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Georgia
02-09-2006, 09:40 AM
So, has anyone now decided to give the inhalor a go?

This is from Diabetes UK.....

Q. What is Exubera ®(inhaled insulin)?
A. Inhaled insulin is a fast- acting, dry powder preparation of human insulin that is inhaled into the lungs via the mouth before meals, using a specially designed inhalation device. Inhaled insulin has been developed for use in people with Type 1 and Type 2 diabetes through collaboration between Pfizer Inc and Nektar Therapeutics. Pfizer is responsible for marketing, manufacturing and the clinical development of Exubera®. Nektar provides support in the manufacturing process for Exubera®, and manufactures the device.

Q. Who can use Exubera ®?
A. It is important to closely liaise with your healthcare team to ensure Exubera ® is right for you. Adults with Type 1 and Type 2 diabetes who aren’t adequately controlled with normal diabetes medications may be able to use inhaled insulin. People must have adequate lung function before starting Exubera ® and for this reason people planning to use Exubera ® will need a baseline basic lung function examination before starting therapy. The lung function test is known as FEV. It is a test in which you will be asked to blow into a device called a spirometer which measures how quickly and easily air flows out of the lungs. In a small number of people further lung function tests may be needed if a significant decline in lung function occurs after starting Exubera®.

Exubera ® is not suitable for smokers. Smoking greatly increases the absorption of inhaled insulin and therefore could increase the risk of hypoglycaemia. For this reason people must have stopped smoking for six months before considering starting inhaled insulin. If a person starts smoking again, inhaled insulin must be stopped immediately and alternative diabetes treatments should be discussed with their healthcare team.

Exubera ® has not been approved for use in children.

Q. Will I still need to inject my background insulin?
If you take background insulin injections it is essential to remember that Exubera ® must be used in combination with this. Talk to your healthcare team about whether the amount or timing of this needs to be changed.

Q. Can Exubera ® be used with other diabetes tablets?
A. Inhaled insulin has been used in trials with other common diabetes tablets including sulphonylureas and metformin. If you are taking diabetes tablets you may still need to continue taking these and your dose may need to be altered. You should discuss this with your healthcare team.

Q. When should Exubera® be taken?
A. The inhaled insulin should be taken before meals.

Q. How much inhaled insulin will I need to take?
A. The dose will be decided with your diabetes care team according to factors such as your weight, your blood glucose levels and what your meal consists of.

Q. What does the inhaler look like?
A. The inhaler is about the size of a spectacle case. The device does not need batteries or electricity to operate.

Q. Are there any side effects of Exubera ®?
A. As is usual with insulin treatments, the most common side effect of Exubera® is hypoglycaemia (low blood glucose levels). In studies hypoglycaemia occurred with approximately the same rate as seen with commonly used subcutaneous (injectable) insulin.
In trials, involving over 3,500 volunteers using Exubera ®, some people experienced coughs with one per cent discontinuing the therapy because of this.
Dyspnoea (difficulty breathing, shortness of breath) productive cough, throat irritation and dry throat were also reported by some of the patients in the clinical trials.
As with all medicines if any of these side effects or unusual symptoms are experienced people should consult their doctor.

Q. Will I still have to blood glucose monitor?
A. As with any insulin treatment people using Exubera ® will need to monitor their blood glucose levels. And as with any change in treatment starting Exubera ® will mean you will have to monitor your blood glucose levels more closely

Q. Is Exubera® available now?
A. The EU licence for Exubera ® has just been granted. Granting of this EU authorisation now allows the production of the inhaler and the dry powder insulin formulation. It is not yet available for prescription but in the UK it is expected to be available for people with diabetes in May 2006. It has been referred to the National Institute for Clinical Excellence (NICE) for consideration. NICE is a body that advises on the clinical and cost effectiveness of medicines.

What do you think? :idea:

psilocybin
02-09-2006, 09:44 AM
i dont know about those side effects. not to impressed with them. i would stick with the good old pens

sydneya
02-09-2006, 10:07 AM
I'm one of the lucky ones--needles don't bother me near as much as not being able to control the dosage and the thought of what it could do to my lungs. I'll still to the pens and syringes. The syringes wouldn't be replaced anyway since this is only being used for fast acting.

seacomp
02-09-2006, 10:21 AM
This is from Diabetes UK....

It reads as a press release, not an evaluation.

lelggren
02-09-2006, 10:24 AM
I just don't know what to think about the new inhaled insulin. The whole point, I thought, of making an inhaled insulin was to do away with shots. But, you still have to take a long-acting insulin due to the fact that the inhaled stuff is only short acting. Granted, you may take a lot less shots, but still. You would need to still buy all the same things to take shots, plus spend money on the new inhaler. It just doesn't seem to me that there are a lot of wonderful benefits to this like everyone thought there would be.

