September 2, 2022 • 46 mins
Today's episode is all about Afrezza, the inhaled insulin! My Guest today is Ginger Vieira. Ginger is the Senior Content Manager at Beyond Type 1 and Beyond Type 2 and has been living with T1D since she was in middle school. She is a WEALTH of diabetes knowledge. Be sure to check below for links to all her diabetes resources including all of the books she has written! At the moment, Afrezza is only FDA approved for people who are 18 years and older BUT, AS WE SPEAK, there is a clinical research trial being done to see if it is safe and effective in the pediatric population. After listening to this episode you are going to want them to hurry and and get that study DONE so our kids will have access to this amazing drug. I will put a link below to the trial as well. Enjoy!
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OTHER INFO MENTIONED IN THE SHOW
Ginger on Instagram
Find all of Ginger's books and resources HERE
The Pediatric Afrezza Clinical Research Trial
Follow the show on Instagram @sugarmamaspodcast
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Katie (00:00):
Hey everybody.
It's Katie and you are listeningto episode 83 of the sugar
mama's podcast.
Today's episode is all aboutAfreza, which is the inhalable
insulin.
My guest today to talk to meabout Afreza is ginger Vera.
Ginger is a type one diabetic.
She currently uses Afreza.
(00:20):
She is extremely connected tothe world of type one.
She has written many, many booksand other blog posts and
resources for the diabetescommunity, which I will link to
in the show notes.
She is also the content managerat beyond type one and beyond
type two, which basically meansin her words that she writes a
lot and creates a lot of reelsfor Instagram.
(00:42):
That sounds like a fantasticjob.
Sign me up.
I really enjoyed having gingeron.
I thought she had lots ofinsight and wisdom to share, and
I'm really excited for you guysto hear more and learn more
about Afreza.
Right now Afreza is onlyapproved for use and people who
are 18 or older, but currentlygoing on as we speak is a
clinical research trial todetermine if Afreza is effective
(01:05):
and safe in the pediatricpopulation.
That is very exciting news to myears.
All right.
Without further ado, let's getstarted.
Be sure to check out the shownotes as always for links to
other episodes that might bementioned in the show links to
where you can find ginger andall of her amazing resources and
books that she's written.
And not to mention links to thepodcasts, buy me a coffee page
(01:30):
and other ways that you cansupport this show.
All right.
You guys, here we go.
You're listening to the sugarmamas podcast, a show designed
for moms and caregivers of typeone diabetics here.
You'll find a community oflike-minded people who are
striving daily to keep theirkids safe, happy, and healthy in
(01:53):
the ever-changing world of typeone.
I'm your host and fellow T one Dmom, Katie Roseboro.
Before we get started.
I need you to know that nothingyou hear on the sugar mamas
podcast should be consideredmedical advice.
Please be safe, be smart, andalways consult your physician
before making changes to the wayyou manage type one diabetes.
(02:17):
Thanks.
All right, everybody.
I am here today with a greatguest.
Her name is ginger, but I'mgoing to allow her to introduce
he.
So ginger, just tell everybody alittle bit about yourself and
how you are connected to theworld of type one diabetes.
Ginger (02:36):
Sure.
Hi.
My name is Ginger Vierira and Ihave lived with type one
diabetes for 23 ish years.
I was diagnosed when I was 13 in1999.
I actually diagnosed myself.
Nobody believed me for a week.
The seventh grade I was inseventh grade and our class was
working on projects for theschool health fair.
And one of my classmates wasdoing his own diabetes and.
(02:59):
I saw all the symptoms listed onhis poster board while we were
working on our projects inclass.
And I said, I think I have that.
Can you die from that?
And he's like, oh yeah.
And you know, seventh grade.
And I told my mom, she said, noonly old people get that.
And a few days later I justburst into tears cuz I felt so
lousy and all my symptoms, youknow, it's like, oh, well
(03:22):
everybody has glasses in thisfamily.
You think you just need glassesand well of course you lost
weight.
You.
Going through puberty and ofcourse your legs feel heavy and
you don't wanna go to school.
You're a teenager, you know?
And so it really ramped upquickly.
But yeah, so that was, that wasmy diagnosis.
Katie (03:40):
Wow.
That's wild.
I you're, that's definitely thefirst I've heard of somebody
diagnosing themselves as achild, at least.
Um, but
Ginger (03:48):
proud of itself that they, that they very proud of
themselves, that they served apurpose that year.
Katie (03:55):
yeah, had that kid just randomly chosen diabetes or did
he have
Ginger (03:58):
Yeah.
And you know, his, this is,again, this is seventh grade,
right?
So it, he didn't have type oneor type two on his poster board.
He just, it was just diabetes.
And he later asked me out and Isaid, oh no, I've gotta pack for
summer camp.
I can't be your girlfriend.
So poor guy.
Yeah.
Katie (04:16):
He thought he was totally gonna get a date out of that.
He's like, oh, I diagnosed her.
I'm definitely gonna be able toget a date.
funny.
Ginger (04:22):
So I also have a, the year later I was diagnosed with
celiac because they justscreened all the teenagers that
was upsetting as my family'sItalian and weight spaghetti,
like twice a week.
But I have since come to reallyappreciate what celiac does to
keep garbage food outta yourbody.
Not that you can't find garbagefood, that's gluten free, but
(04:43):
and I.
In college developed what we'recalling fibromyalgia.
Lots of people are stillskeptical of fibromyalgia.
We can't pinpoint it, but itreally.
Seems to fit what I startedexperiencing while I was
training and competing incompetitive power lifting.
And I just really, I think mybody is prone to autoimmune
(05:05):
disease and I triggered kind ofchronic muscle spasms.
And I'm now very.
Sensitive to exercise.
I have rebuilt my tolerance forexercise.
So I, I exercise a lot.
I would consider myself still anathlete, but I don't go to any
extremes.
I just kind of maintain physicalfitness.
Katie (05:24):
Interesting.
Yeah, I'm a, I'm a physicaltherapist by trade and you know,
fibromyalgia is always such aninteresting diagnosis, cuz it's
so hard to talk people intolike, Exercising when their body
just hurts.
You know what I mean?
And, and, you know, I, I try todo my best to explain that like,
no exercising will help.
I promise it will help.
(05:44):
It will not only help youphysically, but it'll help you
mentally and emotionally.
And,
Ginger (05:49):
Regular exercise is part of my treatment for my
fibromyalgia.
It makes me feel awesome.
Yes, indeed.
Katie (05:56):
Well, good.
Regular exercise is just part ofmy mental care treatment,
mental, you know, mental healthtreatment for myself.
It's funny.
Sarah asked me the, the otherday, like, mommy, why do you,
why do you exercise?
Is it, you know, is it to likelose weight?
And I'm like, honestly, honey,at this point in time in my
life, it is to keep myself fromgoing crazy.
Ginger (06:14):
Yeah, I can't, if I, for some reason don't get to go for
my morning jog.
I just can't think straight bylike nine, 10:00 AM.
Like I need to get it outta mysystem.
So yeah.
I also have mild hypothyroidthat I take a, a low dose of
thyroid medicine for, and, youknow, it sounds like a list of
things, but I know you have alot of parents listening.
(06:35):
I wanna tell you that I amfrigging thriving and I love
light.
I have a ton of energy and Iwould say I'm thriving because I
embrace what my challenges areand I figure out my limits and I
figure out what helps me feelawesome.
And what doesn't.
And I live my life by that.
And,
Katie (06:53):
Hmm.
I love that.
And I know parents listeninglove to hear.
Ginger (06:56):
Yeah.
And I'm a mother.
I have two children.
I work full time.
I walk my dog six miles a day.
Life is good.
Katie (07:03):
Wow.
Wow.
That's awesome.
Where, and, and you, you work,you work full time, correct?
Tell, tell listeners a littlebit about that too, because
that's another way in whichyou're connected.
Ginger (07:12):
Roughly.
Yeah.
So I went to school for writing.
I have a bachelor's inprofessional writing and I have
really combined Miley passionfor helping people figure out
how to get through the day withtype one diabetes.
Safely and, you know, asjoyfully as possible with
writing.
And so I have been writing forprobably 15 years about type one
(07:33):
diabetes.
I started, I got my niche in,when I started going to the gym.
I hired a personal trainerbecause I didn't really, I kind
of acted like a typical collegestudent for one year and my A1C
jumped up and I just felt lousy.
And I was like, I don't wannafeel this way.
And so I got really sucked intothe fitness world.
(07:55):
And power lifting and I gotreally strong, very quickly.
and I went to an endocrinologistshortly before my, when I,
shortly after I started trainingin power lifting and I said to
him, I would like, you know, I'mplanning to compete in a few
months in my first power liftingmeat, but I really need some
help because I, my blood sugarsare not really, you know, and
(08:16):
this is back before everybodyhad a CGM.
I did not have a CGM.
This is.
Early 2000.
This is maybe 2010.
So CGMs were just around thecorner and he laughed at me.
The endocrinologist did not helpme accused me of forgetting or
skipping my long acting insulindose, which I was not.
(08:36):
I was waking up with high bloodsugars because I needed help.
Not because I was deliberately.
Neglecting my insulin.
Right.
so I, I cried, I did not go backto that guy and I kind of had to
figure out how to train andcompete and do all of that
without much help.
And fortunately, my coach lovedexercise physiology, so he
helped me learn exercisephysiology, and then mashing it
(09:01):
in with type one diabetes.
And.
I set seven records at my firstcompetition, without that stupid
doctor's help.
And from there kind of startedtrying to write exercise science
in layman's terms for my fellowtype ones to help them also
enjoy exercising with type one.
And now.
(09:23):
10 15 years later, I understandit even more and understand how
to explain it even more.
But in the midst of that havereally written almost on every
topic.
There is for dozen differentwebsites
Katie (09:37):
Yeah.
I know when I was kind ofpreparing for our interview and,
and you know, of course Googlingyou.
I'm like, oh my gosh, she's,she's written quite a bit.
And you know, you've actuallyauthored a few books that I
heard about one a while ago,just listening to the juice box
podcast, cuz you.
You coauthored it with JennySmith, correct.
The one about pregnancy.
(09:58):
And I remember hearing, youknow, Jenny talk about how she
wrote it with her friend ginger,and that's just not a name you
forget.
Cause I don't, I don't know thatI know any other gingers, but
and then I came across you youknow, by other means O on the
web and, and here we areconnected and chatting, but so
would you mind telling listenersjust a little bit about the
books that you've written.
Ginger (10:16):
Sure.
Sure.
So my very first book I wrote incollege, please forgive all the
typos.
It was self-published with ateam of college students helping
me and it's called your diabetesscience experiment.
And that was my, really my firstattempt at helping people learn
how to exercise with diabetes.
I am literally right now workingon a.
New and improved version ofexercising as a beginner with
(10:38):
type one diabetes.
But I still keep selling thatbook despite all the typos,
because people tell me howuseful it's been.
I also have a 30 page kind ofguidebook called emotional
eating with diabetes that helpspeople who live with diabetes
for a long time.
Untangle the impact it's had ontheir relationship with food and
especially for your audience asparents.
(10:59):
I mean, the biggest piece ofadvice I could give you is, do
not try to force a diet andrestriction upon your child with
diabetes instead, help themembrace.
