Inhaled Insulin

[Tyler]

I have on opportunity to participate in a study for the next two years and three months with inhaled insulin. Well, if I make the study group I will be on AERx, if not I'll be on one of the fast acting injectables from NovoNordisk. Both groups will be using Levemir.

I have pretty good control with my pump. Most A1Cs are in the low 6s, I've had a couple in the mid 6s. I'd have to go without my pump for the next two years which would kind of scare me.


Would you give it a shot (or snort)?

[JediSkipdogg]

I personally would not, the fact is you will be more miserable on inhaled insulin. The major reason is because control is not as accurate. When you inject insulin, you are injecting a certain amount, you know that for a fact and ALL of the insulin you inject will work. When you inhale, unless you hold your breath for a minute, you are going to inhale and then exhale a large amount of the insulin. Also, being sick affects the lung as one of the first of all body organs. This will make your lungs pick up the insulin differently.

Personally, I'm one that won't ever do inhaled insulin unless I see good proof from someone else that it works. But from listenin to the major downfalls of Exubera for type 2, how could they avoid those for a type 1?

[SueM]

I can't remember where I read it but from what I understood it was not suitable for type 1's was not accurate in it's dosing and was exspensive too. You need lungs to live and breath I certainly wouldn't clog mine up with a powder. Have you seen the size of the inhaler too?:eek:
If you have good control with your pump why alter it?
In the UK Drs have been refused permission to prescribe the stuff.

[JediSkipdogg]

I can't remember where I read it but from what I understood it was not suitable for type 1's was not accurate in it's dosing and was exspensive too. You need lungs to live and breath I certainly wouldn't clog mine up with a powder. Have you seen the size of the inhaler too?:eek:
If you have good control with your pump why alter it?
In the UK Drs have been refused permission to prescribe the stuff.

FYI...I think he's asking if he should participate in a study to see if inhaled insulin COULD work for a Type 1.

Still, I'm all about studies and have done over a dozen. But I would still not participate in one involving trying an untested insulin. I know too many people that have gone through **** trying new insulins to find out they have to abandon the study because their levels are all over the place. And your doctor can't really hlep you much since they have no idea what the product is. I stick with BG meter studies and medical condition studies.

[am1977]

Personally speaking, I probably would not to it :thumpdown.

It sounds like you have good control right now. Who knows how the study will go and what will happen to your control as you go along on the trial on the inhaled insulin... it may really mess up your control. And then there could be a lot of difficulty regaining it.

Of course, there are some good things about participating. it would be an interesting experience and you would get first hand experience in using the inhaler and seeing how it works (if you aren't in the control group).

But, considering everything, I think the negatives outweigh the positives and I'd probably pass....

[corwin]

I would give it a shot. I think studies like these are great for advancing diabetes treatment and I would love a chance to participate in any study that can help others with this condition. As far as inhaled insulin go, my new endo says, after hearing lectures and reading medical studies, that it is as accurate as injections and in the future it will probably replace fast acting injections. I would love to see more data and people experience with it, that's exactly why the companies are doing these studies. Also as far as I know you can drop out of any study at any point if you see it's not working for you. To me it seems like there's really not much to lose and it can really help others, so why not?

[KickStart101]

I have on opportunity to participate in a study for the next two years and three months with inhaled insulin. Well, if I make the study group I will be on AERx, if not I'll be on one of the fast acting injectables from NovoNordisk. Both groups will be using Levemir.
I have pretty good control with my pump. Most A1Cs are in the low 6s, I've had a couple in the mid 6s. I'd have to go without my pump for the next two years which would kind of scare me.
Would you give it a shot (or snort)?

Hi Tyler: I would try it. When I applied for the Clinical Trials for the new
drug for RA, they mentioned to me that I could quit anytime I wanted to
plus they would be doing alot of blood work on me so the Doc's could cut
it anytime the tests showed something they didn't like or if I was having
unsavory effects. That made me feel alot better. It would be the same
for you.
It would be a rest from the pump for you plus an interesting experience.
Plus you'd get it free while you were in the study and probably longer.

I would not stay on it for prolonged time(unless off for a while then back
on, etc.)since I heard on the news that the Patients lost about 20% or 25%
lung capacity after being on it for some time. But you would probably know
when to quit it. I would ask about that also to make sure it's true.

Your pump would still be around so if the inhaler wasn't working for you
then you just hop back on the pump and in a little while you would be back
under control. I would think that people who are not under control with
other methods would be accepted first for the study or perhaps they accept
anyone who is Type 1(I'm assuming this is for).

Good Luck in your Big decision. :) (Good control you have now). :top:

[Tyler]

I think I'm going to give it a shot. I'm going to call my CDE back and make sure that 1) I can quit if things aren't going well, and 2) I get all of this stuff for free.

I've been wanting to take a pump break anyway. If things start going bad, it's always right there.

