Inhaled Insulin (Afrezza): Dosing, Timing & The Power of Inhaled Insulin

Get a practical breakdown of Afrezza, the ultra-rapid inhaled insulin, with this comprehensive guide to efficacy, timing, and real-world application. Join Drs. Jeremy Pettus and Steve Edelman—endocrinologists living with Type 1 diabetes—as they reveal why this unique tool is often misunderstood and how to use it effectively to flatten post-meal spikes.

In this episode, we move beyond the basics to correct the biggest mistake users make regarding Afrezza dosage. If you’ve tried this therapy before and felt it "didn't work," the issue often lies in the conversion ratio. We review data from Afrezza MannKind studies (such as INHALE-3) to explain the shift from the old 1:1 ratio to the more effective 1:3 ratio. We also cover why this "rapid-on, rapid-off" insulin is the ultimate solution for exercise and how to navigate insurance coverage and prior authorizations.

Topics covered in this episode:

• The Dosing Fix: Why you often need a higher Afrezza dosage compared to subcutaneous insulin.
• Speed & Kinetics: How inhaled insulin mimics the body's natural beta cells to clear glucose fast.
• Lifestyle Benefits: Managing "sticky highs," exercise without crashing, and dietary freedom.
• Safety & Screening: Spirometry requirements and who should (and shouldn't) use Afrezza.
• Pediatric Updates: The latest on clinical trials and potential approval for children.
• Whether you are managing Type 1 or Type 2 diabetes, this episode provides the practical "tips and tricks" you need to determine if Afrezza is the missing tool in your diabetes management kit

Timecodes: 0:00 Intro: Inhaled Insulin History 0:59 How Fast is Afrezza? (Rapid On/Rapid Off) 2:19 Why It Prevents "Delayed Lows" 3:24 The Big Mistake: Why Dr. Pettis Quit Using It 5:20 The Correct Dosing Conversion (1:1 vs 1:3) 7:40 Timing: Do You Need to Pre-Bolus? 8:44 "Follow-On" Dosing for High Protein/Fat Meals 10:32 Cartridge Sizes & "Bucket" Dosing 12:11 Using Inhaled Insulin for Exercise 13:58 Real-World Test: Trix Cereal & Afrezza 15:00 Storage Tips: Fridge vs. Room Temp 16:20 Dealing with the Cough Side Effect 17:05 Proper Inhalation Technique 19:13 Using Afrezza with Insulin Pumps & Closed Loops 21:30 Pediatric Update: Is it Safe for Kids? 23:25 Lung Safety, Smokers & Spirometry Tests 24:25 How to Talk to Your Doctor About Afrezza 26:32 Prescriptions & Trainers 28:44 Conclusion

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