Would You Switch to an Insulin Inhaler?

We ran an article this morning on Diabetes News Hound about a new type of inhaled insulin that supposedly acts more like insulin produced naturally in the body. Reports out of a diabetes conference in Vienna tout this insulin as far superior to the kind of insulin many diabetics currenly inject. You can read the article here. The inhalable insulin called Afresa and is currently in Phase III studies.

Would you switch from your pump or regular injections to this inhalable insulin if it comes to market?


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Yes I would use the inhaled insulin.  I used the Exubera when it was on the market and had better control with the inhaled than with shots!  Was really upset when it was taken off the market.

Nope.  I guess it just depends on how much research is out there.  I mean, what does the insulin do to your lungs?  Are there long term effects?  Does it affect your breathing?  The flip side to that is what dosages can you take it in.  When the first inhaler came out, my endo went to a conference about it and was excited and then realized it wasn't really made for T1's.  He said there were only 2 different size blister packs and so it would be like taking your insulin in 3 or 5 unit dosages.  He said he felt like it wouldn't give you tight control.  Like I said, I would have to see lots of research, but I am just a little wary of some things. 

I don't think it was out long enough to reach everyone who would have loved to use it.

i'm content with taking shots. the inhaler seems like an interesting idea, but how do you figure out how much insulin you're actually giving? it's still too early of a method for me to even consider at this point. like mentioned: what, if any, are the side effects of inhaling it instead of injecting?

I wouldn't. I have an acquaintance who works in medical research developing a type of inhaled insulin. She said it's really better for T2 b/c of the lack of exact doses.

I also get an allergy where I inject. It would probably make my lungs close up!

im new to the whole diabetes thing, but i am already sick and tired of shots...that being said..i have asthma so i would really need to wait and see how the inhaler would effect the lungs and breathing.  dont get me wrong, i would LOVE not to inject myself anymore...but i am already have enough trouble with breathing since i became diabetic...i dont need anything else to mess with it.

if the research backed it up i'd buy that in a heartbeat. shots are not for me.

me i will never try it.

I would have when I was on shots, but now with the Omnipod, it givers such wonderful increments, and is so almost painless to attach, that inhaled will probably never match.

It just seems to be too easy.....I don't think I would be able to trust inhaling the insulin and it doing the job that it does with injections.  Although I hate injections, I think I would feel more comfortable staying on injections.

No way. I can't imagine how an inhaler could match the programming of an insulin pump. I've been T1 since 1942 and have seen many advances, but I don't think this is one of them.



I'm actually on a clinical study for this Afresa insulin and I absolutely LOVE it!!! Everyone that is on this clinical study seems to like it, and my doctor said that it is very close to being FDA approved. It is soooo easy to use and is very effective. I was on the Exubera inhaled insulin before the Afresa, before Exubera was pulled off the market. I was so upset when it was no longer available, and was so happy when offered a chance for me to participate in this clinical study. I have been using Afresa for over a year, and have no breathing problems or complications whatsoever.

The inhaled insulin is absorbed very quickly, and does a great job of keeping blood sugars under control. I took 5 shots a day for the first year I was diabetic, and then I was on the insulin for 5 years and absolutely hated it. I have been using inhaled insulin since 2007 and wouldn't have it any other way. Hopefully, the FDA will approve it very soon so more people will have the opportunity to use it.

If anyone wants any more info about how it works or just any questions about inhaled insulin, let me know!! :)

[quote user="Sarah"]

I have been using Afresa for over a year, and have no breathing problems or complications whatsoever.


I'm glad you're happy about it..but I worry about long term complications that might come with it. it's still new..unlike injected insulin, we don't know what the long term effects on the body are yet...and we won't know for a long time.

[quote user="Sarah"]

The inhaled insulin is absorbed very quickly, and does a great job of keeping blood sugars under control.

If anyone wants any more info about how it works or just any questions about inhaled insulin, let me know!! :)


hi Sarah, Exubera had a fast onset but a long half-life.  (comes on like Humalog then hangs out like regular). How long does Afresa actually work?  did you have a c-peptide test as part of your medical surveilance?  if so what's your c-peptide (and reference numbers)?  do you use any basal insulin at all?

sorry for the questions but you said it was okay ;-)

That's true that we wont' know the long-term complications for a long time. I have to get a chest x-ray and a breathing test done every 6 months just to monitor that there's no changes in my lungs or pulmonary functions. There's been no change according to the x-rays and breathing tests, and hopefully it will stay that way!