What do I need to do around thistype of food?
What do I need to do around thistype of food to help me thrive,
to help me reach my blood sugargoals.
Versus those foods are bad.
(11:20):
Those foods are bad.
You're bad for eating them.
Go on a keto diet, et cetera,that can just really lead to.
So much complicated emotions andbehavior around food as you get
older.
So that book is to help peoplekind of untangle that and, and
figure out what's going on intheir head and how it's
impacting their decisions andbinge eating after a lot of
(11:41):
restriction, et cetera.
I also have dealing withdiabetes burnout.
Which also has a section forparents um, and caregivers and
family and pregnancy with typeone diabetes.
It's still the only guide tomanaging pregnancy with type one
diabetes out there.
And all of these are on Amazon.
And then we have two children'sbooks now.
My friend Mike Lawson, and Ihave written together, he's the
(12:04):
artist and I'm the writer and hehas type one.
When I go low and ain't gonnahide my T one D and those are on
Amazon.
Katie (12:11):
I think I've listened to you to an interview on a
different podcast.
And honestly, I might have beendiabetes connection.
I'm not sure you would know.
Um, But I what you were talkingabout, that, that book when I go
low and, and I listened to theinterview and I, you know, loved
everything you had to say.
And then again, when I was kindof preparing for this interview,
I'm like, oh, that she's theauthor of that book that I
remember hearing about.
So.
Ginger (12:32):
Great.
Katie (12:33):
Yeah.
Okay.
Well, awesome.
I mean, definitely my earsperked up with the diabetes
burnout situation.
Cause I mean, I think it's, Idon't know, as a parent who's
only been dealing with this fortwo years, I feel like burnout
is just a normal part ofmanaging diabetes for yourself
or for your kid.
And I mean, hopefully as timegoes on, it kind of.
(12:55):
Comes and goes very quickly.
But I feel like it, for me, atleast it kind of just comes and
goes in waves.
You know, I'll just go through aweek where I'm just completely
over it and and then I'll bounceback and everything will be
fine.
And so I'll have to take a lookat that one.
And I, I, I'm gonna, I'mactually getting ready to do a
little mini series with adiabetes educator.
Who's also a registereddietician specifically on eating
(13:16):
like emotional eating and justeating in general.
Surround you.
With type di type one diabetesin mind.
So I might have to grab that andskim through it and read through
it before I talk with her to, toget a little bit more questions
and content, cuz that'ssomething we haven't encountered
yet in our household.
But I feel like the teenageyears are coming and we're just
(13:40):
have to see.
Okay, well, you are veryconnected to the world of type
one in many different ways.
But the reason I really wantedto have you on today is because
I read an article recently thatpopped up on LinkedIn about
Afreza and your use of Afreza.
And I have read a lot aboutAfreza, but I feel like my
listen.
Maybe haven't just becauseAfreza is only approved for
(14:03):
people who are 18 and older atthis time.
But I wanted to learn more aboutit.
I think it's fascinating.
And they are currently doing astudy on it right now, a
clinical trial on it right now.
That's actually still active inrecruiting participants.
So at the end of this episode,if you're interested, I will
link to that study in, in theshow notes and people can check
it out and see if.
(14:23):
You know, recruiting in yourarea, but I will let you explain
since you actually havefirsthand experience with Afreza
tell listeners what Afreza is.
Ginger (14:32):
Sure Afreza is inhaled insulin.
So it's very it's this, theinhaler itself is just
mechanical.
There's nothing.
Really complicated about it.
And then you have thesecartridges of powdered insulin.
So they come in units of four,eight, and 12, and your first
thought, and what actually keptme from trying it for a long
(14:53):
time is how the heck could Imanage type one diabetes with
predetermined doses of four,eight and 12 Afreza is a totally
different.
It is not the same as four unitsof Novalog.
I wouldn't even dare to say, andthey do try to do this when they
talk about Afreza so they cangive you some context, but I
(15:15):
wouldn't even dare to say thatit converts to a specific unit
of Novalog because.
It just works so differently.
The most significant differenceof Afreza is that it is active
in your system within like twoand a half minutes of inhaling
it because it's going throughyour lungs straight into your
(15:36):
bloodstream and insulin has toget C processed and, and
eventually get to yourbloodstream.
Right.
So.
It's really fast acting, whichmeans you don't need to pre Boce
for your meals.
It means you can turn aroundblood sugars that are rising
very quickly.
And please remember, I am not adoctor and I am definitely not
(15:58):
your doctor.
And I'm gonna be speaking frompersonal experience using
Afreza.
I really love that.
It's also out fast, so it actsfast and it's out fast.
And when I say out fast, thefour unit cartridge in, in the
FDA approved language aroundthis is that it's out at
approximately 90.
(16:19):
Minutes after dosing, but mostpeople who use Afreza will tell
you that they see little to noimpact in their blood sugar
after 60 minutes.
And what's really cool aboutthat.
Especially as someone who'sreally active, I walk my dog
three times a day and if I wastaking Novalog for my meals, I
would, let's say I eat mystrawberries and cheese lunch at
(16:44):
noon.
I have to take NovoLog for that.
And then I might be able to walkmy dog an hour later, or maybe
immediately, or whatever I haveto account for how much NovoLog
is still in my system withAfreza.
I know I can eat at noon and ifI wanna walk my dog at one
o'clock or two o'clock, I don'thave to worry about insulin on
(17:06):
board, rapid acting insulin onboard, cuz it's not on board
anymore.
And so the risk of going low.
It's just for me, I'm alwaysgonna bring those back to my
personal experience, cuz I'm notyour doctor is significantly
lower.
And I don't even have to thinkabout it.
And I always go on dog walks orany type of exercise with candy
(17:29):
in my dog walking bag.
Right.
Or my little belt around mywaist for jogging, but I never
use it.
I never use it anymore.
And with Novalog.
I never had any severe lowswhere I needed glucagon and I'm,
you know, on the sidewalk layingdown cuz of a low, but I would
have to eat candy that I didn'twant because I knew I had
(17:50):
insulin on board and I know Iwanna walk two and a half miles
and yada yada yada.
Right.
So that's the coolest thingabout Afreza is.
It acts fast and it's out fastand the bigger the dose you take
the longer, it could be still inyour system.
So an eight unit could still bearound 90 minutes daily
(18:10):
languages that it could be inyour system for up to like two
hours or something.
But it really it's so minimalthe biggest impact I can
literally I could take, let'ssay my blood sugar was rising
right now because I slightlyunderdosed for.
I could look at a one 40 with anup arrow or a 180 with an up
arrow, take a four or an eight,depending on what I know is
(18:32):
digesting.
Right.
And turn it around.
And within 15 minutes I will beheaded down and not worrying
about being high for the nextthree hours.
Katie (18:44):
Hmm.
Wow.
Ginger (18:45):
correct high, really fast.
So if I.
Completely underestimatedessert.
And I miss that I'm risingbecause I'm playing pegs and
jokers, my boyfriend of myfriends.
And I look at my blood sugar.
I like, oh, shoot.
I'm like two 70 because Icompletely underdosed.
And I didn't notice till justnow I can bring that down within
(19:05):
an hour I'm down.
Cause I'm because it's out fast,you just land, you don't crash
and then keep crashing becauseit out fast.
So it's, it's really cool.
Katie (19:19):
So I, I have a lot of questions.
Ginger (19:21):
Okay.
Yes,
Katie (19:22):
so, okay.
First, what is, what's yourwhole insulin profile look like?
Like, are you, are you taking aninjection of basal insulin and
using Afreza or what, what kindof combo do you got going on?
Ginger (19:34):
tried pumping.
I pumped for years in my earlyyears of type one, but I've
really come to love thesimplicity of multiple di daily
injections.
They can't fail me like aninsulin pump can And so I take
one dose a day of long actingLantis, and then I do still take
every day.
(19:55):
Probably two units, a two,sorry, two doses of NovoLog,
because what Afreza can't do isgive me a teeny teeny amount,
right in the morning, Isometimes need like a half unit
for Don phenomenon.
I, I am also very fond ofintermittent fasting.
And so the longer I fast, themore likely my liver is gonna
release some glucose and I needa, a tiny, slow insulin to cover
(20:18):
that.
I also would take Novalog beforebed.
I save, I, enjoy carbs.
In the evening.
So I don't follow any strictcarb diet, but I try to eat
really clean whole foods duringthe day.
And I, and give myselfpermission to enjoy homemade
cookies or whatever it is,Hershey, kisses, whatever
(20:41):
dessert, and because of Afrezzaacts so fast.
Is really great for thebeginning of digesting that
dessert, but then I go to sleepand I'm not gonna take a follow
up dose of Afreza when I'munconscious.
So I take no vlog to help dealwith the slow digestion of that
meal.
Same could be set for pizza,Chinese food, you know, those,
(21:03):
those high fat, high carb foodsthat I personally don't eat on a
regular basis, but I enjoy themas a treat here and there.
So that's a combo of Afreza andNovoLog to help me tackle that
slow digestion.
Katie (21:14):
Hmm.
So for you personally, you, youtake Afreza first when you kind
of start eating the dessert or,or high fat meal like you
described.
And then before you would go tobed, you would take Novalog
that's that's interesting.
Ginger (21:26):
It's a, and it's a very, there's a, a great learning
curve to using Afreza.
And.
It takes a little while, but youreally have to approach it.
Like this is a new game of typeone diabetes.
And for me, it's been a reallyfun new game because it's just
like after 23 years of doing theother game, it's like, whoa,
this is so different.
I love, like, I just love how,how fast it acts.
(21:49):
I don't really ever feel theneed to rage.
I have overcorrected lows acouple times with Afreza where I
underestimated its power.
But again, because it's out sofast, the lows are not nearly as
stressful as lows with Novalogwhere you're like, Ugh, I'm
gonna be dealing with this extrainsulin on board for another two
hours.
(22:10):
You know, it doesn't feel likethat with Afreza because you can
look at the clock and say, well,I took this dose at noon.
I know it's gonna be out by oneor one 30 or two.
If it was a really big.
It's just, it's a much more fungame in my opinion.
Katie (22:26):
Yeah.
I mean, it sounds amazing.
I'm I'm curious, you said youcan't, you can't really compare
it to dosing, like a Novalog ora Humalog or anything like that,
like for a, do they call it afour unit cartridge?
Like, is it actu
Ginger (22:39):
the blues are fours.
Katie (22:41):
Mm-hmm
Ginger (22:42):
The green cartridge is eights.
There's also a 12, which I don'tuse.
And I believe those are likepurple.
I, I haven't even seen a pictureof them in so long that I can't
cuz I just don't.
I don't use those.
And a friend of mine who lovesAfreza.
She has a great description ofit that it's kind of like small,
medium and large.
(23:03):
So if you're eating a small mealthen you know, from, and
everybody's insulin needs aredifferent, right?
I'm fairly sensitive to insulin.
So my insulin needs are fairlylow.
So for me, a four could cover asmall meal or a small
correction.
I don't need an eight for anexample to cover.
To correct a high blood sugar,unless I'm like over two 50, a
(23:25):
four can bring me down into thelow hundreds.
And then an eight would be amore carby meal for me.
There's also because it's outfast.
