What if you could get insulin without needles?

on pump, if that helps...

This inhalable insulin is the brainchild of someone very unfamiliar with the real challenge of diabetes: that is 24/7 micromanagement of the blood glucose. The injection process itself is not important but its reliability is. Under no circumstances this process justifies to inhale preservatives - the ingredience of every insulin on the market today. I also find it questionable to use lung tissue to absorb proteins like insulin. This is specially true for T1 diabetics that can develop autoimmune based inflammations. Even people otherwise healthy develop deadly diseases of the lung like pulmonary fibrosis. Why mess around with tissue that is so utterly important for our health and physical energy level - just for convenience?

From the bulk of the replies, it seems clear that people with T1D don't seem overly enthusiastic about AFREZZA. I would like to share more info published by diaTribe on AFREZZA, to shed more light on the topic:

Taken at meal time, Afrezza is an ultra-rapid-acting insulin that peaks in 12-15 minutes. The resubmission to the FDA includes the two recently completed phase 3 trial results for Afrezza that showed several benefits for people with type 1 and type 2 diabetes – a lower A1c (superior to placebo in type 2, non-inferior to Novolog in type 1), improvements in fasting glucose (type 1 and type 2), less hypoglycemia (type 1), and less weight gain (type 1). The trial did not reveal any serious safety concerns, and the most common side effects were a mild cough during the first few weeks of treatment, which means there will likely be a contraindication for people who smoke, have asthma, or have other respiratory issues.

I would too like to hear from people with T2D who are NOT on insulin (majority of people with type 2 diabetes), as to how this topic makes you feel about insulin therapy.

We're all different... so is my perspective :-)

As a pump/CGM user, this is not really a useful alternative to me, except for having available as an additional tool for dealing with particularly difficult bolus situations (party, indulgent celebration), or stubborn highs -- and only if there is truly a marked difference in time-to-peak and action duration.

I can see asking my endo to let me have one of these if it is something like 2-3x faster, to use as needed in addition to my pump. Of course, I only consider this because I am trying to maintain control as good as a non-diabetic (Sisyphean, I know, but as a goal it works for me, and I'm getting reasonably close!)

However, unlike many here, when I was doing MDI the shots were a major PITA. Not physical pain or any squeamishness about shots, rather the awkwardness of it, social issues, etc. I was never one comfortable in a room full of people pulling up my shirt, plunging a needle, and injecting.

An inhaler means of delivery changes everything for MDI people who are a bit modest about the whole affair.

I am with you, Dave. As with everything in diabetes, each person will go about it in their own way, and certainly, if it ain't broken, why fix it. ;)

Though there's those of us (who don't produce insulin any more) for whom injected or infused insulin is not an option, needle-phobia and fear of pain associated with injections are a reality that can hardly be denied that gets in the way of many people with T2D benefiting from an insulin-based therapy:
http://en.wikipedia.org/wiki/Fear_of_needles
http://www.jfponline.com/index.php?id=22143&tx_ttnews[tt_news]=171636
http://macha.itc.griffith.edu.au/dspace/bitstream/handle/10072/27947/55983_1.pdf?sequence=1
http://bja.oxfordjournals.org/content/early/2014/02/25/bja.aeu013.extract
http://www.dsr.dk/Artikler/Documents/English/Evidence-based_clinical_guidelines_for_injection.pdf
http://www.ncbi.nlm.nih.gov/pubmed/24164794
http://insulinnation.com/devices/products/a-bee-takes-the-sting-out-of-shots/

Wow!! I'm really surprised by the near-consensus in this thread so far! I, personally would try this thing in a heartbeat. I would want more information about it, and definitely want to know what's been studied thus far regarding long-term effects on the lungs, but life with fewer needles would be HUGE for me.

Case in point, last night I had this dream: I was at some kind of needle fair, where PWD were trying different kinds of infusion sets and syringes. I had to try all of them, and had needles sticking into me everywhere.

Last week I had this dream: my CGM sensor got twisted inside my arm, and I was trying to pull it out. It was bloody and painful.... and stuck.

I was diagnosed with diabetes when I was 3, and have had these dreams my entire life. Finger sticks I can do all day without a care in the world, but infusion sets and syringes still stress me out. If I could take 1-2 long-acting shots per day and use an inhaled insulin the rest of the time I think I'd spend the rest of the year laughing with glee.

In previous discussions on this, Emily, someone mentioned dosages which is what really made me reject this idea; weren't they something like 2, 5 and 10 units?

Every so often we get a new member in the chatroom who is agonizing about having to do an injection or insert an infusion set for the first time. These are adults, newly diagnosed, who are terrified. An amazing collection of community members in the chatroom always jump to their aid, encouraging them to get it over-with, telling them it'll get better, it will be fast, they'll get used to it.... Those folks might like this idea :)

Awesome step forward. No more needles! Might not work for all however.
Folks with asthma might find the inhaled particles problematic.
One would also want to ask what IS in the inhalant. What is the stabilizer.