Aftiel
02-09-2006, 11:18 AM
I keep trying to find an "advantage" of an inhaler, and so far I don't see one.

No matter where I am, I can take an injection of Novalog before a meal - it seems setting up a special inhaler to accomplish the same thing is more of a pain than anything.

They still don't get the fact that "taking a shot" isn't the real problem.

- Aftiel

JediSkipdogg
02-09-2006, 01:12 PM
There are numerous problems with Exubera. Firstly, I personally hope that doctor's won't let patients on insulin switch to Exubera. I think it should ONLY be allowed to be used by those that have fears of needles and are on no form of treatment.

Then here's a good question...that inhaler looks pretty complex therefore making it pretty expensive. Say it breaks, you can't just go to Walgreens and get one. I think it will be a prescription only item (as otherwise it could be used somehow for smoking other items) at first. The problem would come if you are on a vacation somewhere or if it breaks in the evening at home. You are pretty much screwed until you can get ahold of your doctor and get one sent to you, unlike needles which you can go to Walgreens and I believe anyone can buy.

seacomp
02-09-2006, 02:37 PM
unlike needles which you can go to Walgreens and I believe anyone can buy.
Not true, need script and can be a BIG deal. I carry a spare script in my wallet, just in case.

JediSkipdogg
02-09-2006, 02:41 PM
Not true, need script and can be a BIG deal. I carry a spare script in my wallet, just in case.

That makes sense that you need a script, I just wasnt' 100% sure if you did or not. I wasn't sure if it was like pump supplies in that some companies you need a script and some don't.

camjen1
02-09-2006, 03:24 PM
Does anyone have a pic of this exact inhaled insulin? I seen one in the past that almost looked like you can use it as a weapon if you were getting attacked but haven't seen any pics since.

JediSkipdogg
02-09-2006, 03:42 PM
A picture of the machine can be seen here as it basically collapses onto itself:

http://www.pfizer.com/pfizer/download/exubera_release_faq.pdf

Also a video of the machine being used and seeing it's actual size can be seen here:

http://xgen.vitalstream.com/mcasx.asx?media=1970281&package=1848098

One last thing to keep in mind is...pills can only be inserted one at a time. So say you need to take 3 3 mg tablets, you have to do the machine work 3 times. And that to me takes longer than drawing up one shot and injecting it or just dialing in an amount on a pump. At least with doing it once, you don't have to count how many times you inhaled insulin and somehow miscount.

lelggren
02-09-2006, 04:17 PM
Actually, you can buy syringes w/o a rx, but it cannot be billed to your insurance without one. Insurance co.'s are picky and need medical necessity verification for everything....I know because I have bought syringes before without an rx. Paid cash price which is usually anywhere from $13-$30 depending on the brand. Insulin however, you do need the rx. They won't just let you take it without a rx, whether you have insurance or not....


Not true, need script and can be a BIG deal. I carry a spare script in my wallet, just in case.

duck
02-09-2006, 04:21 PM
Actually, you can buy syringes w/o a rx, but it cannot be billed to your insurance without one. Insurance co.'s are picky and need medical necessity verification for everything....I know because I have bought syringes before without an rx. Paid cash price which is usually anywhere from $13-$30 depending on the brand. Insulin however, you do need the rx. They won't just let you take it without a rx, whether you have insurance or not....

I'm pretty sure you can buy Insulin R without insurance. Others here have said it, and I kinda remember a few years ago that my "backup" plan if I ever ran out of insulin was to go to the 24-hour CVS down the street and buy a bottle of R if I needed it.

lelggren
02-09-2006, 04:26 PM
I'm pretty sure you can buy Insulin R without insurance. Others here have said it, and I kinda remember a few years ago that my "backup" plan if I ever ran out of insulin was to go to the 24-hour CVS down the street and buy a bottle of R if I needed it.


Good point!:thumbsup: I wasn't thinking about R, but you are right. But, I know that Humalog and Lantus and things like that require an rx in order for the pharmacy to even give it to you. Although, most dr.'s get sample bottles of insulin too from the reps that they see, so if you are ever in a bind, ask the dr. :)

camjen1
02-09-2006, 05:10 PM
Just so I'm getting this correct, they pull all the cold medicine off the shelf because of people using it to make drugs but yet they let anyone buy the very thing that injects it? :hmmmm2: