Female, 26 years of age, type 1 diabetes for 15 years, well-educated, uses insulin pump. Recent A1C 7.6%; has been rising from 6 to 6.5. Thinks her mealtime insulin is not working fast enough. She does bolus about 20 minutes before eating. Assessed pump, CGM, food intake and activity. Her report seemed to be the case. Plan is to continue her basal insulin, but instead of bolusing from pump, will use Afreeza right before meals. Although insulin dose with Afreeza may not be exact, watch CGM, and let us know. She may need to change dose and if doesn’t stay in her system long enough to lower postprandial glucose, may need to increase or repeat dose.
- Onset of insulin is not the same all for all people. There are several ways to assess and even change onset for people. For example, some brands may have quicker or slower onset in various people. Changing brand of insulin can help as it can change in administration, such as injection/pump and/or inhalation.
- CGM extremely helpful to assess.
- One size does not fit all.
- Since diabetes and diabetes management is so individualized, sometimes it is trial and error.
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