[Georgia]

You'll have to keep us all posted on how you are doing with the inhalor. Good luck with it :top:

[snowhite]

I personally wouldn't do it because the long term affect on the lungs has not clearly been determined. I do applaud you for participating in the study. Just be sure the fine print says you are able to withdraw from it at any time. Good luck!

[jeggeman31]

I personally wouldn't do it because the long term affect on the lungs has not clearly been determined. I do applaud you for participating in the study. Just be sure the fine print says you are able to withdraw from it at any time. Good luck!

I agree with snowhite. We don't know to much about the long term affects. It would also be very hard for me to give up my pump. I would think about it if, I could go back to the pump at anytime. However I would say NO if I had to pay for anything, or unable to go back to the pump.

[JediSkipdogg]

From my experience in doing studies you give up nothing. Many times you can get paid for them, usually in the form of transportation costs that come out more in your end, so you make some extra money.

The one thing I always hate with doing studies is they have a limit on how many they need. Say a limit of 2000 for a device or drug. If you enter, they expect you to complete the study. If you drop out at any time, you are either not included in final study results (I hate when studies do this) or you are included and have a negative impact on the study.

If you go into this study, please make a committment to at least try. I know alot of people that have tried insulins and quit because it was simply **** the first few weeks. You have to realize you have to re-work all your ratios over again. Basically you have to totally relearn a treatment method, and sometimes the numbers won't change equally (if you had a morning 1:2 ratio and now it's 1:5 on the new insulin, that may not apply at dinner if you had 1:5 at dinner, you may still have a 1:5 at dinner.)

Good luck if you enter and keep us posted. I have done a few clinical trials, but never for any drugs.

[beveykin]

Keep us all updated on your progress and good luck

[Tim_Roy]

How I got started with the pump was doing a medical study in 1980 with the AS*1C.

Of course, that was something that would prove to provide BETTER control than what I'd been using before it.

I don't see the point of inhaled insulin. It's for newbies who are afraid of needles. I don't see how it can possibly give you better control, I'd suspect it would make for worse control, even than shots. Once you're past a frear of needles, who would need this stuff?

I'm not saying it's a bad idea for the wimps out there, but what would a diabetic already accustomed to needles gain from the experience?

[corwin]

Tim_Roy, I think the benefits are much greater then you realize. If it really works and they manage to make it as accurate as injections many people will benefit from it. First of all newly dx'ed like you mentioned. I also think it's much more socially acceptable to use an inhaler at the dinner table then lift your shirt and inject insulin. My cousin has a very bad phobia of needles, just discussing the fact I'm injecting myself makes him shiver and nervous, for this reason I always leave the room to inject during family dinners, an accurate inhaler I could use for these occasions will be nice. I also heard about people who can't get used to injections, years after dx, they can really benefit from it. Personally I don't see why anyone will ever want to use the pump, with modern insulin and pens I don't see myself ever considering having something attached to my body 24/7, however obviously many people enjoy this option. Same thing for inhaled insulin, it's a different treatment and if it prove accurate with no side effects I'm sure many people will benefit from it.

[JediSkipdogg]

I also think it's much more socially acceptable to use an inhaler at the dinner table then lift your shirt and inject insulin.

The problem is this device is not the size of an inhaler. It's about the size of a can of coke collapsed and gets to the size of a 20 oz bottle when expanded. How the heck is that LESS obvious than just lifting your shirt to inject insulin?

The other problem I see is it's proven from illegal drug users that inhaling isn't as effective as injecting. So I see the same holding true here. Again, we need more studies to show that, and we need long term studies, since we have no idea what effect this has on the lungs, good or bad. My major concern is people will change from great control with shots to this and get less control. I went on the pump cause I hated shots, that's why many choose it. I use to bruise all the time with shots, now they have short needles out, but I didn't have those when I made the change.

Again, I won't make too many negative comments towards it, since I haven't used it. But so far studies have shown you can't get as accurate of a control from it since it comes in two doses, a 3 unit and 9 unit, which also poses a problem since 9 units IS NOT equal to 3 3 unit doses, not sure why. And each dose has to be taken seperately, so if you need 17 units, you have to take 6 three unit doses. Not to mention it still doesn't eliminate needles, a type 1 still needs the long acting insulin like Lantus, so using this to eliminate needles is really not a justifiable reason.

[corwin]

I didn't say it's less obvious, it's much more obvious, but it doesn't involve peircing your skin, blood, lifting your shirt. Think of an asthma inhaler, how many people will go to a restroom to use it? How many insulin user will not inject in public?

I'm not arguing accuracy, doses, long term effects, that's why they make these studies. I'm arguing against saying "I'm not going to use it so nobody ever should". What 1 person find pointless and a waste of time can be the perfect solution for anohter. Do you honestly beleive nobody will benefit from a perfectly tuned for doses, 0 size effects inhaler? That's what they are trying to create and if they manage to do it, I think it will help thousands of people. If it won't work they'll keep looking for other ways to improve our lives and it's a great thing for us that they are trying.