I tend to eat things during theday where I'm combining either
fruit or vegetables with somekind of fat.
So sometimes I do need a followup dose, which means, let's say
I ate strawberries and cheese atnoon at one o'clock, I'll take a
(23:49):
look at my blood sugar.
You know, it depends on.
How, how many miles I ran in themorning could depend on how much
more follow up dose I reallyneed.
Or if I don't just that, youknow, that kind of constantly
fluctuating insulin sensitivitywith other variables, but I
might need a follow up dose ofanother four unit cartridge at
one o'clock.
If I'm trending higher that day,if I'm about to get my period,
(24:11):
my normal dosing for that meal,isn't gonna be as effective as
it.
From a different time of themonth.
Right.
So those, those little variablesand I just, you just check your
blood sugar and, and decide.
Katie (24:23):
yeah.
Okay.
So one of my questions for you,like was, does carb counting
have to be as exact as it wouldbe with like a Novalog or a
Humalog.
And I get the impression thatit's not
Ginger (24:34):
Right.
Which is a cool benefit that youdon't have to, you don't have to
get it exactly.
Right.
In order to prevent lows orhighs.
And if you do underestimate andI can tell within 45 minutes of
like, oh, I'm gonna need moreAfreza cuz it acts so fast.
It's not stressful orfrustrating because I can, let's
say I look and I'm like, oh darnI, you know, I don't measure the
(24:55):
blueberries.
Right.
So I was like, well I guess twohandfuls was way more than the
two handfuls I had yesterday andI need more, I can turn that
rising blood sugar around soquickly that it's just, it's not
a big deal.
Katie (25:09):
So does it, does it have a taste or anything?
I mean, is it, is it kind of,you know, one of those things
where you take it and thenyou're like, eh,
Ginger (25:15):
It doesn't have a taste.
The only time it's made me coughin the beginning, they do, they,
a mankind has it in theirwriting.
I believe that you might cough alittle bit in the beginning is
you're getting used to it andalso learning how to just inhale
it.
It doesn't have a taste.
I do notice sometimes that cuzwhen you.
you go like that that's as longas the inhale is it doesn't
take, you know, lots of power.
(25:36):
I can.
I like in a swimming pool, I'museless for holding my breath
underwater.
Right?
Like you don't need powerfullungs.
You do, you might noticesometimes a little white powder
comes out once you exhale after.
Taking a dose.
And I do notice sometimes thatthe hair right in my nose, it
looks a little bit white.
(25:57):
So I always go like that after Ieat, I just fight my nose
quickly after I inhale.
Too, it look like I don't havewhite powder on
Katie (26:04):
or a drug problem.
Yeah.
Ginger (26:05):
I've never heard anybody else mention that, but maybe I
have a moist in nostril.
I have no idea.
And the only other time it'smade me cough is if my, my
throat is already sore fromsomething else.
Like if I have a cold or I justwent for a run and I'm still,
you know, from my run.
And then I immediately took adose of Afreza.
I might like just cough a littlebit because I wasn't calm enough
(26:27):
when I did it.
Katie (26:28):
Well, that brings up an interesting question.
What if you are sick?
Like what if you had arespiratory infection or there
was something going on with likeyour lungs and that whole
system?
Could you still use it or haveyou used it?
Have you experienced that
Ginger (26:39):
have not been sick.
I've still not had COVID knockon wood.
I really haven't been sick inlike three years since the
pandemic, I would say I've hadlike one mild cold.
But I can see how, if I did havesomething like COVID and I was
coughing a lot that I would takea break from Afreza and use
Novalog because it would just,you know, it just wouldn't be as
(27:00):
comfortable to use it.
Is there aren't.
If you look at the medical infoon mankind's website about who
can and cannot use Afreza,there's certain lung conditions
that make you not such a greatcandidate.
I don't have that memorized andI'm not even gonna try, but
definitely look into that.
Yeah.
Katie (27:16):
Interesting.
So I'm, so I, when I was readingabout Afreza, I didn't even
apparently there was like avery, a much older version of
inhaled insulin that was notAfreza that did not go well.
And so that kind of madeendocrinologists and physicians
hesitant to, you know, prescribethis when it came out.
Cuz they had a bad taste intheir mouth from, from that.
(27:39):
So how did you hear about it?
Did you research and ask yourdoctor
Ginger (27:43):
So I actually was in the Exubera is the name of the other
one.
And I was actually in that trialfor like a week, but they made
me wear a CGM that was like waybefore CGMs were as comfortable
as they are today.
And I bailed on the trial causeI didn't want this thing in my
arm.
Exubera failed for a number ofreasons.
It was a completely differentproduct.
The inhaler was also like thesize of your arm.
(28:04):
It was huge and very cumbersome.
And so that failed and a lot ofendocrinologists still have that
in their head as, oh, no, itdoesn't work.
Don't bother.
Or, oh, it's not safe for yourlungs.
Don't bother.
It's been FDA approved and, andresearched.
Like how that it is safe foryour lungs.
(28:24):
And it, I laugh when I hear the,is it safe part because it's
like, well, injected insulin hasa lot of dangerous to it.
it's not exactly the safestthing.
It's just that we've allaccepted it because it's our
only option, but it's not ouronly option anymore.
People often ask me if itaffects my ability to exercise.
I run every day.
I have seen no difference in myability to go for a job.
(28:48):
I seen one study where it.
Afreza decreases lung functionby like 2% or something.
And then the study then hadthose people stop taking Afreza
and the lung function went backto normal.
So it's just because you'reusing your, you know, so I'm not
even gonna try to go into thedetails of that science, but
(29:08):
it's a, a temporary impact, nota long term impact.
Nothing I personally havenoticed.
Another one was on the cancerrisk in this group of people and
the only people in the group, itwas like, I'm not gonna get the
exact numbers, but let's say itwas like 1800 people.
Three people had cancer, lungcancer and they were smokers.
(29:28):
So that says
Katie (29:30):
right.
Which came first, the chicken orthe eggs type of thing,
Ginger (29:33):
Yeah.
And those three smokers gotcancer and all the others didn't
that, that says enough.
Yeah.
Katie (29:38):
Okay.
Very interesting.
So you are, you are MDI.
Do you know, can people useAfreza if they're on an insulin
pump
Ginger (29:45):
I know many people who do, yeah.
I know many people who do theythey'll say I, I see people who
say, oh, I use it to correcthighs cuz it's so fast to
correct.
I'm sure there are people whouse it for meals as well, and
then they take their basilinsulin through their pump.
And when it comes to closed looppumps, I don't know enough about
(30:05):
how you would integrate justbecause your pump is gonna try
to correct the high and you'recorrecting the high with Afreza.
So I don't know enough aboutwhether you can do that or not,
or people are doing that.
Katie (30:18):
Yeah.
I have no idea either.
We just started the Omnipod fiveclosed loop and are really
enjoying it.
But yeah, I'm not sure how thatwould work with, I mean, from
what I can tell, cause we didDIY loop for a while too.
Omnipod five is a lot moreconservative when it comes to
giving corrections and, andwhatnot.
So that has kind.
Forced people.
(30:38):
I say that cautiously to kind ofchange their settings almost to
like trick the algorithm intodoing what they want it to do.
So yeah, I mean, honestly, toanswer your answer, that
question or comment on thatquestion, I also have no idea,
but I did notice when I wasreading about the study that
they're currently doing.
In the pediatric population forFresno that I, I probably need
(30:59):
to read the fine print, but Igot the impression that you D
you could not be on an insulinpump if you were doing this
study.
And I would imagine definitelynot an automated system, cuz
yeah, like you said, like thatprobably be double dipping.
Right.
And trying to correct or highthat's already trying to be
corrected.
Ginger (31:15):
Yeah,
Katie (31:16):
All right.
Yeah, I mean, just note for theaudio and I'm sure people can
easily look it up online, butthe inhaler is super small.
I mean, it's smaller than likean asthma inhaler free.
She has it balled up in her fistand I can't even see it.
It's tiny.
Is it, is it like price?
Like, I mean, everybody'sinsurance is different and yada,
yada, but like what aboutpricing?
Ginger (31:35):
If you go to your doctor and ask about it, they might
first tell you, oh no, that'sfor type twos.
Oh no, that's not safe.
Oh no, that doesn't work.
Right.
You're gonna have to bring somematerial in explain it to them.
And if you search for myarticles on inhaled insulin
print,'em out, there's even oneson how to talk to your doctor
and bring it to them and helpthem learn that they might be
(31:57):
wrong.
Which I love to hear.
Of course.
But Where are we going?
Oh, so then you have your doctorsend in the prescription and
it's very important.
And you'll find this in thearticle titled putting inhaled
insulin to the test directionson where your doctor should send
that prescription, because ifthey just send it to your normal
pharmacy, your is, is just gonnabe a mess.
(32:19):
Instead, you're sending it to apharmacy that mankind works
closely with mankindmanufacturers of Fresno and
while.
Their team is helping work withyour insurance company to get
you approval.
Mankind will actually send youAfreza for free for like three
months while you're gettinggoing, because they want you to
(32:39):
try it and, and love it.
Right.
Katie (32:42):
I love it.
And fight for it.
Right.
Ginger (32:44):
And help you get started while you're dealing with
insurance and it's still such anew product that insurance puts
up resistance.
So you might, and I explainedthis in that article, you might
have to have your doctor reallyexplain that your current
methods are not working for you.
Maybe you're tired of needles.
Maybe it's hurting too much totake injections.
Maybe you're having too manylows.
You gotta put something down onthere and.
(33:06):
If that fails.
If your insurance refuses, theydo have a patient assistance
program.
I believe it's$99 a month.
And you get your Afrezaprescription filled through the
pharmacy that mankind worksclosely with.
Katie (33:21):
So have you found any issues now that you are getting
a however many months supply ofAfreza for yourself?
Have you found any issues withyour insurance company now?
Not covering like another, like,like your Novalog
Ginger (33:34):
Nope.
I still get my Novalog.
I still get they never evenquestioned math or prescription
and I still need the Novalog.
So I would not feel safe if Ididn't also have Novalog as an
option, you know?
So no,
Katie (33:46):
So is it, is it, I mean, you mentioned the patient
assistance program, but forsomebody that has insurance that
qualifies.
Yeah.
Yeah.
Mm-hmm
Ginger (33:53):
So then you can download a, I think it's a copay card
from mankind that makes yourcopay$15 every time you fill
that prescription.
Katie (34:03):
wow.
Hmm.
That's great.
Ginger (34:06):
So.
I've heard people say, oh, it'smore expensive.
I'm like, I don't know.
It seems a lot more affordableto me than NovoLog, but
everybody's system is different,right.
So
Katie (34:15):
well, yeah, I guess everybody's insurance could vary
for sure.
But I mean, if that's, if that'sthe monthly price that that's
definitely not a bad price tag,so, Hmm.
So what have you seen in termsof numbers, just with your own,
and I don't need specifics ifyou don't wanna share, but just
with your, you know, A1C yourtime and range, your standard
deviation ever since you startedusing.
Ginger (34:35):
So I can tell you that.
And I wasn't wearing a CGM ver Itook a long break after
pregnancy from wearing a CGM.
So when I started using Afreza,I had also just started using a
CGM again.
