Does anyone know a rep who can give samples of Afrezza to my Dr here in Dallas? Or an Endo they can suggest?
have your doctor fill this out I guess
https://www.afrezza.com/hcp/product-sample-request
Sam - Afrezza user has list of docs here
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Great thankyou RaDe!
Not too complete, my endo prescribes it and he’s not on the list.
Judi, agree. That list can not be a complete list. Sam (Afrezzauser) is making a good effort to assemble the list based on inputs from patients. Based on information released by Mannkind Corp., there are around 3,000 doctors who have wrote one or more prescriptions of Afrezza since the launch of Afrezza in early 2015. Since there are only about 100+ doctors listed on Sam’s list, it certainly can not be a complete list. However, since the list is compiled based on patients’ input, it is likely that many of the doctors listed there are among the top prescribers of Afrezza.
Bear in mind that you will be required to complete spirometry before getting the prescription and spirometry may not be covered in order to get afrezza.
My Dr is pretty good about letting me try most things fortunately.
Now I have some fears after reading this… does this cause anyone to pause about trying Afrezza?
Afrezza® has been shown to cause a decrease in lung function as measured by FEV1. In clinical trials lasting up to 2 years, Afrezza® treated patients experienced a small (40 ml) but greater FEV1 decline than comparator treated patients. Therefore, pulmonary function should be assessed with spirometry at baseline, after the initial 6 months of therapy and annually thereafter even in the absence of pulmonary symptoms. More frequent lung function assessment should be considered in patients with pulmonary symptoms, e.g., wheezing, bronchospasm, breathing difficulties, or cough.
In Afrezza® clinical trials, 2 cases of lung cancer were reported in patients exposed to Afrezza® while no cases were reported for the comparators. Two additional cases of lung cancer (squamous cell) were reported in non-smokers exposed to Afrezza® after the trial completion. In patients with active lung cancer, a prior history of lung cancer, or in patients at risk of lung cancer, consider whether the benefits of Afrezza® outweigh the risks.
read this study on lung function
http://www.mannkindcorp.com/Collateral/Documents/English-US/Brain_PFTs%2070%20vs%2080_ADA_FINAL.pdf
another link i found
http://www.afrezzajustbreathe.com/tag/pulmonary-safety-studies/
My FEV1 actually improved slightly, after starting Afrezza. I am not attributing the improvement to Afrezza, but it certainly hasn’t decreased my lung capacity.
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The problem is that no one knows the long term effects since no one has used it continuously for more 1-2 years. The company selling it must do a safety study at some point to address such questions but so far hasn’t mentioned when they will start one. Further reading:
http://ajplung.physiology.org/content/early/2016/02/23/ajplung.00091.2015
That study prompted an article in which one of the authors was quoted:
"A collaborative study between IGIB, Mayo Clinic College of Medicine, University of Groningen, the Netherlands, University of Copenhagen, Research Centre for Prevention and Health, Denmark, examined and analysed the implications of raised insulin levels against the backdrop of obesity, insulin resistance and emergence of inhaled insulin.
Never use inhaled insulin. Injecting insulin or giving drugs that make more insulin to curb excess blood sugar can, over the time, result in lung problems,” said Agrawal. For Indians, the findings drive the message of improving diet and exercising."
My opinion is that Afrezza is no more risk then injected insulin, I’d even argue its safer as it does not stay in your body as long as other insulin’s to me that is a big reason it should be seen as a safer drug. As for it being inhaled through the lungs, it uses technosphere for delivery, or tiny particles that are adsorbed through the lungs. Afrezza does not accumulate in the lungs as its particles are to small, its absorbed by the lungs into the blood stream just like oxygen is.
People who smoke accumulate black tar in their lungs over many years before they get lung cancer, I find it hard to believe Afrezza which does not accumulate as its physically impossible due to its size and structure would be any different from an injected insulin. This is my opinion, as always do your own DD.
