Fiasp, Lyumjev & Afrezza: Do You Still Need to Pre-Bolus? | T1D
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"Neil, I use Fiasp, or Lyumjev, or Afrezza, do I even have to wait?" Great question, and this episode gets genuinely nerdy about the answer. Fiasp and Lyumjev are ultra-rapid analogs, built with ingredients (niacinamide in Fiasp, citrate and treprostinil in Lyumjev) that speed up subcutaneous absorption. Afrezza is inhaled Technosphere insulin with a Tmax around 12 to 15 minutes that delivers more than half its effect in the first hour, versus about 10% for regular rapid insulin.
So the fast insulins shrink the pre-bolus window. But here's the honest part: most people aren't on them, and standard rapid insulins like Humalog and Novolog are excellent. The whole point of the challenge, timing, is the great equalizer. Know your insulin, and you know how big your head start should be.
In this episode:
- The pharmacology of Fiasp, Lyumjev, and Afrezza, in plain English
- Why inhaled Technosphere insulin peaks in about 12 minutes
- Why the fast insulins shrink, but don't erase, the pre-bolus window
- Why standard rapid insulins still run beautiful numbers
This Week's Challenge: Know your insulin. Look up, or ask your care team, roughly how fast the insulin you take starts working. That one fact tells you how big your head start should be.
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