So I couldn't give you reallygreat percentages on time and
range, but.
I can tell you that before Istarted using Afreza, my A1C was
6.1 and I wasn't really tryingto make it lower.
(34:58):
I've done the intense pregnancymanagement with A1C in the
fives.
I know what it takes.
I know the benefits.
I just was content with my A1Cat 6.1.
Right.
The only change I made.
was that I started using Afrezaand I didn't obsess more about
highs.
I didn't micromanage my dietmore.
(35:18):
Again, I eat dessert every day.
I do not limit my carbon intake,but I'm what I would say is carb
thoughtful.
Right?
I I'm prioritized the carbs Icare about most and, and I eat
mostly, very whole real food.
So my A1C less than a year laterwas five point.
And the only change I've made isAfreza.
Katie (35:44):
Yeah.
I mean, that's significant.
That's, that's a, I mean, 6.1 isalready on the lower, on the low
end for sure.
But.
Ginger (35:51):
and because you have a parent audience, I wanna just
put it out there that when I wasa teenager, my A1C was not in
the low sixties or the highfives.
And I wouldn't expect that froma teenager despite any
technology and, you know, so.
Please don't take that to meanand that your child's A1C ought
to be that I'm a grown woman andI've been dancing this dance for
(36:13):
23 years.
Right.
So that is different thanmanaging a kid.
Katie (36:17):
I feel like I need to do a series just every week.
Just have like a T one D who'snow an adult, just come on and
tell me stories about about howthey were like awful at managing
their type one when they wereyounger.
And now they've like, you knowreformed themselves
Ginger (36:34):
Right or not even awful, just a teenager whose biggest
priority was not your bloodsugar, your insulin doses,
right?
Like their.
it.
It's just not, it's not gonnawork that way for most kids and
it's okay.
It's okay.
I just had my annual eye examthis morning.
My eyes are still dilated rightnow, actually, and I have zero
(36:56):
signs of diabetes in my eyes.
And I can tell you while I'venever deliberately neglected my
diabetes, I had A1C in thesevens high six.
I've had plenty of high bloodsugars throughout the last 23
years.
And I am not blind or bleedingfrom my eyeballs.
So take a deep breath andremember that your kid is a kid
(37:16):
and encourage them to do thebest.
They can give them a high five,even when they're struggling,
even when the blood sugar isn'tperfect.
If they check it, then they'retrying and they get the high
five for.
Katie (37:28):
Oh yeah, absolutely.
I mean, we, we are, I do my verybest, not to say a word, unless,
unless it's like true safetyconcern, you know what I mean?
Ginger (37:38):
course, of
Katie (37:38):
what we have to treat your low blood sugar
Ginger (37:40):
right.
It's not, I don't mean tosimplify it at all, but yeah.
Katie (37:44):
Yeah.
Yeah, no, I, I know.
I know, but I feel like I feel,and I know it will be okay in
the end.
It's all gonna work itself out,but I just think I need to have
somebody come on like once aweek and just be like, just
remind.
Ginger (37:55):
Yeah, that party in college in St.
Patty's day.
And you know, like it's notnormally how I manage my
diabetes, but holy moly, I feelgrateful for how that night
went.
You know, like you might needstories like that.
Katie (38:08):
I do.
I think I do.
it'd be a good series.
I don't know what I'd call ityet, but I don't know.
I'll have to think of a name.
all right.
Let's see.
Let me skim down my list ofquestions.
So I feel like I was, you know,I had a question about cons,
like if you've noticed any conswith using it, you, you
mentioned a couple about it.
(38:29):
Not being able to give you tinydoses, not being able to handle
those high fat meals.
Anything else that you can thinkof that you didn't don't
Ginger (38:36):
I mean for me.
So I use a CGM that doesn'talarm.
It's not continuous.
I use the Libre 14 day, so Ihave to scan my arm to get a
blood sugar.
And I it's a deliberate choice.
I cannot handle being alarmed atanymore.
And for me, the alarms triggerme to over.
React.
(38:56):
And it just, it gives me anxietyand I used alarms during
pregnancy and that's enough.
I'm done with the alarms.
so that's why I use this.
And that means though that if Iget distracted, like I was in
the Cape Cod with my family acouple weeks ago and we're whale
watching and I'm not thinkingabout my blood sugars, I'm on a
boat looking for whales, right.
(39:17):
I was also fasting and I hadn'tchecked my blood sugar Mylon.
I'd taken that anti nausea pill.
And I just thought I wasprobably fine and I checked my
blood sugar.
After hour two on this boat.
And I'm up near 300, because Ithink, I don't know whether I, I
think that anti nausea pillspikes my blood sugar because
it's done it on airplanes too,but I thought it was the
(39:38):
altitude anyway, real life ofdiabetes.
Right.
Which variable is it?
Two things I don't go on a lot.
Right.
Is boats and airplanes.
Katie (39:46):
Mm-hmm
Ginger (39:47):
so because I don't have the alarms bring this back to
Afreza the follow up dose.
Can be frustrating for somepeople in that you do need to
stop and take the time to seehow that meal is digesting an
hour later when Afreza is fadingfrom your system and decide for
me to follow up dose.
(40:07):
And that could be annoying orhard to remember for some
people.
I mean, it's a great thing thatit's out so fast, but the side,
the other side of that is thatyou have to remember to take a
follow up dose.
I really like the freedom.
Of how fast it works.
So for me, it's a worthwhile,extra step to have to check and
see where I'm at.
Katie (40:26):
Yeah.
Especially somebody like youthat's it sounds like you're
super active.
So that would be veryfrustrating.
If you were having to plan yourAC you know, your exercise and
everything around.
Yeah.
Ginger (40:37):
really nice because I can, even if let's say I was one
60, an hour later, if I knew Iwas gonna be sitting with my
computer writing, then I wouldtake another four unit cart.
If I knew I was about to go walkmy dog, I might hold off and see
where I'm at after the dog walk.
And therefore I don't end uphaving to eat food.
I didn't wanna eat.
Katie (40:58):
Mm-hmm Well, anything else you think would be helpful
for, for listeners to know?
I mean, you know, parents andcaregivers are the main
listeners and, and I feel likemost of them have young kids,
but some of them have older kidsthat are, you know, 18 or older
and going to the col college andall
Ginger (41:13):
critical thing to know when you start Afreza is
because, and, and this alsocould be advice for, even if
you're not using Afreza.
I'm a really big believer intiny tweaks in your background
in insulin dose.
And when you start Afreza younow don't have these multiple
doses of NovoLog on board inyour system all day.
(41:34):
I mean, if you think about it,you've almost always got some
NovoLog on board.
Because every time you eat, it'sin there for four hours, right.
By the time you eat again, it'srare that it's been more than
four hours, right?
So that's helping covering someof your background insulin
needs.
So when you start Afreza, you'lllikely need a small increase.
(41:55):
In your long acting insulin.
So if you take Afreza and, andthere's a Facebook group where
you see this, a lot of peoplesay I started taking Afreza, but
it doesn't seem like it'sworking and they, because
they're taking it to correct ahigh and it's not correcting,
it's not the Afreza, it's mostlikely that they don't have
enough background insulin.
So that's really something toconsider.
Katie (42:15):
mm-hmm
Ginger (42:15):
And pay attention to, and I would say that also
applies to even when you're noton Afreza.
If blood sugars are beingstubborn, if you're taking more
corrections and thus you'reactually having more lows, cuz
you keep taking more correctionsof Novalog chances are you
might, your child might need asmall boost to their long acting
insulin dose.
(42:37):
You're constantly takingcorrections.
It's not that they're notnecessarily getting enough
insulin with their meals.
It might be that they don't evenhave enough background insulin
and a child's insulin needschange more than anybody's
right.
Except for maybe pregnancy Sopregnancy could be like week to
week and a child's not far offfrom that.
so especially puberty andeverything.
(42:58):
So really remember that insulinneeds are not permanent and need
tweaking regular.
Katie (43:06):
Yeah, no, that's a, that's a great point.
Yeah.
Yeah, we could always tell thatSarah's basil when she was on
MDI, that it wasn't high enoughor, or, or the basil rate the
pump, but like, you know, we'dcorrect for a high and it would
start to go down and we'd belike, oh, it's working.
And then it would like stop andstart to go back up.
And you know, this is like acouple hours after she's eaten
and I'm like I think that'sprobably her basal, you know?
Ginger (43:27):
Right.
And you can get reallyfrustrated and mad and feel like
you're failing.
Or you can say what's notworking here.
What do I know more of or lessof.
Right.
And, and that's what you didwhen you adjust your basil and
then you get to move on withyour life until the next little
diabetes moment.
Katie (43:43):
yeah.
Yeah.
Well, I sure do wish Sarah hadsome Afrezza right now cuz she
is at a camp and her blood sugaris really high.
So I'm like, what happened?
Did you not Boles for your lunchor maybe not pre Boles?
Who knows?
But um,
Ginger (43:57):
Summer camp doesn't sound fun at all.
So
Katie (44:00):
No, it really doesn't.
Fortunately, he's there withanother T one D buddy.
It's not a diabetes camp, butit's just a, a, you know, camp
and at least they have eachother, you know, solidarity,
Ginger (44:10):
And speaking of pre bolus, I mean with Afreza, you
definitely don't need to prebolus.
And in many cases, I don't evenwanna take my insulin until I
see my blood sugar start torise, cuz it's so fast.
So they, the only times Ireally.
Start going low from Afreza iswhen I took it too early for a
(44:30):
meal that's digesting slowly.
Katie (44:32):
Hmm.
Ginger (44:33):
So I like that freedom.
Katie (44:35):
Yeah, definitely not having to wait to eat.
Absolutely.
That.
Fantastic.
well, I'm super excited to seethe results of this study.
I'm, I'm kind of debatingwhether or not I actually wanna
email the lady cuz they'rethey're doing they're recruiting
at the university of Florida,which is not too far from where
we are.
But I'm like, oh, we juststarted the Omnipod five system.
And right now we're really,really loving it.
(44:56):
And I'm like, I know they'regonna make me come off.
They're gonna make us come offof that.
And.
I dunno, selfishly I'm like, doI really want to, but even just
to talk to her about it, youknow, maybe I could have her on
and be like, okay, what's whatare you seeing so far?
Ginger (45:11):
There's no way Yeah.
Katie (45:13):
Okay.
Maybe in two years or threeyears when it's over.
Cause it's a long study.
It's like a, it's a long study.
I think it'll be a couple yearsbefore we know whether or not
that gets approved for kids, butexciting stuff for sure.
Well, thank you, ginger, forcoming on.
Thank you for your time.
And I will definitely link toyou know, your books and, and
some of the other blogs you'vewritten on Afreza and anything
else that you would like me tolink to in the show?
Ginger (45:36):
Sure ginger vera.com.
I link to as much as I canthere.
So you don't have to go lookingall over the web for it.
Katie (45:42):
Yeah.
Awesome.
Well, thank you so much.
Have a great
Ginger (45:44):
thanks for having me.
Katie (45:46):
Thanks, bye.
All right.
You guys, that is it for ourshow today.
Wasn't ginger, an awesome guest.
I really love talking with her.
I feel like she just has so muchknowledge and wisdom to share.
