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Can You Breathe In Insulin?

Afrezza | Rapid Acting Inhaled Insulin For Type 1 And Type 2 Diabetes

Afrezza | Rapid Acting Inhaled Insulin For Type 1 And Type 2 Diabetes

Want to discontinue insulin injections with meals Dont have lung problems (for example COPD, asthma, currently smoke or have stopped smoking <6 months) If diet, exercise, and your current diabetes medications are no longer giving you the blood sugar control you need, ask your healthcare provider about Afrezza. Afrezza may be able to help. Inhale Afrezza at the beginning of your meal to bring down blood sugars caused by eating. After you inhale Afrezza, the insulin passes quickly through your lungs and into your bloodstream (in less than one minute).1 This allows insulin to get into your blood quickly and work on reducing blood sugars within about 12 minutes.2 This rapid action allows you to take Afrezza when you are ready to eat and not worry about timing your mealtime insulin in advance of your meals. Afrezza is designed to be in your body for approximately 1.5 - 4 hours,** depending on your dose.2Once Afrezza leaves your system it doesn't continue to lower your blood sugar. This helps you time your insulin therapy to your insulin need. ** For the 4 and 12 unit cartridges respectively. Research shows that the better you get your blood sugar in control, the lower your risk can be for long term complications such as eye, heart, kidney, and nerve damage.3 By keeping your blood sugar levels in a healthy range through food choices, physical activity, and proper medications, you can avoid long-term diabetes complications.3 These complications can develop over many years and they all relate to how blood sugar (also called blood glucose) levels affect the blood vessels. Over time, high amounts of sugars in your blood can damage the body's blood vessels, both tiny (microvascular) and large (macrovascular).4 Using inhaled insulin can mean 1 less injection per meal which is ~1,0 Continue reading >>

Inhaled Insulin: How To Teach Patients

Inhaled Insulin: How To Teach Patients

This feature requires the newest version of Flash. You can download it here . Note: In the video, Dr Peters demonstrates how to teach patients to use inhaled insulin. Today I am going to give you a short demonstration on how to teach patients to use inhaled insulin. They need two things to do this: the inhaler device and the cartridges. These cartridges are for demonstration use, so they are red. The cartridges your patients will be using are blue and green. The blue cartridges correspond to 4 units, and the green cartridges correspond to 8 units. In advance, you are going to tell a patient how much inhaled insulin to take. Hopefully you have helped the patient figure out how many cartridges will be needed before a meal. If you are starting a patient on inhaled insulin who is not on prandial insulin, you are going to start with 4 units, in most cases. That is one blue cartridge. It is very simple. They hold this inhaler device level and put the cartridge in. Then, they close this lever over it until it clicks, and now it's ready to go. They are not supposed to tip the device, because you don't want the powder to come out of the cartridge. They take off the guard. They exhale, and then they breathe it in and hold it in their lungs. That was one cartridge. If a patient needs to take more than one cartridge, they open this up, take out the used cartridge, dispose of it, and then put in another cartridge. They inhale as many units of insulin as they need before each meal. Because this form of inhaled insulin is new to most of us and to our patients, it's important that we carefully read the package insert and the user guide so that we can help patients understand that this is, in fact, insulin, and then teach them how to use it. It's particularly important for patients who Continue reading >>