:topic: I thought it's different illegal drugs that are used for inhaling and injecting, but I'm sure in your line of work you know more about this then I do.

[JediSkipdogg]

:topic: I thought it's different illegal drugs that are used for inhaling and injecting, but I'm sure in your line of work you know more about this then I do.

:topic: Some drugs come in both forms. Cocaine for one example, the effects are the same from cocaine. However, some is snorted (powder cocaine) and some is injected (liquid cocaine, ie powder cocaine dissolved in water.) The effects are the same, however, the inject reaction takes place almost immediately, whereas snorting it can take a few minutes for it to begin to work.

Oh, it can also be smoked, which has an equal time reaction as inhaling, since it's a finer particle, reaction time is faster, but it's mixed with other chemicals (tobacco) that slow time down, therefore equalling out to inhaling.

Cocaine is just one drug, there's many many more that can be inhaled or injected. You may say it's because many of the above drugs are injected intraveniously, however, even when they miss a vein, and just go into fat (like injecting insulin) the reaction time is still much faster than that of inhaling.

Now, let's go back on topic, lol. Unless you all want to know more about illegal drugs?

[jenet]

... a type 1 still needs the long acting insulin like Lantus...
And some Type 2s as well, I believe. (Sorry. Even though I am a Type 1, I just couldn't resist. ;) )

Cheers,
j

[Tyler]

It's been a while now, control has been great, even better than the pump. Dosing has been incredibly accurate.

First A1C on the inhaled was 6.1. Last A1C a few weeks ago was 5.8, that's my lowest ever.

[JediSkipdogg]

Which one are you using again? Are you on Exubera or is this one of the newer ones that is still under FDA review?

[Tyler]

Which one are you using again? Are you on Exubera or is this one of the newer ones that is still under FDA review?

Novo AERx, still under review...by me. :)

[JediSkipdogg]

Novo AERx, still under review...by me. :)

Cool, I hear that's one of the best inhalable insulins out there in terms of precision. I'm not sure if you can answer this or not, but how large is the machine? Can you measure it because pictures to me make it seem pretty large? Also, how large is each dose? Can you take a 10 unit dose at one time?

[Tyler]

Cool, I hear that's one of the best inhalable insulins out there in terms of precision. I'm not sure if you can answer this or not, but how large is the machine? Can you measure it because pictures to me make it seem pretty large? Also, how large is each dose? Can you take a 10 unit dose at one time?

It's pretty big, and honestly, it's making me think about going back to the pump just because of the inconvenience of having ot lug it around all the time. It's about the size of a DVD case only a tad bit wider and about 3 inches thick. The battery makes it pretty heavy.

Each dose is 2-10 units. For example, if you want 15 units, you use two strips. You can take a 10 unit dose at once if you wish, but I've found that it's about half as strong as Novolog.

[JediSkipdogg]

It's pretty big, and honestly, it's making me think about going back to the pump just because of the inconvenience of having ot lug it around all the time. It's about the size of a DVD case only a tad bit wider and about 3 inches thick. The battery makes it pretty heavy.

That's even bigger than I thought. What irks me is alot of the companies/media market that as less conspicuous than giving a shot. I'm sorry, but if I have to lug a DVD player to a fancy restaurant for dinner and pull it out before the meal to inhale, that's not less conspicuous. Less conspicous would be a needle and vial of insulin in my pocket, pull out, dose in my lap, inject in the leg, nobody sees.

Each dose is 2-10 units. For example, if you want 15 units, you use two strips. You can take a 10 unit dose at once if you wish, but I've found that it's about half as strong as Novolog.

Have you experienced any times this winter being sick? I know it's hard to say what changes would be made during being sick since even on shots everything can go wacko. I'm just curious how something like a congestion may affect it.

[Tyler]

That's even bigger than I thought. What irks me is alot of the companies/media market that as less conspicuous than giving a shot. I'm sorry, but if I have to lug a DVD player to a fancy restaurant for dinner and pull it out before the meal to inhale, that's not less conspicuous. Less conspicous would be a needle and vial of insulin in my pocket, pull out, dose in my lap, inject in the leg, nobody sees.

And the pump is probably the least conspicuous of all. Everyone thinks I have asthma or something until I explain it to them. I couldn't care less though/


Have you experienced any times this winter being sick? I know it's hard to say what changes would be made during being sick since even on shots everything can go wacko. I'm just curious how something like a congestion may affect it.

Yeah, one time when I was very congested I just went to shots for a few days so I can't say for sure.

I often have mild congestion and have noticed no problems, I just try to make sure and clear my throat beforehand just in case.

[chinku]

hey Tyler,

I am newly dxd with type 1 this jan and I fell great to hear that the inhaler works (A1C 5.8, is just GREAT) .

I hope this is just a beinning of something good and will evolve in to more feasible , and easy to carry.

I appreciate your participation and effort in this kind of study.