Inhaled Insulin: Myths vs. Facts

This content material initially appeared on Beyond Type 1. Republished with permission.

By Ginger Vieira

Inhaled insulin—Afrezza (insulin human) Inhalation Powder from MannKind—has existed now for a number of years, however there are various myths floating across the diabetes neighborhood about this zero-poke technique of taking your insulin.

What Is Afrezza?

• Afrezza is a man-made insulin that’s breathed-in by way of your lungs (inhaled) and is used to manage excessive blood sugar in adults with diabetes mellitus.
• Afrezza isn’t to be used rather than long-acting insulin. Afrezza should be used with long-acting insulin in individuals who have sort 1 diabetes mellitus.
• Afrezza isn’t to be used to deal with diabetic ketoacidosis.
• It isn’t identified if Afrezza is secure and efficient to be used in individuals who smoke. Afrezza isn’t to be used in individuals who smoke or have lately stopped smoking (lower than 6 months).
• It isn’t identified if Afrezza is secure and efficient in kids below 18 years of age.

Here, we’ll have a look at the most typical myths and misconceptions that we hear about—and the info—about Afrezza.

Myth #1: It’s Only for People With Type 2 Diabetes.

Fact: Afrezza is permitted to be used in grownup sufferers with sort 1 or sort 2 diabetes.

People with sort 1 and kind 2 diabetes respect Afrezza for its ultra-fast motion time, how rapidly it’s out of your system, and the way simple it’s to make use of with a fast inhalation.

Afrezza can be utilized in each sort 1 and kind 2 diabetes as your mealtime or short-acting insulin. (In sufferers with sort 1 diabetes, you should use Afrezza with a long-acting insulin.)

Some major care docs and endocrinologists imagine that Afrezza is meant just for folks with sort 2, so there might be some resistance in the case of prescribing it.

There’s additionally a studying curve to transitioning your blood sugar administration to Afrezza from injected rapid-acting insulin.

The variations in Afrezza’s dosages, how rapidly it impacts your blood sugar, and the size of time it’s in your bloodstream are completely different sufficient from injected rapid-acting insulin that you just’ll want to extend your glucose monitoring and be able to make changes together with your physician the primary few weeks of utilizing it. If your physician isn’t conversant in Afrezza, they might attempt to steer you away from it altogether.

Myth #2: The Four/eight/12-Unit Dosing Cartridges Won’t Work for Carb-Counting or Type 1 Diabetes.

Fact: It’s not the identical as dosing injected insulin.

Learning easy methods to dose Afrezza can take just a few weeks working together with your physician to search out the best dose. Afrezza explains the conversion of dosing injected rapid-acting insulin to inhaled insulin like this:

Image supply: Beyond Type 1

While you could have used 2 items of rapid-acting insulin, for instance, in your high-protein/moderate-carb lunch, you could discover that the Four-unit Afrezza dose is equal in protection.

Based on scientific trials, it might take 1.5x the quantity of Afrezza to realize the identical blood sugar management as injected insulin.

Another issue to think about is that some folks may have to extend their long-acting background insulin dose when switching to Afrezza. In a scientific trial, folks reported a 15 p.c improve of their background insulin dose on common over the course of the trial.

This is as a result of it’s out of your system so rapidly. While different rapid-acting injectable insulins have a Four to five hour period of motion that overlaps together with your background dose between meals, Afrezza is out of your system usually inside 1.5 to three hours, relying on the dose.

Myth #three: Afrezza Works Too Fast, Increasing the Risk of Severe Lows.

Fact: In a scientific trial, hypoglycemia with Afrezza was much like aspart within the first two hours after a meal, and decrease 2 to five hours after a meal. 

Hypoglycemia is the most typical hostile response of insulin remedy, together with Afrezza, and could also be critical and life-threatening.

For years, you’ve been instructed to take your injected mealtime insulin earlier than you eat—and on the very least, whenever you begin consuming. That’s as a result of injected mealtime insulin takes not less than 30 minutes to actually begin affecting your blood sugar.

Afrezza is quick—actually quick. It begins affecting your blood sugar in as little as 12 minutes. If you’re taking Afrezza earlier than you begin consuming, the quick motion time of this insulin could hit your bloodstream earlier than your meal is even being digested.

With Afrezza, you now not have to pre-bolus your insulin for meals as a result of Afrezza is out of the physique so quick it permits for supplemental doses 1 to 2 hours after meals.

Using any sort of insulin will increase your threat of low blood sugars. That is why it will be significant for all folks with diabetes on insulin to have the ability to acknowledge the indicators and signs of low blood sugar. The threat of low blood sugar will depend on many components, considered one of which is the kind of insulin and the way lengthy it really works in your physique.

Myth #Four: Afrezza Causes Lung Cancer.

Fact: Let’s take a better have a look at analysis on Afrezza and lung most cancers and lung perform…

In quick, thus far there isn’t a analysis that implies Afrezza causes lung most cancers. In scientific trials, Afrezza was studied in over three,000 sufferers with sort 1 or sort 2 diabetes. In research of Afrezza in folks with diabetes, lung most cancers occurred in just a few extra individuals who have been taking Afrezza than in individuals who have been taking different diabetes drugs.

There have been too few circumstances to know if lung most cancers was associated to Afrezza. If you’ve gotten lung most cancers, you and your healthcare supplier ought to determine when you ought to use Afrezza.