What Breathing Insulin Means For Diabetes Treatment

What Breathing Insulin Means For Diabetes Treatment

What Breathing Insulin Means for Diabetes Treatment US Endocrinology, 2006;(2): DOI: Type 1 diabetes is a disease of severe deficiency of endogenously secreted insulin. When introduced in the late 1920s, injected insulin treatment proved to be a lifesaving treatment for type 1 patients. The primary abnormality in type 2 diabetes is a relative deficiency of insulin secretory capacity resulting in insufficient response to tissue insulin resistance. Normalization of blood glucose levels is the goal of diabetes treatment.Yet, a large proportion of patients with diabetes fail to meet recommended glycemic goals. Two-thirds of patients (67%) in one survey conducted by the American College of Clinical Endocrinologists failed to meet the target goal of 6.5% glycosylated hemoglobin (HbA1c).1 Although there are many oral hypoglycemic agents to stimulate insulin secretion, reduce insulin resistance, and slow glucose absorption, even combinations of multiple agents often fail to achieve normal HbA1c.2 Perhaps, more important, multiple oral agents (OAs) do not sufficiently reduce postprandial hyperglycemia.3,4 The most effective means of lowering blood sugar is externally administered insulin, particularly in patients with very high glucose levels.5 Due to degradation and poor absorption by the digestive system, insulin has historically been delivered subcutaneously (SC) by injection. Although injections with a small needle are almost painless, puncture of the skin elicits significant psychological resistance in the majority of patients.The reluctance of patients to accept insulin injections also stems from additional concerns including possible weight gain, risk of hypoglycemia, embarrassment at being observed injecting oneself, and the perception of having failed to control the di Continue reading >>

Inhaled Insulin

Inhaled Insulin

Researchers, doctors, and people with diabetes agree that injected insulin works well to manage the disease. They'll probably also say that getting insulin into your body through something other than a needle would be even better. You can't get insulin in a pill, but how about breathing it in? The idea of inhaling insulin has been around for decades. It wasn't until the 1990s that researchers made it possible. With an inhaler much like the ones people with asthma use, you breathe a fine insulin powder into your lungs. There, it enters your blood through tiny blood vessels. In June 2014, the FDA approved Afrezza. It's an inhaler with pre-measured, rapid-acting insulin you use before meals. It's not for diabetes emergencies such as diabetic ketoacidosis (DKA). Common side effects of inhaled insulin are low blood sugar, a cough, and a scratchy or sore throat. If you have type 1 diabetes, you'll still need to take long-acting insulin, too, to help control your blood sugar. If you smoke or you have a lung disease, such as asthma or COPD, you shouldn't use inhaled insulin. The FDA approved the first inhaled insulin, Exubera, in September 2006. People who had type 1 or type 2 diabetes could use it. But the drug's maker took it off the market in October 2007, because it didn't seem to catch on with patients. People thought the inhaler was too big and clunky. (The Afrezza inhaler is much smaller.) Later, the FDA was concerned that Exubera might cause lung problems including cancer. Continue reading >>

How Afrezza Inhaled Insulin Makes My Life Better

How Afrezza Inhaled Insulin Makes My Life Better

The first time I took Afrezza––an inhalable fast-acting insulin––in public, it was at Wildair, a small, hip restaurant in Manhattan. I inhaled deeply into my lungs and waited. A guy seated nearby widened his eyes and said loudly, “Are you vaping?” The question pinged through the small restaurant, but I held my breath for ten seconds per the instructions. “Is she vaping?” he exclaimed again when I didn’t answer. The friend I was dining with took over: “No, she’s not. She’s taking insulin. It’s brand new. Isn’t that cool?” The young guy wasn’t quite as interested once he learned I wasn’t vaping, but he did share his squid-ink calamari with us. Until Afrezza came along, I injected insulin with needles: dejectable tools that I had to use, clip and dispose of daily. I don’t know why I never went on a pump, but I didn’t. (Okay, fine. I didn’t want to have something that looked like an antiquated pager attached to me 24/7.) I was twelve-years old when I was diagnosed with Type 1 diabetes. In the hospital, the nurses taught me how to inject myself using an orange. For decades thereafter I stuck myself four times a day using the citrus technique. Change doesn’t come easy to all people with diabetes and I dug in my heels doing the same thing for three decades until early 2015 when I wrote about Afrezza for Wired. I was the first patient my doctor prescribed Afrezza to and, after passing a lung capacity test, I skipped my way over to the pharmacy practically high-fiving strangers on the street. It was one of the few times in my life that I have been excited to have diabetes. (The other time was when I crossed the finish line cycling at Tour de Cure. Everyone cheered for me!) While insulin formulations have evolved, its delivery method is u Continue reading >>

Will Inhaled Insulin Really Take Your Breath Away?