I might have to have her back onagain, to talk about some other
things like caregiver, burnout,or how to keep from going low or
(46:06):
high while you're exercising.
Make sure you check out the shownotes again.
I will provide you with one veryconvenient link to where you can
find ginger in all of herdiabetes resources.
She has.
Written them out nicely in oneplace with links to everything.
So you can find it super, superfast.
All right.
My friends have a fabulous week.
(46:27):
I hope you're weak.
And your weekend with diabetesgoes well, and I will chat with
you soon until then stay calmand Boless on.
Hey everybody.
It's Katie and you are listeningto episode 83 of the sugar
mama's podcast.
Today's episode is all aboutAfreza, which is the inhalable
insulin.
My guest today to talk to meabout Afreza is ginger Vera.
Ginger is a type one diabetic.
She currently uses Afreza.
(00:20):
She is extremely connected tothe world of type one.
She has written many, many booksand other blog posts and
resources for the diabetescommunity, which I will link to
in the show notes.
She is also the content managerat beyond type one and beyond
type two, which basically meansin her words that she writes a
lot and creates a lot of reelsfor Instagram.
(00:42):
That sounds like a fantasticjob.
Sign me up.
I really enjoyed having gingeron.
I thought she had lots ofinsight and wisdom to share, and
I'm really excited for you guysto hear more and learn more
about Afreza.
Right now Afreza is onlyapproved for use and people who
are 18 or older, but currentlygoing on as we speak is a
clinical research trial todetermine if Afreza is effective
(01:05):
and safe in the pediatricpopulation.
That is very exciting news to myears.
All right.
Without further ado, let's getstarted.
Be sure to check out the shownotes as always for links to
other episodes that might bementioned in the show links to
where you can find ginger andall of her amazing resources and
books that she's written.
And not to mention links to thepodcasts, buy me a coffee page
(01:30):
and other ways that you cansupport this show.
All right.
You guys, here we go.
You're listening to the sugarmamas podcast, a show designed
for moms and caregivers of typeone diabetics here.
You'll find a community oflike-minded people who are
striving daily to keep theirkids safe, happy, and healthy in
(01:53):
the ever-changing world of typeone.
I'm your host and fellow T one Dmom, Katie Roseboro.
Before we get started.
I need you to know that nothingyou hear on the sugar mamas
podcast should be consideredmedical advice.
Please be safe, be smart, andalways consult your physician
before making changes to the wayyou manage type one diabetes.
(02:17):
Thanks.
All right, everybody.
I am here today with a greatguest.
Her name is ginger, but I'mgoing to allow her to introduce
he.
So ginger, just tell everybody alittle bit about yourself and
how you are connected to theworld of type one diabetes.
Ginger (02:36):
Sure.
Hi.
My name is Ginger Vierira and Ihave lived with type one
diabetes for 23 ish years.
I was diagnosed when I was 13 in1999.
I actually diagnosed myself.
Nobody believed me for a week.
The seventh grade I was inseventh grade and our class was
working on projects for theschool health fair.
And one of my classmates wasdoing his own diabetes and.
(02:59):
I saw all the symptoms listed onhis poster board while we were
working on our projects inclass.
And I said, I think I have that.
Can you die from that?
And he's like, oh yeah.
And you know, seventh grade.
And I told my mom, she said, noonly old people get that.
And a few days later I justburst into tears cuz I felt so
lousy and all my symptoms, youknow, it's like, oh, well
(03:22):
everybody has glasses in thisfamily.
You think you just need glassesand well of course you lost
weight.
You.
Going through puberty and ofcourse your legs feel heavy and
you don't wanna go to school.
You're a teenager, you know?
And so it really ramped upquickly.
But yeah, so that was, that wasmy diagnosis.
Katie (03:40):
Wow.
That's wild.
I you're, that's definitely thefirst I've heard of somebody
diagnosing themselves as achild, at least.
Um, but
Ginger (03:48):
proud of itself that they, that they very proud of
themselves, that they served apurpose that year.
Katie (03:55):
yeah, had that kid just randomly chosen diabetes or did
he have
Ginger (03:58):
Yeah.
And you know, his, this is,again, this is seventh grade,
right?
So it, he didn't have type oneor type two on his poster board.
He just, it was just diabetes.
And he later asked me out and Isaid, oh no, I've gotta pack for
summer camp.
I can't be your girlfriend.
So poor guy.
Yeah.
Katie (04:16):
He thought he was totally gonna get a date out of that.
He's like, oh, I diagnosed her.
I'm definitely gonna be able toget a date.
funny.
Ginger (04:22):
So I also have a, the year later I was diagnosed with
celiac because they justscreened all the teenagers that
was upsetting as my family'sItalian and weight spaghetti,
like twice a week.
But I have since come to reallyappreciate what celiac does to
keep garbage food outta yourbody.
Not that you can't find garbagefood, that's gluten free, but
(04:43):
and I.
In college developed what we'recalling fibromyalgia.
Lots of people are stillskeptical of fibromyalgia.
We can't pinpoint it, but itreally.
Seems to fit what I startedexperiencing while I was
training and competing incompetitive power lifting.
And I just really, I think mybody is prone to autoimmune
(05:05):
disease and I triggered kind ofchronic muscle spasms.
And I'm now very.
Sensitive to exercise.
I have rebuilt my tolerance forexercise.
So I, I exercise a lot.
I would consider myself still anathlete, but I don't go to any
extremes.
I just kind of maintain physicalfitness.
Katie (05:24):
Interesting.
Yeah, I'm a, I'm a physicaltherapist by trade and you know,
fibromyalgia is always such aninteresting diagnosis, cuz it's
so hard to talk people intolike, Exercising when their body
just hurts.
You know what I mean?
And, and, you know, I, I try todo my best to explain that like,
no exercising will help.
I promise it will help.
(05:44):
It will not only help youphysically, but it'll help you
mentally and emotionally.
And,
Ginger (05:49):
Regular exercise is part of my treatment for my
fibromyalgia.
It makes me feel awesome.
Yes, indeed.
Katie (05:56):
Well, good.
Regular exercise is just part ofmy mental care treatment,
mental, you know, mental healthtreatment for myself.
It's funny.
Sarah asked me the, the otherday, like, mommy, why do you,
why do you exercise?
Is it, you know, is it to likelose weight?
And I'm like, honestly, honey,at this point in time in my
life, it is to keep myself fromgoing crazy.
Ginger (06:14):
Yeah, I can't, if I, for some reason don't get to go for
my morning jog.
I just can't think straight bylike nine, 10:00 AM.
Like I need to get it outta mysystem.
So yeah.
I also have mild hypothyroidthat I take a, a low dose of
thyroid medicine for, and, youknow, it sounds like a list of
things, but I know you have alot of parents listening.
(06:35):
I wanna tell you that I amfrigging thriving and I love
light.
I have a ton of energy and Iwould say I'm thriving because I
embrace what my challenges areand I figure out my limits and I
figure out what helps me feelawesome.
And what doesn't.
And I live my life by that.
And,
Katie (06:53):
Hmm.
I love that.
And I know parents listeninglove to hear.
Ginger (06:56):
Yeah.
And I'm a mother.
I have two children.
I work full time.
I walk my dog six miles a day.
Life is good.
Katie (07:03):
Wow.
Wow.
That's awesome.
Where, and, and you, you work,you work full time, correct?
Tell, tell listeners a littlebit about that too, because
that's another way in whichyou're connected.
Ginger (07:12):
Roughly.
Yeah.
So I went to school for writing.
I have a bachelor's inprofessional writing and I have
really combined Miley passionfor helping people figure out
how to get through the day withtype one diabetes.
Safely and, you know, asjoyfully as possible with
writing.
And so I have been writing forprobably 15 years about type one
(07:33):
diabetes.
I started, I got my niche in,when I started going to the gym.
I hired a personal trainerbecause I didn't really, I kind
of acted like a typical collegestudent for one year and my A1C
jumped up and I just felt lousy.
And I was like, I don't wannafeel this way.
And so I got really sucked intothe fitness world.
(07:55):
And power lifting and I gotreally strong, very quickly.
and I went to an endocrinologistshortly before my, when I,
shortly after I started trainingin power lifting and I said to
him, I would like, you know, I'mplanning to compete in a few
months in my first power liftingmeat, but I really need some
help because I, my blood sugarsare not really, you know, and
(08:16):
this is back before everybodyhad a CGM.
I did not have a CGM.
This is.
Early 2000.
This is maybe 2010.
So CGMs were just around thecorner and he laughed at me.
The endocrinologist did not helpme accused me of forgetting or
skipping my long acting insulindose, which I was not.
(08:36):
I was waking up with high bloodsugars because I needed help.
Not because I was deliberately.
Neglecting my insulin.
Right.
so I, I cried, I did not go backto that guy and I kind of had to
figure out how to train andcompete and do all of that
without much help.
And fortunately, my coach lovedexercise physiology, so he
helped me learn exercisephysiology, and then mashing it
(09:01):
in with type one diabetes.
And.
I set seven records at my firstcompetition, without that stupid
doctor's help.
And from there kind of startedtrying to write exercise science
in layman's terms for my fellowtype ones to help them also
enjoy exercising with type one.
And now.
(09:23):
10 15 years later, I understandit even more and understand how
to explain it even more.
But in the midst of that havereally written almost on every
topic.
There is for dozen differentwebsites
Katie (09:37):
Yeah.
I know when I was kind ofpreparing for our interview and,
and you know, of course Googlingyou.
I'm like, oh my gosh, she's,she's written quite a bit.
And you know, you've actuallyauthored a few books that I
heard about one a while ago,just listening to the juice box
podcast, cuz you.
You coauthored it with JennySmith, correct.
The one about pregnancy.
(09:58):
And I remember hearing, youknow, Jenny talk about how she
wrote it with her friend ginger,and that's just not a name you
forget.
Cause I don't, I don't know thatI know any other gingers, but
and then I came across you youknow, by other means O on the
web and, and here we areconnected and chatting, but so
would you mind telling listenersjust a little bit about the
books that you've written.
Ginger (10:16):
Sure.
Sure.
So my very first book I wrote incollege, please forgive all the
typos.
It was self-published with ateam of college students helping
me and it's called your diabetesscience experiment.
And that was my, really my firstattempt at helping people learn
how to exercise with diabetes.
I am literally right now workingon a.
New and improved version ofexercising as a beginner with
(10:38):
type one diabetes.
But I still keep selling thatbook despite all the typos,
because people tell me howuseful it's been.
I also have a 30 page kind ofguidebook called emotional
eating with diabetes that helpspeople who live with diabetes
for a long time.
Untangle the impact it's had ontheir relationship with food and
especially for your audience asparents.
(10:59):
I mean, the biggest piece ofadvice I could give you is, do
not try to force a diet andrestriction upon your child with
diabetes instead, help themembrace.
What do I need to do around thistype of food?
What do I need to do around thistype of food to help me thrive,
to help me reach my blood sugargoals.
Versus those foods are bad.
(11:20):
Those foods are bad.
You're bad for eating them.
Go on a keto diet, et cetera,that can just really lead to.
So much complicated emotions andbehavior around food as you get
older.
So that book is to help peoplekind of untangle that and, and
figure out what's going on intheir head and how it's
impacting their decisions andbinge eating after a lot of
(11:41):
restriction, et cetera.
