Afrezza An Ultra Rapid-Acting Insulin / Inhaled Insulin Onset 12 minutes!

I have been on Afrezza now for months. It is an ultra rapid insulin that is inhaled. I been on it now for 4 months and it has changed my life as I have no more worries of nighttime lows or lows throughout the day. When I was on Humolog / Novolog / Humilin my lows were daily. As we know this is a killer among diabetics as 1 in 20 will die from a low blood sugar.

Last year I almost went into coma 2 times and barely got revived the 2nd time. I also have had numerous lows rushing to the fridge on Novolog and Humolog. This all changed 4 months ago. I have been needle free for 4 months other than taking my daily Lantus. I have had 0 severe lows and only a few lows under 70 in 4 months. I have no daily swings over 250 readings anymore.. Why is this? It is because my management with Afrezza is so easy when I can adjust my blood sugar in minutes. Afrezza is about 90% out of my system in 30-40 minutes after taking it. So lets say I eat a late meal at 10pm. I can take my insulin and at 11pm before going to bed if my sugar is good I know its impossible for me to have a low at night. This has freed from all the stress and scares of lows.

Not only has it effected me this way but all my family members have noticed that I never have any emergencies or rushes for sugar..They all are able to sleep well with no worried about me during the night.

So why am I saying all this?

It actually makes me ill knowing that most people do not even know that this is coming and should of been available to all diabetics already. People die every day of low blood sugar. How about kids that have to damage this disease and the parents who are worried sick every night. I am not even sure how they can sleep. The inhaler is the size of my pinky as the pictures shows. I can have it in my pocket wherever I go and take the insulin anytime anywhere. The insulin is in powder form in the little cartridges.

For me controlling diabetes is now in real time as I dont have to wait 1-2 hours for it to start working and lingering on for 4-5 hours. If my blood sugar is 300 and I can adjust to 100 in 25 minutes. It is truly amazing and if anyone is reading this and has experienced lows please free to ask questions.

Update on Afrezza posted by the TuDiabetes Administration

What if you could get insulin without needles?

Sounds awesome! Thanks for sharing. I will ask about it next endo visit.
Molly

Is it available? The wikipedia page seems to suggest it's not exactly a slam dunk that it will be marketed.

How do you accurately dose with an inhaled product. Can you dose a single unit? a half unit? The failed inhaled insulin from about 5 years ago only allowed doses in units of five as I recall.

Until they come out with a long acting inhaled insulin I will stay on my pump. Once you have control over your blood sugars ranges like can be done with an insulin pump and grants me to eat whatever I feel like without problems, then I will stay with my pump. Especially since I would need a long acting as well as the inhaled insulin. I have very few lows. Maybe one every few months.

Yes my trial ends in January. Mannkind has to present data to FDA and wait 6 months for FDA approval.

Not yet. I am on the trial. It will take about 1 year and 3 months for approval. You can follow the progress at www.mannkindcorp.com . It will be a slam dunk. There are a lot of miss info out there comparing to the bong replica Exubera that had no clinical benefit as it was not an ultra fast acting insulin. Look at the size of what this is in my picture. This insulin starts working in 12 minutes. The benefit is not thats its inhaled but it is the fact that I can manage my disease current time as the onset is as quick as my meal hits my blood stream.

The units are a little different than normal insulin. The failed inhaled insulin Exubera was larger than a tennis ball can. it had no clinical benefit as it worked at the same speed as normal insulin. This inhaler is the size of my pinkie. (see picture)

The carts come in 2 doses. I have lowered my A1C to the 6s just using the 2 doses. 5s is my goal. I have actually kept my blood sugar between 80-120 for 10 days in a row at some points. a unit dose lowers my blood sugar about 50 points. so lets say my blood sugar is 200 I take a 20 unit does. If its 250 I would take a 20 and a 10...As I have said I rarely even get a reading above 250.
This product is truly remarkable.

Is this a sales pitch?

Not every product is for everyone. Do you know who invented the insulin pump? Alfred Mann...Alfred Mann took that money and put it into Mannkinds Afrezza. The product that you love so much is the same inventor of Afrezza.

I have a friend who is on the pump and she has lows all the time. If you have an A1Cs in the 6s and only have a few lows every few months that is remarkable as my lows used to be daily. It only takes one low to kill you so I had enough. Off course a low is under 70 reading but I am talking about sever lows.

So let me ask you this. If you have a late mean around 9-10pm or your blood sugar is high you do not worry about humolog or novolog causing a low at 2 am or so or do you leave your sugars higher? What I like about Afrezza is that I can inhale the insulin as I start eating and by the time I am done eating the insulin has done its magic. The onset is the same as the normal response of a pancrease. Now I have fasting sugars normally around 90-130 as a diabetic without ever going low. I still take one shot of Lantus per day but the combo of Lantus and Afrezza is the perfect for me. I would guess most people on the pump register under 50 and over 250 on a normal basis so you would be doing really well if you have such as good control. What was your last A1C if I may ask?

lol no as it wont even be available till 2014. It has changed my life and I want to start getting the word out for those diabetics that have had too many close calls as I have with low blood sugars.