Will Inhaled Insulin Really Take Your Breath Away?

Will Inhaled Insulin Really Take Your Breath Away? Mannkinds inhaled insulin, Afrezza, was approved by the FDA on June 28, 2014. Its Dreamboat inhaler delivers a choice of 4u or 8u capsules of insulin powder. Capsules are prepared by loading insulin molecules onto pH-sensitive carrier particles and then drying and placing the powder into plastic capsules. The aerodynamic properties of the particles delivered by the device scatters the insulin powder deep into the lungs when inhaled. Once these pH sensitive particles contact the neutral pH of the lungs, they become a liquid and quickly absorb through the lung membranes. If Afrezzas potency actually proves to be similar to injected insulin, capsule sizes of 4 or 8 units may be too large for people who use less than 30 or 40 units of insulin a day. From the 1800 Rule that calculates the dose of fast insulin needed to correct high glucose levels, a 4u capsule would lower the blood sugar about 120 mg/dl (6.7 mmol) for someone whose average daily dose of insulin is 60 units a day. Someone on 30 units a day will drop about 240 mg/dl (13.3 mmol) with one capsule and 480 mg/dl on an 8u capsule. This crude dosing might be contrasted with that of an insulin pump where one twentieth of a unit delivered with with precision equates to 1.5 mg/dl and 3 mg/dl declines in the glucose, respectively. A major benefit of Afrezza is its ability to quickly raise blood insulin levels. In Type 2 diabetes a major defect is the loss of first phase insulin release that gets quickly released from the pancreas after a meal and then reaches high levels in the portal vein that goes directly to the liver. Afrezza obviously does not mimic this pathway when delivered through the lungs to the peripheral circulation, but blood levels of insulin may rise fa Continue reading >>

Health Risks Of Inhalation Insulin For Diabetics

Health Risks Of Inhalation Insulin For Diabetics

Diabetes is a disease in which the body does not produce and/or properly use insulin—in other words, the body is insulin resistant.1 The treatment of type I and some cases of type II diabetes with subcutaneous insulin injections is sometimes associated with lack of compliance due to the pain of multiple daily injections.2 Hence, there is a big demand for insulin that can be administered without painful shots. Development of such an insulin delivery system could open the way to a multibillion-dollar market, while making diabetics more treatment-compliant. The search for a non-injectable form of insulin continues as the diabetic population all over the world continues to explode.3-5 An apparent advance arrived with the development of a preparation that could simply be inhaled.6 While the FDA had deemed this novel insulin preparation safe and effective, many questions regarding its long-term health effects remained unresolved.7-9 After an article was published on the potential cancer-causing effects of inhaled insulin using a medication called Exubera®, the Pfizer company withdrew the drug, taking a $2.5 billion loss.10-12 Pfizer later reported the development of lung cancer in six patients who had used inhaled insulin. Pfizer’s timely withdrawal potentially saved hundreds of diabetics using inhaled insulin from developing cancer.13 Unfortunately, on June 27, 2014, the FDA approved another inhaled insulin drug.7 It is obvious that the FDA did not thoroughly look at the ill effects of inhaled insulin. What Causes Diabetes? Insulin is a hormone secreted by endocrine cells (specifically beta cells located in the islets of Langerhans) of the pancreas and is essential for human life. It works by interacting with the insulin receptors on cell membranes to facilitate the ent Continue reading >>