I also have dealing withdiabetes burnout.
Which also has a section forparents um, and caregivers and
family and pregnancy with typeone diabetes.
It's still the only guide tomanaging pregnancy with type one
diabetes out there.
And all of these are on Amazon.
And then we have two children'sbooks now.
My friend Mike Lawson, and Ihave written together, he's the
(12:04):
artist and I'm the writer and hehas type one.
When I go low and ain't gonnahide my T one D and those are on
Amazon.
Katie (12:11):
I think I've listened to you to an interview on a
different podcast.
And honestly, I might have beendiabetes connection.
I'm not sure you would know.
Um, But I what you were talkingabout, that, that book when I go
low and, and I listened to theinterview and I, you know, loved
everything you had to say.
And then again, when I was kindof preparing for this interview,
I'm like, oh, that she's theauthor of that book that I
remember hearing about.
So.
Ginger (12:32):
Great.
Katie (12:33):
Yeah.
Okay.
Well, awesome.
I mean, definitely my earsperked up with the diabetes
burnout situation.
Cause I mean, I think it's, Idon't know, as a parent who's
only been dealing with this fortwo years, I feel like burnout
is just a normal part ofmanaging diabetes for yourself
or for your kid.
And I mean, hopefully as timegoes on, it kind of.
(12:55):
Comes and goes very quickly.
But I feel like it, for me, atleast it kind of just comes and
goes in waves.
You know, I'll just go through aweek where I'm just completely
over it and and then I'll bounceback and everything will be
fine.
And so I'll have to take a lookat that one.
And I, I, I'm gonna, I'mactually getting ready to do a
little mini series with adiabetes educator.
Who's also a registereddietician specifically on eating
(13:16):
like emotional eating and justeating in general.
Surround you.
With type di type one diabetesin mind.
So I might have to grab that andskim through it and read through
it before I talk with her to, toget a little bit more questions
and content, cuz that'ssomething we haven't encountered
yet in our household.
But I feel like the teenageyears are coming and we're just
(13:40):
have to see.
Okay, well, you are veryconnected to the world of type
one in many different ways.
But the reason I really wantedto have you on today is because
I read an article recently thatpopped up on LinkedIn about
Afreza and your use of Afreza.
And I have read a lot aboutAfreza, but I feel like my
listen.
Maybe haven't just becauseAfreza is only approved for
(14:03):
people who are 18 and older atthis time.
But I wanted to learn more aboutit.
I think it's fascinating.
And they are currently doing astudy on it right now, a
clinical trial on it right now.
That's actually still active inrecruiting participants.
So at the end of this episode,if you're interested, I will
link to that study in, in theshow notes and people can check
it out and see if.
(14:23):
You know, recruiting in yourarea, but I will let you explain
since you actually havefirsthand experience with Afreza
tell listeners what Afreza is.
Ginger (14:32):
Sure Afreza is inhaled insulin.
So it's very it's this, theinhaler itself is just
mechanical.
There's nothing.
Really complicated about it.
And then you have thesecartridges of powdered insulin.
So they come in units of four,eight, and 12, and your first
thought, and what actually keptme from trying it for a long
(14:53):
time is how the heck could Imanage type one diabetes with
predetermined doses of four,eight and 12 Afreza is a totally
different.
It is not the same as four unitsof Novalog.
I wouldn't even dare to say, andthey do try to do this when they
talk about Afreza so they cangive you some context, but I
(15:15):
wouldn't even dare to say thatit converts to a specific unit
of Novalog because.
It just works so differently.
The most significant differenceof Afreza is that it is active
in your system within like twoand a half minutes of inhaling
it because it's going throughyour lungs straight into your
(15:36):
bloodstream and insulin has toget C processed and, and
eventually get to yourbloodstream.
Right.
So.
It's really fast acting, whichmeans you don't need to pre Boce
for your meals.
It means you can turn aroundblood sugars that are rising
very quickly.
And please remember, I am not adoctor and I am definitely not
(15:58):
your doctor.
And I'm gonna be speaking frompersonal experience using
Afreza.
I really love that.
It's also out fast, so it actsfast and it's out fast.
And when I say out fast, thefour unit cartridge in, in the
FDA approved language aroundthis is that it's out at
approximately 90.
(16:19):
Minutes after dosing, but mostpeople who use Afreza will tell
you that they see little to noimpact in their blood sugar
after 60 minutes.
And what's really cool aboutthat.
Especially as someone who'sreally active, I walk my dog
three times a day and if I wastaking Novalog for my meals, I
would, let's say I eat mystrawberries and cheese lunch at
(16:44):
noon.
I have to take NovoLog for that.
And then I might be able to walkmy dog an hour later, or maybe
immediately, or whatever I haveto account for how much NovoLog
is still in my system withAfreza.
I know I can eat at noon and ifI wanna walk my dog at one
o'clock or two o'clock, I don'thave to worry about insulin on
(17:06):
board, rapid acting insulin onboard, cuz it's not on board
anymore.
And so the risk of going low.
It's just for me, I'm alwaysgonna bring those back to my
personal experience, cuz I'm notyour doctor is significantly
lower.
And I don't even have to thinkabout it.
And I always go on dog walks orany type of exercise with candy
(17:29):
in my dog walking bag.
Right.
Or my little belt around mywaist for jogging, but I never
use it.
I never use it anymore.
And with Novalog.
I never had any severe lowswhere I needed glucagon and I'm,
you know, on the sidewalk layingdown cuz of a low, but I would
have to eat candy that I didn'twant because I knew I had
(17:50):
insulin on board and I know Iwanna walk two and a half miles
and yada yada yada.
Right.
So that's the coolest thingabout Afreza is.
It acts fast and it's out fastand the bigger the dose you take
the longer, it could be still inyour system.
So an eight unit could still bearound 90 minutes daily
(18:10):
languages that it could be inyour system for up to like two
hours or something.
But it really it's so minimalthe biggest impact I can
literally I could take, let'ssay my blood sugar was rising
right now because I slightlyunderdosed for.
I could look at a one 40 with anup arrow or a 180 with an up
arrow, take a four or an eight,depending on what I know is
(18:32):
digesting.
Right.
And turn it around.
And within 15 minutes I will beheaded down and not worrying
about being high for the nextthree hours.
Katie (18:44):
Hmm.
Wow.
Ginger (18:45):
correct high, really fast.
So if I.
Completely underestimatedessert.
And I miss that I'm risingbecause I'm playing pegs and
jokers, my boyfriend of myfriends.
And I look at my blood sugar.
I like, oh, shoot.
I'm like two 70 because Icompletely underdosed.
And I didn't notice till justnow I can bring that down within
(19:05):
an hour I'm down.
Cause I'm because it's out fast,you just land, you don't crash
and then keep crashing becauseit out fast.
So it's, it's really cool.
Katie (19:19):
So I, I have a lot of questions.
Ginger (19:21):
Okay.
Yes,
Katie (19:22):
so, okay.
First, what is, what's yourwhole insulin profile look like?
Like, are you, are you taking aninjection of basal insulin and
using Afreza or what, what kindof combo do you got going on?
Ginger (19:34):
tried pumping.
I pumped for years in my earlyyears of type one, but I've
really come to love thesimplicity of multiple di daily
injections.
They can't fail me like aninsulin pump can And so I take
one dose a day of long actingLantis, and then I do still take
every day.
(19:55):
Probably two units, a two,sorry, two doses of NovoLog,
because what Afreza can't do isgive me a teeny teeny amount,
right in the morning, Isometimes need like a half unit
for Don phenomenon.
I, I am also very fond ofintermittent fasting.
And so the longer I fast, themore likely my liver is gonna
release some glucose and I needa, a tiny, slow insulin to cover
(20:18):
that.
I also would take Novalog beforebed.
I save, I, enjoy carbs.
In the evening.
So I don't follow any strictcarb diet, but I try to eat
really clean whole foods duringthe day.
And I, and give myselfpermission to enjoy homemade
cookies or whatever it is,Hershey, kisses, whatever
(20:41):
dessert, and because of Afrezzaacts so fast.
Is really great for thebeginning of digesting that
dessert, but then I go to sleepand I'm not gonna take a follow
up dose of Afreza when I'munconscious.
So I take no vlog to help dealwith the slow digestion of that
meal.
Same could be set for pizza,Chinese food, you know, those,
(21:03):
those high fat, high carb foodsthat I personally don't eat on a
regular basis, but I enjoy themas a treat here and there.
So that's a combo of Afreza andNovoLog to help me tackle that
slow digestion.
Katie (21:14):
Hmm.
So for you personally, you, youtake Afreza first when you kind
of start eating the dessert or,or high fat meal like you
described.
And then before you would go tobed, you would take Novalog
that's that's interesting.
Ginger (21:26):
It's a, and it's a very, there's a, a great learning
curve to using Afreza.
And.
It takes a little while, but youreally have to approach it.
Like this is a new game of typeone diabetes.
And for me, it's been a reallyfun new game because it's just
like after 23 years of doing theother game, it's like, whoa,
this is so different.
I love, like, I just love how,how fast it acts.
(21:49):
I don't really ever feel theneed to rage.
I have overcorrected lows acouple times with Afreza where I
underestimated its power.
But again, because it's out sofast, the lows are not nearly as
stressful as lows with Novalogwhere you're like, Ugh, I'm
gonna be dealing with this extrainsulin on board for another two
hours.
(22:10):
You know, it doesn't feel likethat with Afreza because you can
look at the clock and say, well,I took this dose at noon.
I know it's gonna be out by oneor one 30 or two.
If it was a really big.
It's just, it's a much more fungame in my opinion.
Katie (22:26):
Yeah.
I mean, it sounds amazing.
I'm I'm curious, you said youcan't, you can't really compare
it to dosing, like a Novalog ora Humalog or anything like that,
like for a, do they call it afour unit cartridge?
Like, is it actu
Ginger (22:39):
the blues are fours.
Katie (22:41):
Mm-hmm
Ginger (22:42):
The green cartridge is eights.
There's also a 12, which I don'tuse.
And I believe those are likepurple.
I, I haven't even seen a pictureof them in so long that I can't
cuz I just don't.
I don't use those.
And a friend of mine who lovesAfreza.
She has a great description ofit that it's kind of like small,
medium and large.
(23:03):
So if you're eating a small mealthen you know, from, and
everybody's insulin needs aredifferent, right?
I'm fairly sensitive to insulin.
So my insulin needs are fairlylow.
So for me, a four could cover asmall meal or a small
correction.
I don't need an eight for anexample to cover.
To correct a high blood sugar,unless I'm like over two 50, a
(23:25):
four can bring me down into thelow hundreds.
And then an eight would be amore carby meal for me.
There's also because it's outfast.
I tend to eat things during theday where I'm combining either
fruit or vegetables with somekind of fat.
So sometimes I do need a followup dose, which means, let's say
I ate strawberries and cheese atnoon at one o'clock, I'll take a
(23:49):
look at my blood sugar.
You know, it depends on.
How, how many miles I ran in themorning could depend on how much
more follow up dose I reallyneed.
Or if I don't just that, youknow, that kind of constantly
fluctuating insulin sensitivitywith other variables, but I
might need a follow up dose ofanother four unit cartridge at
one o'clock.