In phrases of lung perform, Afrezza has been discovered to trigger a slight lower in your total lung perform.

Doctors will carry out lung testing earlier than prescribing Afrezza, and a check-up in your lungs after you’ve been utilizing it for six months and a yr after. Afrezza isn’t advisable in sufferers with power lung illness comparable to bronchial asthma or COPD. It can be necessary to take Afrezza at room temperature.

Before an Afrezza cartridge is put in an inhaler, it should be at room temperature for 10 minutes. Having a sip of water earlier than and after inhalation can also assist. In the scientific research, coughs have been delicate and sometimes declined with continued use after 1-Four weeks. If you develop a persistent or recurring cough, or have respiration difficulties whereas utilizing Afrezza, contact your healthcare supplier.

Important Safety Information

What is a very powerful data I ought to learn about Afrezza?

Afrezza could cause critical negative effects, together with:

• Sudden lung issues (bronchospasms). Do not use Afrezza in case you have long-term (power) lung issues comparable to bronchial asthma or power obstructive pulmonary illness (COPD). Before beginning Afrezza, your healthcare supplier provides you with a respiration take a look at to verify how your lungs are working.

What is Afrezza?

• Afrezza is a man-made insulin that’s breathed- in by way of your lungs (inhaled) and is used to manage excessive blood sugar in adults with diabetes mellitus.
• Afrezza isn’t to be used rather than long-acting insulin. Afrezza should be used with long-acting insulin in individuals who have sort 1 diabetes mellitus.
• Afrezza isn’t to be used to deal with diabetic ketoacidosis.
• It isn’t identified if Afrezza is secure and efficient to be used in individuals who smoke. Afrezza isn’t to be used in individuals who smoke or have lately stopped smoking (lower than 6 months).
• It isn’t identified if Afrezza is secure and efficient in kids below 18 years of age.

What ought to I inform my healthcare supplier earlier than utilizing Afrezza?

Before utilizing Afrezza, inform your healthcare supplier about all of your medical circumstances, together with when you:

• Have lung issues comparable to bronchial asthma or COPD
• Have or have had lung most cancers
• Are utilizing any inhaled drugs
• Smoke or have lately stopped smoking
• Have kidney or liver issues
• Are pregnant, planning to turn into pregnant, or are breastfeeding. Afrezza could hurt your unborn or breastfeeding child.

Tell your healthcare supplier about all of the medicines you’re taking, together with prescription and over-the-counter medicines, nutritional vitamins or natural dietary supplements.

Before you begin utilizing Afrezza, discuss to your healthcare supplier about low blood sugar and easy methods to handle it.

What ought to I keep away from whereas utilizing Afrezza?

While utilizing Afrezza don’t:

• Drive or function heavy equipment, till you know the way Afrezza impacts you
• Drink alcohol or use over-the-counter medicines that comprise alcohol
• Smoke

Do not use Afrezza when you:

• Have power lung issues comparable to bronchial asthma or COPD
• Are allergic to common human insulin or any of the components in Afrezza.

What are the doable negative effects of Afrezza?

Afrezza could trigger critical negative effects that may result in loss of life, together with:

See “What is the most important information I should know about Afrezza?”

Low blood sugar (hypoglycemia). Signs and signs which will point out low blood sugar embrace:

• Dizziness or light-headedness, sweating, confusion, headache, blurred imaginative and prescient, slurred speech, shakiness, quick heartbeat, nervousness, irritability or temper change, starvation.

Decreased lung perform. Your healthcare supplier ought to verify how your lungs are working earlier than you begin utilizing Afrezza, 6 months after you begin utilizing it, and yearly after that.

Lung most cancers. In research of Afrezza in folks with diabetes, lung most cancers occurred in just a few extra individuals who have been taking Afrezza than in individuals who have been taking different diabetes drugs. There have been too few circumstances to know if lung most cancers was associated to Afrezza. If you’ve gotten lung most cancers, you and your healthcare supplier ought to determine when you ought to use Afrezza.

Diabetic ketoacidosis. Talk to your healthcare supplier in case you have an sickness. Your Afrezza dose or how usually you verify your blood sugar could have to be modified.

Severe allergic response (entire physique response). Get medical assist immediately in case you have any of those indicators or signs of a extreme allergic response:

• A rash over your entire physique, bother respiration, a quick heartbeat, or sweating.

Low potassium in your blood (hypokalemia).

Heart failure. Taking sure diabetes capsules referred to as thiazolidinediones or “TZDs” with Afrezza could trigger coronary heart failure in some folks. This can occur even in case you have by no means had coronary heart failure or coronary heart issues earlier than. If you have already got coronary heart failure it might worsen when you take TZDs with Afrezza. Your healthcare supplier ought to monitor you carefully while you’re taking TZDs with Afrezza. Tell your healthcare supplier in case you have any new or worse signs of coronary heart failure together with:

• Shortness of breath, swelling of your ankles or ft, sudden weight achieve.

Get emergency medical assist in case you have:

• Trouble respiration, shortness of breath, quick heartbeat, swelling of your face, tongue, or throat, sweating, excessive drowsiness, dizziness, confusion.

The most typical negative effects of Afrezza embrace:

• Low blood sugar (hypoglycemia), cough, sore throat

These should not all of the doable negative effects of Afrezza. Call your physician for medical recommendation about negative effects.

Please see full Prescribing Information and Medication Guide, together with BOXED WARNING on Afrezza.com.

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