Breathe It In: Inhaled Insulin Options For Type 2 Diabetes

Breathe It In: Inhaled Insulin Options For Type 2 Diabetes

Breathe It In: Inhaled Insulin Options for Type 2 Diabetes Many people with type 2 diabetes have fears about starting insulin therapy. Some are afraid of needles and injections, others think that they have failed at diabetes management if they have to start insulin, and some people are afraid of the risk of hypoglycemia (low blood sugar) that can happen with insulin. Using inhaled insulin, one of the newest insulin options, may get around some of these fears. One thing is for sure, using ANY type of insulin will help control your diabetes and does not represent a failure on your part. Diabetes is a progressive disease and at least a third of people with type 2 diabetes will eventually need insulin. Normally insulin is injected under the skin. Afrezza is a man-made insulin powder made by MannKind Corporation that is inhaled into the lungs using an inhaler device. The inhaled insulin is absorbed into the blood stream more rapidly than insulin injected under the skin. Afrezza starts working in 12-15 minutes and is out of your system in about 3 hours! This means that Afrezza works as a fast-acting insulin to be used at meal time or to quickly lower a high blood sugar. In fact, Afrezza inhaled insulin works even faster than our fastest injectable meal-time insulins such as humalog , novolog , or apidra . The rapid on/rapid off effects of Afrezza can help control blood sugar even better than traditional meal-time insulin and reduce the risk of hypoglycemia (low blood sugar) after meals because the insulin is out the body in a few short hours. Are dosages similar to other types of insulin? Inhaled insulin is delivered to the body with an inhaler device instead of an insulin pen or syringes & vials that patients are used to with traditional insulin. This means it is possible t Continue reading >>

A Breath Test For Blood Glucose

A Breath Test For Blood Glucose

Making strides in finding an alternative to finger sticks Occupation: Director, Metabolism and Bionutrition Core, Institute for Clinical and Translational Science, University of CaliforniaIrvine Research Funding: ADA Clinical/Translational Research Award Imagine if instead of a finger prick, you could measure your blood glucose with a puff of breath. The potential of such technology is enormous, going far beyond what would clearly be an improvement in the lives of people with diabetes. But because of its complexity, breath analysis of something as complicated as blood glucose has remained out of reach. With help from an ADA research grant, University of CaliforniaIrvine scientist Pietro Galassetti, MD, PhD, is hoping to change that. He's looking for ways to detect changes in blood glucose levels in the breath using technology originally developed to sense chemicals in the atmosphere. If he can prove the technique works, he hopes private industry can refine it and make breath-based glucose monitors a reality in the next 20 years. "Gases have for decades been courted by researchers," Galassetti says. "If we could find them, it would be the holy grailit's very easy to take a breath sample." The idea is simple. Think of the body as a car. As it burns fuelfats and sugarsit creates exhaust. Tweak the fuel mixture, and the hundreds of different gases change, too. When it comes to diabetes, the fuel-mixture metaphor is particularly apt. "The body usually has a balance of energy sources," Galassetti says, but diabetes cuts the potential fuel sources in half: Without insulin, the body can't burn sugar (glucose) and must rely on fat alone for fuel. In fact, before insulin was discovered in 1921, one of the characteristic signs of end-stage diabetes was the smell of acetonethe sam Continue reading >>

Lantus Side Effects Center

Lantus Side Effects Center

Lantus (insulin glargine [rdna origin]) Injection is a man-made form of a hormone that is produced in the body used to treat type 1 (insulin-dependent) or type 2 (non insulin-dependent) diabetes. The most common side effects of Lantus is hypoglycemia, or low blood sugar. Symptoms include: hunger, sweating, irritability, trouble concentrating, rapid breathing, fast heartbeat, seizure (severe hypoglycemia can be fatal). Other common side effects of Lantus include pain, redness, swelling, itching, or thickening of the skin at the injection site. These side effects usually go away after a few days or weeks. Lantus should be administered subcutaneously (under the skin) once a day at the same time every day. Dose is determined by the individual and the desired blood glucose levels. Lantus may interact with albuterol, clonidine, reserpine, or beta-blockers. Many other medicines can increase or decrease the effects of insulin glargine on lowering your blood sugar. Tell your doctor all prescription and over-the-counter medications and supplements you use. Tell your doctor if you are pregnant before using Lantus. Discuss a plan to manage blood sugar with your doctor before becoming pregnant. Your doctor may switch the type of insulin you use during pregnancy. It is unknown if this drug passes into breast milk. Insulin needs may change while breastfeeding. Consult your doctor before breast-feeding. Our Lantus (insulin glargine [rdna origin]) Injection Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication. This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. Continue reading >>