If I'm trending higher that day,if I'm about to get my period,
(24:11):
my normal dosing for that meal,isn't gonna be as effective as
it.
From a different time of themonth.
Right.
So those, those little variablesand I just, you just check your
blood sugar and, and decide.
Katie (24:23):
yeah.
Okay.
So one of my questions for you,like was, does carb counting
have to be as exact as it wouldbe with like a Novalog or a
Humalog.
And I get the impression thatit's not
Ginger (24:34):
Right.
Which is a cool benefit that youdon't have to, you don't have to
get it exactly.
Right.
In order to prevent lows orhighs.
And if you do underestimate andI can tell within 45 minutes of
like, oh, I'm gonna need moreAfreza cuz it acts so fast.
It's not stressful orfrustrating because I can, let's
say I look and I'm like, oh darnI, you know, I don't measure the
(24:55):
blueberries.
Right.
So I was like, well I guess twohandfuls was way more than the
two handfuls I had yesterday andI need more, I can turn that
rising blood sugar around soquickly that it's just, it's not
a big deal.
Katie (25:09):
So does it, does it have a taste or anything?
I mean, is it, is it kind of,you know, one of those things
where you take it and thenyou're like, eh,
Ginger (25:15):
It doesn't have a taste.
The only time it's made me coughin the beginning, they do, they,
a mankind has it in theirwriting.
I believe that you might cough alittle bit in the beginning is
you're getting used to it andalso learning how to just inhale
it.
It doesn't have a taste.
I do notice sometimes that cuzwhen you.
you go like that that's as longas the inhale is it doesn't
take, you know, lots of power.
(25:36):
I can.
I like in a swimming pool, I'museless for holding my breath
underwater.
Right?
Like you don't need powerfullungs.
You do, you might noticesometimes a little white powder
comes out once you exhale after.
Taking a dose.
And I do notice sometimes thatthe hair right in my nose, it
looks a little bit white.
(25:57):
So I always go like that after Ieat, I just fight my nose
quickly after I inhale.
Too, it look like I don't havewhite powder on
Katie (26:04):
or a drug problem.
Yeah.
Ginger (26:05):
I've never heard anybody else mention that, but maybe I
have a moist in nostril.
I have no idea.
And the only other time it'smade me cough is if my, my
throat is already sore fromsomething else.
Like if I have a cold or I justwent for a run and I'm still,
you know, from my run.
And then I immediately took adose of Afreza.
I might like just cough a littlebit because I wasn't calm enough
(26:27):
when I did it.
Katie (26:28):
Well, that brings up an interesting question.
What if you are sick?
Like what if you had arespiratory infection or there
was something going on with likeyour lungs and that whole
system?
Could you still use it or haveyou used it?
Have you experienced that
Ginger (26:39):
have not been sick.
I've still not had COVID knockon wood.
I really haven't been sick inlike three years since the
pandemic, I would say I've hadlike one mild cold.
But I can see how, if I did havesomething like COVID and I was
coughing a lot that I would takea break from Afreza and use
Novalog because it would just,you know, it just wouldn't be as
(27:00):
comfortable to use it.
Is there aren't.
If you look at the medical infoon mankind's website about who
can and cannot use Afreza,there's certain lung conditions
that make you not such a greatcandidate.
I don't have that memorized andI'm not even gonna try, but
definitely look into that.
Yeah.
Katie (27:16):
Interesting.
So I'm, so I, when I was readingabout Afreza, I didn't even
apparently there was like avery, a much older version of
inhaled insulin that was notAfreza that did not go well.
And so that kind of madeendocrinologists and physicians
hesitant to, you know, prescribethis when it came out.
Cuz they had a bad taste intheir mouth from, from that.
(27:39):
So how did you hear about it?
Did you research and ask yourdoctor
Ginger (27:43):
So I actually was in the Exubera is the name of the other
one.
And I was actually in that trialfor like a week, but they made
me wear a CGM that was like waybefore CGMs were as comfortable
as they are today.
And I bailed on the trial causeI didn't want this thing in my
arm.
Exubera failed for a number ofreasons.
It was a completely differentproduct.
The inhaler was also like thesize of your arm.
(28:04):
It was huge and very cumbersome.
And so that failed and a lot ofendocrinologists still have that
in their head as, oh, no, itdoesn't work.
Don't bother.
Or, oh, it's not safe for yourlungs.
Don't bother.
It's been FDA approved and, andresearched.
Like how that it is safe foryour lungs.
(28:24):
And it, I laugh when I hear the,is it safe part because it's
like, well, injected insulin hasa lot of dangerous to it.
it's not exactly the safestthing.
It's just that we've allaccepted it because it's our
only option, but it's not ouronly option anymore.
People often ask me if itaffects my ability to exercise.
I run every day.
I have seen no difference in myability to go for a job.
(28:48):
I seen one study where it.
Afreza decreases lung functionby like 2% or something.
And then the study then hadthose people stop taking Afreza
and the lung function went backto normal.
So it's just because you'reusing your, you know, so I'm not
even gonna try to go into thedetails of that science, but
(29:08):
it's a, a temporary impact, nota long term impact.
Nothing I personally havenoticed.
Another one was on the cancerrisk in this group of people and
the only people in the group, itwas like, I'm not gonna get the
exact numbers, but let's say itwas like 1800 people.
Three people had cancer, lungcancer and they were smokers.
(29:28):
So that says
Katie (29:30):
right.
Which came first, the chicken orthe eggs type of thing,
Ginger (29:33):
Yeah.
And those three smokers gotcancer and all the others didn't
that, that says enough.
Yeah.
Katie (29:38):
Okay.
Very interesting.
So you are, you are MDI.
Do you know, can people useAfreza if they're on an insulin
pump
Ginger (29:45):
I know many people who do, yeah.
I know many people who do theythey'll say I, I see people who
say, oh, I use it to correcthighs cuz it's so fast to
correct.
I'm sure there are people whouse it for meals as well, and
then they take their basilinsulin through their pump.
And when it comes to closed looppumps, I don't know enough about
(30:05):
how you would integrate justbecause your pump is gonna try
to correct the high and you'recorrecting the high with Afreza.
So I don't know enough aboutwhether you can do that or not,
or people are doing that.
Katie (30:18):
Yeah.
I have no idea either.
We just started the Omnipod fiveclosed loop and are really
enjoying it.
But yeah, I'm not sure how thatwould work with, I mean, from
what I can tell, cause we didDIY loop for a while too.
Omnipod five is a lot moreconservative when it comes to
giving corrections and, andwhatnot.
So that has kind.
Forced people.
(30:38):
I say that cautiously to kind ofchange their settings almost to
like trick the algorithm intodoing what they want it to do.
So yeah, I mean, honestly, toanswer your answer, that
question or comment on thatquestion, I also have no idea,
but I did notice when I wasreading about the study that
they're currently doing.
In the pediatric population forFresno that I, I probably need
(30:59):
to read the fine print, but Igot the impression that you D
you could not be on an insulinpump if you were doing this
study.
And I would imagine definitelynot an automated system, cuz
yeah, like you said, like thatprobably be double dipping.
Right.
And trying to correct or highthat's already trying to be
corrected.
Ginger (31:15):
Yeah,
Katie (31:16):
All right.
Yeah, I mean, just note for theaudio and I'm sure people can
easily look it up online, butthe inhaler is super small.
I mean, it's smaller than likean asthma inhaler free.
She has it balled up in her fistand I can't even see it.
It's tiny.
Is it, is it like price?
Like, I mean, everybody'sinsurance is different and yada,
yada, but like what aboutpricing?
Ginger (31:35):
If you go to your doctor and ask about it, they might
first tell you, oh no, that'sfor type twos.
Oh no, that's not safe.
Oh no, that doesn't work.
Right.
You're gonna have to bring somematerial in explain it to them.
And if you search for myarticles on inhaled insulin
print,'em out, there's even oneson how to talk to your doctor
and bring it to them and helpthem learn that they might be
(31:57):
wrong.
Which I love to hear.
Of course.
But Where are we going?
Oh, so then you have your doctorsend in the prescription and
it's very important.
And you'll find this in thearticle titled putting inhaled
insulin to the test directionson where your doctor should send
that prescription, because ifthey just send it to your normal
pharmacy, your is, is just gonnabe a mess.
(32:19):
Instead, you're sending it to apharmacy that mankind works
closely with mankindmanufacturers of Fresno and
while.
Their team is helping work withyour insurance company to get
you approval.
Mankind will actually send youAfreza for free for like three
months while you're gettinggoing, because they want you to
(32:39):
try it and, and love it.
Right.
Katie (32:42):
I love it.
And fight for it.
Right.
Ginger (32:44):
And help you get started while you're dealing with
insurance and it's still such anew product that insurance puts
up resistance.
So you might, and I explainedthis in that article, you might
have to have your doctor reallyexplain that your current
methods are not working for you.
Maybe you're tired of needles.
Maybe it's hurting too much totake injections.
Maybe you're having too manylows.
You gotta put something down onthere and.
(33:06):
If that fails.
If your insurance refuses, theydo have a patient assistance
program.
I believe it's$99 a month.
And you get your Afrezaprescription filled through the
pharmacy that mankind worksclosely with.
Katie (33:21):
So have you found any issues now that you are getting
a however many months supply ofAfreza for yourself?
Have you found any issues withyour insurance company now?
Not covering like another, like,like your Novalog
Ginger (33:34):
Nope.
I still get my Novalog.
I still get they never evenquestioned math or prescription
and I still need the Novalog.
So I would not feel safe if Ididn't also have Novalog as an
option, you know?
So no,
Katie (33:46):
So is it, is it, I mean, you mentioned the patient
assistance program, but forsomebody that has insurance that
qualifies.
Yeah.
Yeah.
Mm-hmm
Ginger (33:53):
So then you can download a, I think it's a copay card
from mankind that makes yourcopay$15 every time you fill
that prescription.
Katie (34:03):
wow.
Hmm.
That's great.
Ginger (34:06):
So.
I've heard people say, oh, it'smore expensive.
I'm like, I don't know.
It seems a lot more affordableto me than NovoLog, but
everybody's system is different,right.
So
Katie (34:15):
well, yeah, I guess everybody's insurance could vary
for sure.
But I mean, if that's, if that'sthe monthly price that that's
definitely not a bad price tag,so, Hmm.
So what have you seen in termsof numbers, just with your own,
and I don't need specifics ifyou don't wanna share, but just
with your, you know, A1C yourtime and range, your standard
deviation ever since you startedusing.
Ginger (34:35):
So I can tell you that.
And I wasn't wearing a CGM ver Itook a long break after
pregnancy from wearing a CGM.
So when I started using Afreza,I had also just started using a
CGM again.
So I couldn't give you reallygreat percentages on time and
range, but.
I can tell you that before Istarted using Afreza, my A1C was
6.1 and I wasn't really tryingto make it lower.
(34:58):
I've done the intense pregnancymanagement with A1C in the
fives.
I know what it takes.
I know the benefits.
I just was content with my A1Cat 6.1.
Right.
The only change I made.
was that I started using Afrezaand I didn't obsess more about
highs.
I didn't micromanage my dietmore.
(35:18):
Again, I eat dessert every day.
