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Afrezza® Insulin Inhaler: Breakthrough Diabetes Treatment Now Widely Available

After years of trial and error, and much anticipation among those in the medical community, Afrezza®, the first-ever rapid acting inhaled insulin, is now widely available by prescription. Afrezza is FDA- approved to control high blood pressure in adults with Type 1 and Type 2 diabetes.

How Afrezza® Works
Afrezza is a drug-device combination that delivers a dry formulation of human insulin via a portable inhaler. The rapid-acting formula is taken at the beginning of a meal and works to control blood sugar in those with diabetes. The drug is manufactured by the Mannkind Corporation and distributed by Sanofi.

X ray of Chest

Indications and Uses

According to the manufacturer, in patients with type 1 diabetes, Afrezza should not be used as a substitute for long-acting insulin, but rather should be used in combination with long-acting insulin. Afrezza should not be used to treat diabetic ketoacidosis, and it’s not recommended in patients who smoke or who have recently stopped smoking. Patients with asthma or COPD should not use Afrezza.

Benefits of Afrezza®

  • Ultra-rapid-acting insulin in powder form, which dissolves immediately when inhaled
  • Peaks within 12-15 minutes, compared to 2-3 hours with other fast-acting insulins. It should be noted that while Afrezza is fast-acting, it remains active in the body only for about 4 hours
  • The Dreamboat inhaler is disposable to prevent powder build-up in the device
  • No refrigeration required
Spirometry before Starting Patients on Afrezza®

Physicians are advised to perform a detailed medical history, physical examination, and spirometry (FEV1) prior to starting patients on Afrezza. This is critical, as Afrezza may cause severe asthma-like breathing problems in those with lung conditions.

A spirometer measures the volume of air inspired and expired by the lungs, and identifies both obstructive and restrictive ventilation patterns. Spirometers are used to diagnose lung diseases like asthma, bronchitis, and emphysema; check lung function before someone has surgery; assess the effects of medication; and measure a person’s progress in the treatment of a disease, among other uses. Doctors should perform a spirometry before prescribing Afrezza, six months into treatment, and annually thereafter.

The Astra100 Spirometer is the ideal choice for testing FEV1/FVC ratios before prescribing Afrezza and for ongoing patient care. Having a spirometer device on site eliminates the need to send patients to specialists, saving patients and physicians time and money.

Astra100 Spirometer

Warnings/Side Effects/Contraindications

There is a risk of acute bronchospasm in patients with chronic lung disease (asthma, COPD); therefore, Afrezza is contraindicated in patients with these conditions.

The most common side effect of Afrezza is hypoglycemia, a condition that can be serious or life threatening. Additional possible side effects are shaking, rapid heartbeat, sweating, and blurred vision, cough, headache, diarrhea, fatigue, and nausea. Afrezza may cause harm to the heart or brain—talk to patients about managing their diabetes and the use of Afrezza.

Traditional Diabetes Treatments
Insulin has traditionally been delivered via injection or infusion.

Injection Devices
  • The most common delivery method today is administering insulin via needle and syringe, in which the needle is inserted into a vial and the appropriate dosage of insulin is drawn and then injected into subcutaneous tissue.
  • Syringe filling devices and insulin pens feature push button devices that trigger the plunger, making insulin injections less unnerving for many patients.
  • Jet injectors, which forego needles in place of a powerful “jet” of insulin that penetrates the skin, never quite took off, as many users described them as more painful than a needle prick.
Infusion Devices
  • Insulin pumps are used for patients who need multiple injections every day for type 1 or type 2 diabetes.
  • Injection ports can be used with or without a pump and work with a catheter to deliver insulin via infusion.
  • Pump patches are relatively new devices that attach directly to the skin and use no tubing to deliver insulin.

Diabetes Facts and Statistics
The rate of diabetes in the U.S. has skyrocketed in recent decades. In 1958 less than one percent of the U.S. population was diagnosed with diabetes. In 1990 that number jumped to 2.5 percent, and as of 2012 there were 29.1 million people (9.3 percent of the population) in the U.S. with diagnosed diabetes. As of 2012, it was estimated that 8.1 million people had undiagnosed diabetes.

Prediabetes in People Aged 20 and Older
According to the Centers for Disease Control (CDC) report, “National Diabetes Statistics Report, 2014,” 37 percent of U.S. adults aged 20 or older had prediabetes in 2009-2012. This was based on fasting glucose or A1C (glycated hemoglobin) levels—51 percent of these individuals were 65 or older. When this percentage was applied to the U.S. population as a whole, an estimated 86 million Americans aged 20 and older had prediabetes in 2012. The number was similar for was similar for non-Hispanic whites (35 percent), non-Hispanic blacks (39 percent), and Hispanics (38 percent).

Diabetes in People under Age 20
As of 2012, about 208,000 people younger than 20 years of age had diagnosed type 1 or type 2 diabetes, which represented 0.25% of all people in that age group. Undiagnosed diabetes numbers were not available for people in this age group at the time of the CDC’s report.

Complications of Diabetes
The impacts of diabetes on a person’s health and quality of life can be enormous, as those in the medical community are well aware. Diabetes can cause a host of health complications, including neuropathy, ulcers, calluses, and foot problems. Diabetics with peripheral arterial disease (PAD) and neuropathy are at an increased risk of developing ulcers and infections, especially in the feet and legs, which can ultimately lead to amputation. Diabetics have an increased risk of heart attack and stroke, kidney disease, eye damage, skin conditions, hearing impairment, and Alzheimer’s disease.

Afrezza is a promising new treatment for type 1 and type 2 diabetes that, coupled with lifestyle changes, may help patients control blood sugar and prevent complications of diabetes. Physicians and other medical professionals will find a broad selection of spirometers to use before and during treatment with Afrezza on our site. We recommend the Astra100 Spirometer, an easy-to-use, affordable option.