Insulin Human Inhalation

Insulin Human Inhalation

Insulin inhalation may decrease lung function and can cause bronchospasms (breathing difficulties). Tell your doctor if you have or have ever had asthma or chronic obstructive pulmonary disease (COPD; a group of diseases that affect the lungs and airways). Your doctor will tell you not to use insulin inhalation if you have asthma or COPD. Your doctor will order certain tests to check how well your lungs are working before therapy, 6 months after starting therapy, and annually while using insulin inhalation treatment. Tell your doctor if you have any of the following symptoms: wheezing or difficulty breathing. Keep all appointments with your doctor and the laboratory. Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with insulin inhalation and each time you refill your prescription. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the manufacturer's website to obtain the Medication Guide. Talk to your doctor about the risks of using insulin inhalation. Insulin inhalation is used in combination with a long-acting insulin to treat type 1 diabetes (condition in which the body does not produce insulin and therefore cannot control the amount of sugar in the blood). It is also used in combination with other medications to treat people with type 2 diabetes (condition in which the body does not use insulin normally and, therefore, cannot control the amount of sugar in the blood) who need insulin to control their diabetes. Insulin inhalation is not used for the treatment diabetic ketoacidosis (a serious condition that may develop if high blood sugar is not treated). Insulin inhalation is a short-acting, man-made version of human insulin. In Continue reading >>

Inhaled Insulin: Take A Deep Breath, But How?

Inhaled Insulin: Take A Deep Breath, But How?

Inhaled Insulin: Take a Deep Breath, but How? 1Profil Institute for Metabolic Research, Neuss, Germany Correspondence to: Prof. Dr. rer. nat. Lutz Heinemann, Profil Institut fr Stoffwechselforschung, GmbH, Hellersbergstr. 9, D-41460 Neuss, Germany; email address [email protected] Disclosure: Drs. Tim Heise and Lutz Heinemann are shareholders of a private research institute (Profil Institut fr Stoffwechselforschung, GmbH). This institute has received research grants from several pharmaceutical companies, including Pfizer, Novo Nordisk, Eli Lilly, KOS Pharmaceuticals, and Baxter Healthcare, which manufacture or develop inhaled insulin formulations. In addition, both have received speaking honoraria and consultancy fees from some of these companies. All authors have worked with companies developing inhaled insulin. All authors have given oral presentations for different companies. Copyright 2008 Diabetes Technology Society Inhalation of insulin is the first alternative route of insulin administration, which has been developed to such a mature status that the first product (Exubera, Pfizer) was made available to the market and subsequently withdrawn as of early 2008. In view of the relatively low bioavailability of inhaled insulin and the intraindividual variability of the metabolic effect induced (which is in the range of that of subcutaneously applied regular insulin), one wonders how to improve both aspects. Unfortunately, it appears as if the impact of the inhalation maneuver on insulin deposition in the deep lung has not been studied extensively. We present some thoughts and data from an alveolar model and propose an experimental procedure that might be helpful in the quantitative evaluation of the impact of the insulin inhalation maneuver. Keywords: i Continue reading >>

The Story Of Inhaled Insulin (so Far)

The Story Of Inhaled Insulin (so Far)