Perhaps it comes across as one because it is hard to contain my excitement. I have no fear of lows and can adjust my blood sugar in minutes for the 1st time in 10 years.

Dean Kamen was an undergraduate student at Worcester Polytechnic Institute when he invented the first portable infusion pump. This device was the precursor of the insulin pump and revolutionized medication delivery for a variety of conditions including chemotherapy and others.

Dean formed his first company called AutoSyringe and continued to further develop multiple uses for his portable infusion pump, most notable the insulin pump. He sold AutoSyringe to Baxter Health Care when he was only 30 years old in 1981.

If the name Dean Kamen sounds familiar, it should. Dean has invented hundreds of devices. Arguably his most famous invention was the Segway PT. The Segway is that selfpropelled, self balancing people mover.

It comes in 20 units and 10 units only? That means it is marketed only to Type 2's because most Type 1's don't take that much at one time.

I don't understand your math. You said a unit lowers your blood sugar about 50 points, so if your blood sugar is 200 you take a 20 unit dose???? Do you mean that 10 units lowers your blood sugar 50 points, so you would take 20 units to get down to 100? That must be what you mean.So your ISF is 1:5??

Definitely not relevant for type 1's, let alone pump users!

A 10 UNIT DOSE lowers my blood sugar about 50 points. Yes I see where I said 1 unit by mistake.

I am a type 1 for 10 years. A 10 units Afrezza dose does not equal 10 unit of humolog or novolog so do not look at it like that.

What does it equal? For example if you now take 10 units of this medication now for a 30 carb meal (just making up numbers) what was your I:C on fast acting insulin?

Whatever it's equivalent I can't imagine having just two choice of doses. Even on MDI most Type 1's use insulin to carb ratios and take very varied doses. Not to mention people on pumps! Let's say it's equivalent to and 2 units of the Apidra I take. That means I could take either 1 unit or 2 units? Or multiples of those numbers. That wouldn't work for me. I'm not giving up my pump anytime soon. I'm a lot more interested in exact dosing then time of action!

I used to take about 10-15 units of Humolog per meal. Now I take 20-30 units of inhaled insulin. For 30 units I inhale a 20 and a 10 unit dose. So if you take 10 units for a meal now you would inhale the one 20 unit cartridge dose of Afrezza for example. Keep in mind everyone is different so you would start with the 1 10unit cart first and see how you respond to it once it is approved. Since it start working in only 12 minutes you could check you blood sugar in 40 minutes and make adjustments. Keep in mind that the person that invented the insulin pump invented this. Alfred Mann...You can read more about it at www.mannkindcorp.com as well. But you are welcome to fire away more question as well.

How much insulin did you use before starting the trial? (TDD)

Afrezza was all but approved...but one of the researchers got caught in a insider trading scheme and a hedge fund manager caused a dispute by sending a letter to the FDA about the inhaler and shorted shares of stock. After the researcher went to prison no one at the FDA will have anything to do with approving Afrezza....it may be years before it happens. If anything happens after the approval someone at the FDA will have to fall on their own sword.

You would guess wrong about "most people on the pump". I don't think I've had a single 250 in the 4.5 years I've been pumping and I've been under 50 only a handful of times. I'm happy that Afrezza works for you but for many of us it isn't the rapid that causes the bad lows; it's the basal.

It "only takes one low to kill you" but I would think missing the dose on your inhaled insulin could kill you just as easily and perhaps more quickly since its ultrarapid. You estimate that you need 3 units for the meal and you really only need 1.5 and suddenly you're 75 points below where you want to be. I don't see how that's different than doing MDI or pumping. The delivery is different but the issue is the same.

Most Type 1's don't take that much insulin. So it sounds like the doses are (roughly) equivalent to 5 and 10 units. Most of us don't take anywhere near that much insulin per meal. And like I said, the inability to use varied doses makes it not too appealing to people on pumps. For example I took 2.70 units for lunch today, the exact amount I needed for the carbs I ate. I can't even see that type of restriction of dose appealing to someone on MDI. It would mean going back to having to feeding the insulin (having to tune meals to the insulin dose), rather than the reverse that we do now.

IMHO the best results with stable blood sugar come with accurate dosing. By dosing the exact dose you need (for food or for corrections), you are less likely to have highs or lows. Your example for a correction was an even number, but I'm not often exactly 50 points high, I'm 27 or 34 or 104). Sorry, but this medication sounds pointless to me.

Might be problematic to people with asthma.