Hello all,
I am a type 2 for over 10 years now, and my meds...metformin and glipizide are not proving to be very effective anymore, I look forward to Afrezza being approved. I have done lots of research on it and am going to share some info from the website:

AFREZZA® (pronounced uh-FREZZ-uh) is a first-in-class, ultra rapid-acting mealtime insulin therapy being developed to improve glycemic control in adults with Type 1 and Type 2 diabetes mellitus. It is a drug-device combination product, consisting of AFREZZA Inhalation Powder single use dose cartridges, and the small, discreet and easy-to-use AFREZZA inhaler.

Administered at the start of a meal, AFREZZA dissolves immediately upon inhalation and delivers insulin quickly to the blood stream. Peak insulin levels are achieved within 12 to 15 minutes of administration, mimicking the release of mealtime insulin observed in healthy individuals.

The extensive and ongoing AFREZZA clinical program, which has involved more than 6,500 adult patients and compared AFREZZA to the standard of care insulin treatment, has demonstrated the following outcomes:

Proven reductions in HbA1c

A reduced risk of hypoglycemia vs. rapid-acting analogs

Less weight gain vs. rapid-acting analogs

Injection-free insulin delivery

In clinical trials of up to two years duration in Type 1 and Type 2 adult patients with diabetes, observed changes in lung function were small, did not progress and resolved when AFREZZA treatment was discontinued. The most common respiratory side effect experienced with AFREZZA in trials was a mild, transient, non-productive cough. Discontinuation due to cough was uncommon.
We believe that AFREZZA is a unique diabetes therapy with the potential to change the way this disease is treated by offering significant benefits to the growing population of patients with diabetes. AFREZZA addresses several limitations of current mealtime insulin treatments by offering glycemic control with lower risk of hypoglycemia, less weight gain and an alternative to injections.
- See more at: http://www.mannkindcorp.com/product-pipeline-diabetes-afrezza.htm#sthash.6FHwp4pY.dpuf

There's some detail about the stabilizer (Technosphere) used in here:
http://insulinnation.com/treatment2/artificial-pancreas/inhalable-insulin-a-breathtaking-development/
http://www.liquidia.com/publications/Liquidia_Inhalation_Magazine_August_2012.pdf

I've been told by my VA Dr. that if my A1C does not go down significantly I will need to go on insulin, and though I do not fear needles, I would much prefer an inhalable insulin which is fast acting and easy to dose, as for the poster who stated that it was developed by someone who has little knowledge of Diabetes, that is incorrect. The owner of the company is Alfred Mann, who has been in the Bio Pharma industry for many many years. He has been working on this insulin product for several years and they are hopefully on the cusp of approval. Just google his name if you want to check out his credentials.

You could not be more wrong! And use of this product would actually make management of Diabetes simpler and more effective.

Hello, IMO would a Pancreas transplant not be more easy and the best way to go? seems like that would be the best fix. but then the insulin company's would go broke along with the Supply company's.And I am sure they would not want that to happen
Not going to snort anything up my nose. I am on the pump and looks like that is where I will stay.
Type I for 6 years 52 years old

I think the reality is that this is a product that not everyone will find to be best for them or worst for them. After all, "your diabetes may vary". ;)

I just looked up the old discussion of Afreeza from two years ago. It was stated by someone in a trial that it came in cartridges of only two doses: 10 units and 20 units. After some exploration it was clarified that these doses were roughly equivalent to half of injectable doses, so approximately 5 and 10 units. Has this changed in the two years since? If so what are dosing options now? As a Type 1 I have never taken as much as 10 units and I rarely take as much as 5. So at best this medication would be relevant only for Type 2's, but I don't think they would do very well either with just two dosing options when we all experience the value of precise dosing! Has this changed in the newest incarnation of this medication?

I am with you in terms of pump therapy, Chuck: I myself am a pump user too (for 8 years now) and find it to be a tremendous option. However, it's all about options... much as AFREZZA would not be for everyone, pumps are not for everyone. ;)

If only a pancreas transplant were so straightforward: unfortunately, there are not enough cadaver pancreases available (1), the autoimmune attack on the transplanted cells (2) and on the beta cells (3) continues to be a very critical issue. :S

The dosages have changed..and if approved the initial cartridge doses will be 3 and 6 units, with larger ones to follow.

Pancreas transplants are not "easy" and you do not snort Afrezza, it is inhaled through a device into your lungs.

Manny I guess it all boils down to Life, Most people will do what ever it takes to live. wither it is taking pills or taking shots or inhaling life saving drugs.
Some people can do better on other types of systems. I have taking as many as 9 shots a day before I went on the pump and treated for type II for 2 years before they found I was type I. I guess a back up E Pen would have to be in order if one was to pass out and could not inhale the mist. Most people can give a shot to someone if they had to.