Tara and I met in our favorite pastry shop to test an ultra-rapid insulin that you inhale. With what? Ice cream and chestnut cakes, of course. 😊
Interestingly, neither of us is “on the needle” anymore. I stopped long ago because I’m on an insulin pump, and Tara just got off the needle too, since she recently switched to a new Ypsomed pump and is still “fine-tuning” things. 😊
Inhaled insulin is a powdered form of insulin delivered through a small inhaler (like the toy whistles from our childhood). You inhale it into your lungs, where it gets absorbed.
In general, inhaled insulins work faster than traditional injected rapid-acting insulin. After “sniffing it through your mouth,” you may feel a slight urge to cough — which is actually good, because it means you’ve really inhaled something.
I ate two scoops of ice cream without syrup (they didn’t have any), while Tara demolished two chestnut cakes — which would soon prove to be a poor choice. In fact, both of us kind of messed things up with this unhealthy meal and the unusual needle-free insulin… but hey, “first pancakes always flop,” right?
We received this insulin from our friend, along with instructions:
“Be careful, it’s very fast. Divide the number of Afrezza units by two to get the equivalent dose of our usual rapid-acting insulins like NovoRapid or Humalog.”
So we each inhaled two blue Afrezza cartridges of 4 units — a total of 8 units — which corresponds to about 4 units of NovoRapid (the insulin we use in our pumps).
Patient 1 – Tara Gamulin – Case Study
Tara’s chestnut cakes turned out to be a huge challenge because they were fatty and had far more carbs than we expected. Everything looked great until she got home — then her Libre went absolutely crazy:
Left: 45 minutes after Afrezza and the cakes — looking great. Right: two hours later!
As you can see in the top-left graph, everything looked perfect — as if I had somehow calculated the ideal 8-unit Afrezza dose for her. Her glucose dropped, rose a bit, then stabilized beautifully at 4.2 mmol/L.
But on the second graph, everything fell apart once she got home.
From this we can conclude:
- Chestnut cakes keep glucose elevated for a long time.
- Poor Afrezza disappears from the bloodstream very quickly.
- Our carb estimate for two cakes was way too low. 🙂
Tara quickly corrected the spike and returned to her “normal tracks” soon after.
Patient 2 – Davor Skeledžija – Case Study
I ate the two scoops of ice cream, which contain more sugar but much less fat — a much better combination for Afrezza. Ice cream raises glucose fast but also stops raising it fairly quickly; Afrezza works in the same fast and short pattern.
But I made a different mistake - I forgot to turn off my automated pump algorithm (Jenny) which increases insulin delivery when glucose rises and decreases it when it falls.
Blue line is glucose curve, green dot is the moment I inhaled insulin and ate the ice cream
The graph shows how the ice cream quickly pushed my glucose up, but Afrezza kicked in immediately and dropped it — beautifully. But since I forgot to disable my algorithm, and I also biked home afterward, I even ended up in mild hypoglycemia.
Still, as you can see, everything stabilized soon because Jenny stopped insulin delivery when she “noticed” I was trending low.
How Much Does Afrezza Cost?
Unfortunately, I cannot give a precise number, bit in short:
Afrezza is roughly three times more expensive than standard rapid insulins (!).
Also, remember Exubera — the first inhaled insulin — which disappeared from the market because it was too expensive.
While searching for prices, I even stumbled upon an article saying the first 1,000 people to register would get a special discount on insulin (!). As if we were talking about a Delimano pancake pan, not a hormone people need to survive.
Conclusion
It’s pretty cool to have a super-fast insulin in your backpack — one you simply inhale when you’re in trouble with ice cream, when your pump fails, or when injecting in public feels awkward.
Still, because Afrezza comes only in fixed doses of 4, 8, and 12 units, precise diabetes management is a little bit tricky for people with type 1. Maybe people with type 2 could benefit more. They could inject the long-acting insulin once a week, and for meals “sniff” Afrezza.