I do not limit my carbon intake,but I'm what I would say is carb
thoughtful.
Right?
I I'm prioritized the carbs Icare about most and, and I eat
mostly, very whole real food.
So my A1C less than a year laterwas five point.
And the only change I've made isAfreza.
Katie (35:44):
Yeah.
I mean, that's significant.
That's, that's a, I mean, 6.1 isalready on the lower, on the low
end for sure.
But.
Ginger (35:51):
and because you have a parent audience, I wanna just
put it out there that when I wasa teenager, my A1C was not in
the low sixties or the highfives.
And I wouldn't expect that froma teenager despite any
technology and, you know, so.
Please don't take that to meanand that your child's A1C ought
to be that I'm a grown woman andI've been dancing this dance for
(36:13):
23 years.
Right.
So that is different thanmanaging a kid.
Katie (36:17):
I feel like I need to do a series just every week.
Just have like a T one D who'snow an adult, just come on and
tell me stories about about howthey were like awful at managing
their type one when they wereyounger.
And now they've like, you knowreformed themselves
Ginger (36:34):
Right or not even awful, just a teenager whose biggest
priority was not your bloodsugar, your insulin doses,
right?
Like their.
it.
It's just not, it's not gonnawork that way for most kids and
it's okay.
It's okay.
I just had my annual eye examthis morning.
My eyes are still dilated rightnow, actually, and I have zero
(36:56):
signs of diabetes in my eyes.
And I can tell you while I'venever deliberately neglected my
diabetes, I had A1C in thesevens high six.
I've had plenty of high bloodsugars throughout the last 23
years.
And I am not blind or bleedingfrom my eyeballs.
So take a deep breath andremember that your kid is a kid
(37:16):
and encourage them to do thebest.
They can give them a high five,even when they're struggling,
even when the blood sugar isn'tperfect.
If they check it, then they'retrying and they get the high
five for.
Katie (37:28):
Oh yeah, absolutely.
I mean, we, we are, I do my verybest, not to say a word, unless,
unless it's like true safetyconcern, you know what I mean?
Ginger (37:38):
course, of
Katie (37:38):
what we have to treat your low blood sugar
Ginger (37:40):
right.
It's not, I don't mean tosimplify it at all, but yeah.
Katie (37:44):
Yeah.
Yeah, no, I, I know.
I know, but I feel like I feel,and I know it will be okay in
the end.
It's all gonna work itself out,but I just think I need to have
somebody come on like once aweek and just be like, just
remind.
Ginger (37:55):
Yeah, that party in college in St.
Patty's day.
And you know, like it's notnormally how I manage my
diabetes, but holy moly, I feelgrateful for how that night
went.
You know, like you might needstories like that.
Katie (38:08):
I do.
I think I do.
it'd be a good series.
I don't know what I'd call ityet, but I don't know.
I'll have to think of a name.
all right.
Let's see.
Let me skim down my list ofquestions.
So I feel like I was, you know,I had a question about cons,
like if you've noticed any conswith using it, you, you
mentioned a couple about it.
(38:29):
Not being able to give you tinydoses, not being able to handle
those high fat meals.
Anything else that you can thinkof that you didn't don't
Ginger (38:36):
I mean for me.
So I use a CGM that doesn'talarm.
It's not continuous.
I use the Libre 14 day, so Ihave to scan my arm to get a
blood sugar.
And I it's a deliberate choice.
I cannot handle being alarmed atanymore.
And for me, the alarms triggerme to over.
React.
(38:56):
And it just, it gives me anxietyand I used alarms during
pregnancy and that's enough.
I'm done with the alarms.
so that's why I use this.
And that means though that if Iget distracted, like I was in
the Cape Cod with my family acouple weeks ago and we're whale
watching and I'm not thinkingabout my blood sugars, I'm on a
boat looking for whales, right.
(39:17):
I was also fasting and I hadn'tchecked my blood sugar Mylon.
I'd taken that anti nausea pill.
And I just thought I wasprobably fine and I checked my
blood sugar.
After hour two on this boat.
And I'm up near 300, because Ithink, I don't know whether I, I
think that anti nausea pillspikes my blood sugar because
it's done it on airplanes too,but I thought it was the
(39:38):
altitude anyway, real life ofdiabetes.
Right.
Which variable is it?
Two things I don't go on a lot.
Right.
Is boats and airplanes.
Katie (39:46):
Mm-hmm
Ginger (39:47):
so because I don't have the alarms bring this back to
Afreza the follow up dose.
Can be frustrating for somepeople in that you do need to
stop and take the time to seehow that meal is digesting an
hour later when Afreza is fadingfrom your system and decide for
me to follow up dose.
(40:07):
And that could be annoying orhard to remember for some
people.
I mean, it's a great thing thatit's out so fast, but the side,
the other side of that is thatyou have to remember to take a
follow up dose.
I really like the freedom.
Of how fast it works.
So for me, it's a worthwhile,extra step to have to check and
see where I'm at.
Katie (40:26):
Yeah.
Especially somebody like youthat's it sounds like you're
super active.
So that would be veryfrustrating.
If you were having to plan yourAC you know, your exercise and
everything around.
Yeah.
Ginger (40:37):
really nice because I can, even if let's say I was one
60, an hour later, if I knew Iwas gonna be sitting with my
computer writing, then I wouldtake another four unit cart.
If I knew I was about to go walkmy dog, I might hold off and see
where I'm at after the dog walk.
And therefore I don't end uphaving to eat food.
I didn't wanna eat.
Katie (40:58):
Mm-hmm Well, anything else you think would be helpful
for, for listeners to know?
I mean, you know, parents andcaregivers are the main
listeners and, and I feel likemost of them have young kids,
but some of them have older kidsthat are, you know, 18 or older
and going to the col college andall
Ginger (41:13):
critical thing to know when you start Afreza is
because, and, and this alsocould be advice for, even if
you're not using Afreza.
I'm a really big believer intiny tweaks in your background
in insulin dose.
And when you start Afreza younow don't have these multiple
doses of NovoLog on board inyour system all day.
(41:34):
I mean, if you think about it,you've almost always got some
NovoLog on board.
Because every time you eat, it'sin there for four hours, right.
By the time you eat again, it'srare that it's been more than
four hours, right?
So that's helping covering someof your background insulin
needs.
So when you start Afreza, you'lllikely need a small increase.
(41:55):
In your long acting insulin.
So if you take Afreza and, andthere's a Facebook group where
you see this, a lot of peoplesay I started taking Afreza, but
it doesn't seem like it'sworking and they, because
they're taking it to correct ahigh and it's not correcting,
it's not the Afreza, it's mostlikely that they don't have
enough background insulin.
So that's really something toconsider.
Katie (42:15):
mm-hmm
Ginger (42:15):
And pay attention to, and I would say that also
applies to even when you're noton Afreza.
If blood sugars are beingstubborn, if you're taking more
corrections and thus you'reactually having more lows, cuz
you keep taking more correctionsof Novalog chances are you
might, your child might need asmall boost to their long acting
insulin dose.
(42:37):
You're constantly takingcorrections.
It's not that they're notnecessarily getting enough
insulin with their meals.
It might be that they don't evenhave enough background insulin
and a child's insulin needschange more than anybody's
right.
Except for maybe pregnancy Sopregnancy could be like week to
week and a child's not far offfrom that.
so especially puberty andeverything.
(42:58):
So really remember that insulinneeds are not permanent and need
tweaking regular.
Katie (43:06):
Yeah, no, that's a, that's a great point.
Yeah.
Yeah, we could always tell thatSarah's basil when she was on
MDI, that it wasn't high enoughor, or, or the basil rate the
pump, but like, you know, we'dcorrect for a high and it would
start to go down and we'd belike, oh, it's working.
And then it would like stop andstart to go back up.
And you know, this is like acouple hours after she's eaten
and I'm like I think that'sprobably her basal, you know?
Ginger (43:27):
Right.
And you can get reallyfrustrated and mad and feel like
you're failing.
Or you can say what's notworking here.
What do I know more of or lessof.
Right.
And, and that's what you didwhen you adjust your basil and
then you get to move on withyour life until the next little
diabetes moment.
Katie (43:43):
yeah.
Yeah.
Well, I sure do wish Sarah hadsome Afrezza right now cuz she
is at a camp and her blood sugaris really high.
So I'm like, what happened?
Did you not Boles for your lunchor maybe not pre Boles?
Who knows?
But um,
Ginger (43:57):
Summer camp doesn't sound fun at all.
So
Katie (44:00):
No, it really doesn't.
Fortunately, he's there withanother T one D buddy.
It's not a diabetes camp, butit's just a, a, you know, camp
and at least they have eachother, you know, solidarity,
Ginger (44:10):
And speaking of pre bolus, I mean with Afreza, you
definitely don't need to prebolus.
And in many cases, I don't evenwanna take my insulin until I
see my blood sugar start torise, cuz it's so fast.
So they, the only times Ireally.
Start going low from Afreza iswhen I took it too early for a
(44:30):
meal that's digesting slowly.
Katie (44:32):
Hmm.
Ginger (44:33):
So I like that freedom.
Katie (44:35):
Yeah, definitely not having to wait to eat.
Absolutely.
That.
Fantastic.
well, I'm super excited to seethe results of this study.
I'm, I'm kind of debatingwhether or not I actually wanna
email the lady cuz they'rethey're doing they're recruiting
at the university of Florida,which is not too far from where
we are.
But I'm like, oh, we juststarted the Omnipod five system.
And right now we're really,really loving it.
(44:56):
And I'm like, I know they'regonna make me come off.
They're gonna make us come offof that.
And.
I dunno, selfishly I'm like, doI really want to, but even just
to talk to her about it, youknow, maybe I could have her on
and be like, okay, what's whatare you seeing so far?
Ginger (45:11):
There's no way Yeah.
Katie (45:13):
Okay.
Maybe in two years or threeyears when it's over.
Cause it's a long study.
It's like a, it's a long study.
I think it'll be a couple yearsbefore we know whether or not
that gets approved for kids, butexciting stuff for sure.
Well, thank you, ginger, forcoming on.
Thank you for your time.
And I will definitely link toyou know, your books and, and
some of the other blogs you'vewritten on Afreza and anything
else that you would like me tolink to in the show?
Ginger (45:36):
Sure ginger vera.com.
I link to as much as I canthere.
So you don't have to go lookingall over the web for it.
Katie (45:42):
Yeah.
Awesome.
Well, thank you so much.
Have a great
Ginger (45:44):
thanks for having me.
Katie (45:46):
Thanks, bye.
All right.
You guys, that is it for ourshow today.
Wasn't ginger, an awesome guest.
I really love talking with her.
I feel like she just has so muchknowledge and wisdom to share.
I might have to have her back onagain, to talk about some other
things like caregiver, burnout,or how to keep from going low or
(46:06):
high while you're exercising.
Make sure you check out the shownotes again.
I will provide you with one veryconvenient link to where you can
find ginger in all of herdiabetes resources.
She has.
Written them out nicely in oneplace with links to everything.
So you can find it super, superfast.
All right.
My friends have a fabulous week.
(46:27):
I hope you're weak.
And your weekend with diabetesgoes well, and I will chat with
you soon until then stay calmand Boless on.
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