I don't get it

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455463/

Before you state that you NEVER SAID that Afrezza causes lung cancer, how about stop mincing words and simply state outright whatever it is you are trying to say instead of beating around the bush.

There is zero evidence that Afrezza causes lung cancer. To imply otherwise is entirely irresponsible.

4 Likes

P. Mayer, et al., “Insulin Action on H292 Bronchial Carcinoma Cells as Compared to Normal Bronchial Epithelial Cells,” Pulmonary Pharmacology and Therapeutics," 25 (1) 104-114 (2011): “Inhaled insulin may contribute to bronchial carcinoma due to IGF-I receptor activation by high local concentrations. … Thus, insulin … may favour progression of pre-existing tumours … .”

K. von Kriegstein, “Inhaled Insulin for Diabetes Mellitus,” New England Journal of Medicine, 350, 2101-2108 (2007): “An important uncertainty about treatment with inhaled insulin is the potentially increased risk of lung cancer. … One of the short-term studies reports an increased risk of mitosis induced by inhaled insulin in rats. … the rate of lung cancer depends on the rate of smoking 20 years earlier. It is therefore unlikely that we can expect a reliable result within 12 years.”

C. Lasagna-Reeves, et al., “Inhaled Insulin Forms Toxic Amyloid Aggregates,” Endocrinology, 151 (10) 4717-4724 (2010): " … ongoing long-term safety and follow-up studies have found decreases in pulmonary diffusion capacity and forced expiration volume in response to inhaled insulin."

Ok.

So, smoking causes lung cancer.

I get it.

Thanks for the follow-up.

In terms of the third article, although you appear to have forgotten to mention it, that article would appear to be discussing Exubera which is NOT the same as Afrezza and NOT the topic under discussion.

4 Likes

The article is discussing inhalable insulin, of which Afrezza is one type.

Ummm - No.

That article is discussing Exubera.

If you are trying to claim that Exubera and Afrezza are the same thing then certainly feel free to state so clearly and unequivocally. Otherwise, simply making an unfounded inference to such is being considerably less than intellectually honest.

5 Likes

My endo visits always involve their uploading and printing out information from my pump. I always ask for a month worth of data, otherwise they would only do 2 weeks. I used to do this for myself, but changed technologies, and need an adaptor now to see the data…procrastination set in on that task ;0). My point is to agree with you, be prepared, and bring as much information about what has occurred since the last visit.

1 Like

I must say, not very open to new ideas. Here’s my take. I have been doing this for a very long time also (47 years). And in that time things moved very, very slow for the first 25-30 years. I mean I was testing urine well into the 80’s. And using Lente and Regular for a very long time. But change is good and I usually wait to see how things go with the new product. So started pumping 27 years ago after many before me were using one. I tried CGM’s on and off for years and usually with newest system, which would frustrate the heck out of me. So now I wait. So Dexcom came into my management plan about 4-5 years ago. And than after many type 1’s using type 2 medications, I decided to try Victoza. And than Afreeza entered my treatment plan. And inhaled insulin has been around for awhile now. And no one with lung issues can use it. So that would never be a problem. You can’t have asthma and use it. So as many of us have said time and time again, everyone is different. And what works for you might not work for me and what works for me might not work for you. But I think you need to open up a little to change. Change can be a very good thing. We could still be testing our urine with that darn test tube and eye dropper for goodness sakes.

6 Likes

Tim - I am not sure where to start but I have been pretty busy lately so unless I saw you email I would not have seen this thread.

Seydlitz has no understanding of afrezza nor the history with Pfizer and the positioning by Pfizer to spread FUD about Exubera through paid studies prior to afrezza hitting the market. In short Pfizer saw afrezza as both a far superior prandial to Exubera and a disruptive technology which will change how diabetics are treated. In short they needed to do whatever they could to stop afrezza which included pulling Exubera before it made the market for afrezza and then appearing to have undercut Mannkinds efforts to sell afrezza or so it seems.

I had the chance to talk with the lead Exubera scientist a few years ago and asked him point blank what were the chances of Exubera causing lung cancer. His professional opinion was zero and he would know. I then asked him what he thought the chances of afrezza causing lung cancer and his answer was “less than zero” and thats a direct quote. He was an afrezza expert it turned out.

Now what we see in some PWDs using afrezza is a very slight tightening of the esophagus which initially shows as a very very slight decrease in FEV. Its not really a decrease in lung function but it tests that way. Not all PWDs show this but some do, some also have a slight cough after use which is easily solved with sip of water.

What is also being seen after several years of use is no further FEV decrease but in a few an actual increase. This is probably due to the increased health as a result of keeping near non-diabetic range, especially the post meal spikes. The key in properly treating diabetes is preventing the post meal spike and nothing is better at that than afrezza or a healthy pancreas.

Now as far as insulin being a carcinogen as Seydlitz is professing all I can say is WOW we are all in trouble as insulin is flowing through everyone’s blood everyday. The misnomer started I think because of the relationship between HGH and insulin but they are very much different. The HGH molecule 191 amino acids and a molecular weight of 22,124 daltons while insulin is composed of 51 amino acids, and has a molecular mass of 5808 Da. They are very different. I even heard it at the afrezza ADCOM where one of the experts was conflating the two.

