I tried Afrezza recently, but have decided not to continue. It took me a few days to dial in. I started with a "standard breakfast." That consisted of 2 oz of Trader Joe's bran flakes, almond milk and a packet of Splenda. I think that's roughly 40 gm CHO, depending on how you account for fiber. But at any rate, it was standard for all tests.
Starting at a BS in the 90-120 range, either two, eight U Afrezza puffs OR 12 U of Humulog would bring my sugar back to roughly the starting point in several hours. But the area under the curve was significantly different. The Afrezza flattened out the curve big time. This is pretty much what other's experience would have predicted. But I was surprised at the amount of Afrezza needed.
I repeated this experience with other meals and found the two, eight U puffs was about right. However, if the meal had more fat, a follow-up dose would be needed. Also, if my sugar was high before the meal, Afrezza had a hard time bringing it down. Again, this seems to be a common experience. This all leads me to believe that I would need at least 6 of the 8 U cartridges and probably several more to take care of high sugars or high-fat meals. I paid for Afrezza out-of-pocket to run the test. But I have real concerns that Medicare would approve coverage, particularly at this high level.
Another issue is that I had minor throat irritation. I laid off for 4-5 days and that returned. There was no coughing though. I would probably have given this a longer trial to see if that would abate. But I just decided the benefit wasn't worth the effort and expense.
On the bright side though, I rediscovered LCHF diets. When I first spoke with Richard Bernstein in the early 70's, he was advocating low carb eating. But the diet suggestions were terrible. The Scandinavian flat bread was like crunchy cardboard and the Farmer's cheese would go moldy after a few days. The diet worked, but it wasn't pleasant. Clearly, a lot of folks have spent time and effort since then, coming up with more palatable choices!