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The authors of the article I linked point to the risks of hyperinsulinemia to the lung from ANY source, not just inhalation. Superimpose that risk on lungs already impaired by diabetes:
http://www.sciencedirect.com/science/article/pii/S0422763813001441
“Diabetes is associated with a significant impaired pulmonary function in a restrictive pattern as compared to non diabetics. The pulmonary function impairment was found to be more marked with diabetic duration especially after 10 years. Subjects with type I diabetes had lower FVC and FEV1/FVC% than predicted; it could be related to poor glycemic control.”
As far as “it does not stay in your body as long as other insulin,” that potentially INCREASES the risk because of hyperglycemia due to late digesting carbs requiring additional doses. Consider someone like “Gustavo Basualdo” who was mentioned above. He tweeted that controlling his glucose requires TWELVE cartridges a day! Even if he’s using just the 4U cartridge, that’s 48U inhaled every day. He uses in ONE day what would last a typical type 1 on lispro a WEEK or more. And that is WITH regular exercise – at least that’s what he claims.
Then open the afrezza insert and look at page 15 and note that the concentration of insulin in the blood reaches 2-3 TIMES that of lispro with each dose. Note what the insert also says:
“AFREZZA provided less HbA1c reduction than insulin aspart, and the difference was statistically significant. More subjects in the insulin aspart group achieved the HbA1c target of ≤7%”
So TWELVE times a day “Gustavo Basualdo” spikes his insulin levels into the stratosphere, risking his lungs and who knows what else – since the safety study hasn’t even started – and he can’t even expect to achieve an A1c that he could get from lispro? Does that really make sense?
When combined with a Dexcom device Afrezza gives you near perfect control of your BG. I’d say the risk is much lower for hyperglycemia as a follow-up dose is simple. That’s the beauty of Afrezza, you only use what you need, there’s a much lower risk of miss-calculation and chasing high’s and lows. The insulin is in your system for only the time you need it, lowering the risk of damage that insulin in general can do to your body. I follow Gustavo Basualdo on Twitter, his control is pretty spectacular for a Tri-athlete Type 1. His tweets rave about his BG control using Afrezza.
I still don’t see how Afrezza can be seen as harmful as compared to others insulins, to me that’s smoke and mirrors.
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Although I’m far from a triathlete… I did just recently run my first half marathon. I can guarantee you that while doing what it took to maintain tight control with MDI there is no way I’d have been able to eat in such a way to have enough energy to do that…
The naysayers all have one thing in common-- they don’t use it.
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Actually there are users of Afrezza who have used Afrezza much longer than 1-2 years.
Per this post, the author of the post spent 5 1/2 years in a research study trial using AFREZZA.
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That’s a great post Charles 5, thanks for sharing it.
Even ignoring that one person does not constitute a safety trial, what “research study” is that person referring to? I know of no trial or study lasting “5 1/2 years” using afrezza.
Read and learn Ray11. This article is from 2009. If you question the article feel free to talk to the writer directly, Amy Tenderich of Diabetes Mine, who interviewed Al. She’s on twitter and now an Afrezza user.
“We also did high-definition CT scans on the 600 patients in our study. That’s the best you can do with people. We saw no change in their lungs, and some of them have been using the product for up to 5 years now.”
-Al Mann
www.healthline.com/diabetesmine/the-truth-about-afresa-inhalable-insulin-a-chat-with-al-mann#3
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“Read and learn”? I did and I learned that Mr. Mann knew very little about either diabetes or diabetes management. I also have to question his honesty, although he may not have been personally responsible for this claim:
“We actually did a survey of hundreds of endos and primary care physicians. Twenty-five percent said they would definitely recommend it for their patients.”
Of course, I don’t know how the survey was done, but I seriously doubt that you could find any endo that would actually recommend afrezza for any patient other than someone with a morbid fear of needles.
That’s more because of a lack of familiarity then anything else, endo’s are human. Time will tell.