What we do know is PWDs have a higher risk of cancer but how much and why is pretty much up in the air. Most think its because of the higher BG levels but most of the meds taken especially by the T2s are frightening and clearly some of these meds have very bad side effects. Here is a good study overview https://www.medscape.com/viewarticle/836608#vp_2

However, what we do know is we ALL have insulin in our bodies and most of us are not getting cancer. Now, IMO Seydlitz should be more concerned that PWDs have about a 3x chance of having heart issues and the #1 cause of death is heart attacks. Most of the heart issues are caused by micro and macro vascular degeneration and this is caused by extended periods of raised BG, 140+. With afrezza you can stop the post meal spike and bring the PWD back to non-diabetic baseline within a few hours post meal just like a non-diabetic. Doing this should significantly reduce vascular degeneration and will stop glucose laden LDL from causing plaque.

If Sedlitz is really concerned about cancer IMO he should be more concerned about the Frankenstein GMO insulins most PWDs are currently taking. Nobody knows what changing the molecular structure for the analogs such as Lantus, Novolog, Humalog, etc. will do long term. But what we do know is changing molecular structures is a tricky game and sometimes like in the ASPB10 development things end badly. For me given the choice between taking a monomer human insulin - afrezza versus taking an engineered analog like Novolog, its a no-brainer, I am taking the afrezza. Let alone the PK profile of afrezza is far superior to Novolog and afrezza is the only diabetic treatment which can “Stop the Spike”.

9 Likes

You cited research done on rats. Humans are not rats. At least not most humans…

The internet will give you what you want:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4634344/#!po=51.8293

Two cases of lung cancer (in 2,750 patient-years of exposure) were observed in clinical trials of Afrezza, whereas no cases were observed with comparators (in 2,169 patient-years of exposure). In both cases, the subjects had a history of heavy tobacco use. Two additional cases of squamous-cell lung cancer were reported in nonsmokers exposed to Afrezza.12

3 Likes

We KNOW what high blood sugars do to us. I am willing to offset that demonstrated side effect by keeping my blood sugar at a non diabetic level using inhaled insulin.

2 Likes

Have you read these articles you cited?

Have you read from any peer-reviewed journals of longitudinal studies on Afrezza (or as you state “AfrEEza)?

Do you have T1D?

In the clinical trials Afrezza users did experience a small decline in FEV (forced expiratory volume) tests.

I said that I gag on LCHF, not that it is a “very restricted diet”.

Interesting how what is heard/read is interpreted

1 Like

You’re funny. Set in your ways too.

Lauri - yes 4 people in the afrezza trials developed cancer. It typically takes 20+ years to develop lung cancer. The 171 and 175 trials ran for 6 months. The bottom line was these people were not properly screened. If I remember correctly many participants were from the eastern block in Europe. The two non smokers had working in a heavy metal smelting plant. The bottom line was these people already had cancer and did not know it.

Now afrezza has been used in compassionate use for 10+ years now with no serious health issues. Its actually shocking how well it has performed. But then again all it is is monomer human insulin which is what the body naturally uses.

3 Likes

Just consider first principles. Insulin is a known carcinogen, and with inhaled insulin you are firing it directly into the lungs, whose cells are extremely susceptible to developing cancer. We know that it takes a good twenty years to demonstrate that other substances operating in the lungs are carcinogenic, such as tobacco, but we have not yet had sufficient study of inhaled insulins to know for certain that they will not cause this problem with sufficient use over enough time. So since you can inject insulin subcutaneously, why take the cancer risk of putting it in your lungs unnecessarily?

I’m not sure why someone accused me of not having read the articles cited, since in one case I quoted directly from the body of the article not available on PubMed.

Please keep in mind that a lot of us old timers have seen “inhalable insulin is right around the corner!” for about 40 years now.

At least one big pharma company lost MANY BILLIONS of dollars on an attempt at inhalable insulin: https://www.forbes.com/2007/10/18/pharmacuticals-pfizer-exubera-biz-sci-cx-mh-1018pfizer.html#6300f7f31040

This history causes us older guys to be skeptical and while that skepticisim may have been valid for 38 of those 40 years, I will admit that I might be over-skeptical even after they get it right.

Seydlitz’s worries about cancer have some historical basis in past worries too. Note that the risk doesn’t have to be real to impact marketing decisions (compare, say, to marketing decision around red M&M’s even though they didn’t use Red Dye #2, and red M&M’s didn’t exist for many many decades even after that completely false scare!). https://www.reuters.com/article/us-pfizer-nektar/pfizer-warns-of-lung-cancer-with-inhaled-insulin-idUSWNAS722620080409

Having had diabetes for 48 years this month, I guess I qualify as an old-timer – but when Afrezza comes to Canada, I hope to be first in line. I’ve been hearing since 1969 that diabetes will be cured in five years. Thankfully that hasn’t prevented me from adopting pumps, human insulins, blood glucose meters, CGMs, and many other advances in treatment.

1 Like

Your firing insulin directly into your blood stream with an injectable, do you really think there’s any difference? Your lungs have constant blood flow running through them, otherwise you’d be dead. A much larger amount of insulin is needed with injectables, therefore more toxicity to your body. Afrezza is in your body less time too, I’d argue it’s safer and less toxic, but time will tell. Any carcinogen effect would be applied much more so with an injectable then with an inhalable.