“Wait, you can inhale insulin? Isn’t that something you have to inject?” Good question! And the answer is that until very recently, shots were the only way to administer insulin. But an inhalable version of this life-sustaining drug has been in the works for decades, and has recently come to market — yet its fate still hangs in the air (pun!) For those who haven’t been following these developments (or even many who have), we present this overview of the inhalable insulin story to date. The Road to Inhalable Insulin For over 85 years after the 1921 discovery of life-saving liquid insulin, scientists were struggling to find a viable way to get insulin into the bodies of people with diabetes without needles. Naturally the idea of an insulin inhaler, similar to an asthma inhaler, was an appealing prospect! But it wasn’t until new technologies appeared on the scene in the late 1990’s that researchers could really begin to experiment with turning insulin into a concentrated powder with particles sized for inhalation into the lungs. Exubera, developed by San Francisco-based Nektar Therapeutics, became the first inhaled insulin product to be marketed in 2006 by pharma giant Pfizer. It was a “mealtime” insulin, meaning it works quickly to bring down blood glucose levels after patients eat carbohydrates, and then is out of the system quickly. This fast-acting profile is one of the big advantages of inhalable insulin, but naturally patients who need basal insulin (a constant level of background insulin), have to combine its use with a long-acting, injectable insulin like Lantus or Levemir. For this reason, Exubera was mainly targeted at people with type 2 diabetes, although a number of type 1 patients, who tend to be early adopters of new treatments, certainly ga Continue reading >>

Respiratory System And Diabetes

Respiratory System And Diabetes

Tweet The respiratory system is the system of organs that allow the body to take in oxygen and expel carbon dioxide, this process is known as gaseous exchange. We generally breathe between 12 and 20 times a minute. There are a number of complications of diabetes that can negatively affect our breathing. Parts of the respiratory system The following parts of the body make up the respiratory system: Mouth and nose Trachea (windpipe) Lungs Diaphragm How the respiratory system works Breathing is usually initiated by contraction of the diaphragm, a muscle which separates the chest cavity from the abdomen. Tweet Type 2 diabetes mellitus is a metabolic disorder that results in hyperglycemia (high blood glucose levels) due to the body: Being ineffective at using the insulin it has produced; also known as insulin resistance and/or Being unable to produce enough insulin Type 2 diabetes is characterised by the body being unable to metabolise glucose (a simple sugar). This leads to high levels of blood glucose which over time may damage the organs of the body. From this, it can be understood that for someone with diabetes something that is food for ordinary people can become a sort of metabolic poison. This is why people with diabetes are advised to avoid sources of dietary sugar. The good news is for very many people with type 2 diabetes this is all they have to do to stay well. If you can keep your blood sugar lower by avoiding dietary sugar, likely you will never need long-term medication. Type 2 diabetes was formerly known as non-insulin-dependent or adult-onset diabetes due to its occurrence mainly in people over 40. However, type 2 diabetes is now becoming more common in young adults, teens and children and accounts for roughly 90% of all diabetes cases worldwide. How serious Continue reading >>

Insulin Inhaler: New Diabetes Option Before Meals

Insulin Inhaler: New Diabetes Option Before Meals

Theres good news for patients who would like an easier way to get their insulin. A new rapid inhaled insulin has been approved by the Food and Drug Administration (FDA). Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy The new drug, called Afrezza, delivers insulin in the form of a fine powder, and you can inhale it at the start of a meal to help with blood sugar control. As a nurse and certified diabetes educator who has also lived with diabetes for the past 17 years, I wanted to try this new option. After using it for a few months, I found the inhaled insulin to be effective, easy to use, and a great alternative to an injection when I needed mealtime insulin. It can be used safely with any basal insulin, such as Lantus, Levemir or Toujeo. Anyone who has Type 1 or Type 2 diabetes can benefit from this treatment option. It decreases risk for hypoglycemia. The onset time is 12 to 15 minutes and it is totally out of your system within 180 minutes. It is painless, convenient and effective. Once inhaled, the insulin gets released into the body through your lungs and released into tiny airways that help move the insulin into the bloodstream quickly. Color coding makes the dosages easy to identify. The color coding of the blisters are blue for four units, green for eight units and yellow for 12 units of insulin. This color coding decreases the possibility of errors. The blister and the inhaling device are small and compact. Both can easily fit into a small purse or pant pocket. The inhaling device is included with the monthly prescription. The device is changed every two weeks and needs no special care. Simply place the cap back on after use. It is Continue reading >>

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