it out. And though I’m unsure precisely how a lot insulin I bought, it’s out of my system so rapidly that it’s not a huge deal to take extra if I would like it.”
For the report, Afrezza is inhaled by means of the mouth, not the nostril. It’s a straightforward mistake to make.
“No, I don’t snort my insulin!”
Afrezza, frankly, isn’t tremendous fashionable. I spend a lot of time within the diabetes on-line group, and I see comparatively little buzz for this distinctive insulin. Maybe it’s the shortage of entry, or possibly it’s suspicion in regards to the novel supply mechanism or potential unwanted effects. But one section of the diabetes inhabitants is fairly captivated with it: these with needle phobia.
“I just spoke to a mother of a small boy that has both type 1 diabetes and sensory issues, so he can’t really do a pump, and he hates injections. The doctor wrote him an off-label Afrezza prescription, and it’s been life-changing for them. He is doing a lot better.”
“Once they get it approved for children, I think that’s when you’ll see more people start using it. Parents are adamant about finding the newest and the greatest techniques and medicines for their kids, whereas adults tend to find something that works and stick with it.”
Mike is planning his subsequent journey – presumably the Pacific Crest Trail. He hopes that his story might help encourage others.
“I know a lot of people probably look at me and think they could never do what I do. Four years ago I was 275 lbs, working a corporate desk job, struggling to make a living. I’m an extreme athlete now, but it was a gradual progression to get where I am. It’s been a development, all from a starting point that lots of other people are at today. I want other people to see that that’s possible, that they’re not stuck where they are.”
Read extra about Afrezza, Dexcom, diabetes administration, train, Humalog, inhaled insulin, insulin, Intensive administration, low blood sugar (hypoglycemia), low-carb weight loss plan, MannKind, NovoLog, kind 1 diabetes.