I'm glad you're asking questions!! Afresa is used as a mealtime insulin, and it also used to treat hyperglycemia, to bring blood sugars down. It is a rapid-acting insulin, and seems to immediately cause blood sugars to decline if I inhale when my glucose is high, and covers the food I eat at mealtimes. It doesn't stay in your body like Lantus or Humalog, where 80% of the insulin stays for 10-12 hours after injection, causing hypoglycemia. It seems to keep my blood sugars consistent throughout the day, as it covers what you eat, not anything extra.

I take Lantus at night as a long-acting insulin is needed in conjunction with Afresa. I haven't had to have a c-petide test done. I am required to get a chest x-ray and pulmonary breathing test done every 6 months, just to monitor that there are no changes in my lungs or breathing patterns. The results come back the same every time-no change in either my chest x-ray or breathing test (and I hope it stays that way!)

I'm so glad that I"m a "guinea pig" for this new technology and it doesn't take long at all to learn how to use. I think I had the hang of it after 2 days. Let me know if you have any other questions, and I'll be more than happy to answer!!

[quote user="Sarah"]

 It doesn't stay in your body like Lantus or Humalog, where 80% of the insulin stays for 10-12 hours after injection, causing hypoglycemia.


well, than's not really how lantus or humalog works.    I was looking for an actual half-life for the inhaled insulin from a user in a non-lab environment.  The abstract for the lab results are here (but the kind research folks compared it to Regular insulin injection, how nice): 

Pharmacokinetics and linear exposure of AFRESA compared with the subcutaneous injection of regular human insulin.

AIM: AFRESA [Technosphere Insulin (TI); MannKind Corporation, Valencia, CA], a dry powder preparation of regular human insulin (RHI), utilizes a novel and versatile drug carrier platform that enables pulmonary administration of medications typically administered by injection. The aim of this study was to compare the pharmacokinetic (PK) and pharmacodynamic (PD) parameters of three different inhaled doses of TI with those of subcutaneous (s.c.) RHI. METHODS: This randomized, open-label, four-way crossover study of 11 healthy, non-smoking volunteers evaluated PK and PD profiles following single inhalations of 25, 50 or 100 U TI and 10 IU RHI administered subcutaneously using a euglycaemic clamp technique. RESULTS: Following inhalation of TI, peak insulin concentrations (C(max)) were achieved approximately 2 h earlier than with RHI (12-17 min for TI vs. 134 min for RHI). Area under the insulin concentration-time curve (AUC) and insulin C(max) values increased with increasing TI dose. Insulin exposure, as measured by AUC, was found to be linear over the dose range studied. Compared with s.c. RHI, TI at doses of 25, 50 and 100 U showed a relative bioavailability of 25, 23 and 21%, respectively. The maximum bioeffect, as measured by the glucose infusion rate, occurred approximately 2 h earlier for all three TI doses (42, 50 and 58 min, respectively) than for s.c. RHI (171 min). No treatment-related adverse events were reported with TI. CONCLUSION: TI is an inhaled insulin with a more rapid absorption and a more rapid elimination than subcutaneously administered RHI, resulting in a quick onset and short duration of action. Insulin exposure following TI administration was found to be linear over the dose range of 25-100 U.

Thanks for the information-I just learned something new about it too! :)

To be honest, alot of those lab results just went over my head, but I do agree with the last statement: The inhaled insulin has a more rapid absorption than subcutaneously adminstered insulin. It seems to have an immediate effect, whereas while I was taking shots or on the pump, it seemed to take longer to get my blood sugars back in range, or cover mealtimes.

I know alot of people weren't happy with the first inhaled insulin, Exubera, and I have to agree that Afresa is definitely more user-friendly, and the inhaler itself is MUCH smaller. Hopefully, the technology will just keep getting better, and we'll get closer to a cure...

Thanks again!!

Hey Sarah, I'm wondering - how does dosing work?