[Sparkle]

Just heard the news! Surprise ! Inhaled insulin will not be available on the NHS to anyone with Type 1 in the UK. The NHS won't put £5.00 per week towards each person with it (our money by the way). What is the point of research unless you have private insurance ? No good at all to us in the UK unfortunately.

Unbelievable. I f I could opt out of the NHS think I would.

Was excited by progress initially but should have known better here in the UK.

What chance of a complete cure in the UK being available - none.

[JediSkipdogg]

Inhaled insulin IS NOT being prescribed for ANYONE in the US with type 1. So don't be upset at all. The problem is there isn't an exact enough dose control, therefore it's hard to make sure you get a decent amount. With insulin injections, you know what you are giving and one way or the other, it WILL work (unless you are on a pump and pump into scar tissue.) But with inhaled insulin and a cold, you may breath 10% of the insulin at one point or 90%. And you have different levels depending on the season and temperature.

[DeusXM]

Don't be upset. The NHS was spot on in not issuing insulin inhalers on prescription. As has been documented on this forum elsewhere, the inhalers are frankly, ****. They are actually of no use whatsoever in treating diabetes because they simpy don't offer the flexibility or effectiveness of injected insulin.

The reason the NHS has decided not to put insulin inhalers on prescription is because they offer neither a financial nor a medical benefit over current treatment. I strongly suspect that if you were indeed paying for your medication, you would choose to stick with insulin injections on the grounds that they are cheaper and medically better.

Indeed, the NHS seems to understand people with diabetes far better than even Diabetes UK.

http://news.bbc.co.uk/1/hi/health/4919802.stm

Andrea Sutcliffe, deputy chief executive at NICE and executive lead for the appraisal, added: "Our review of the evidence indicated that inhaled insulin should not be recommended because it could not be proven to be more clinically or cost effective than existing treatments.

"The clinical experts we asked advised us that using injected insulin is not usually a concern for the majority of people with diabetes."

Too right. Injecting insulin is like brushing your teeth. It's the day-to-day living, constantly worrying about what everything you eat and do will do to your blood sugar that's the kick in the teeth with diabetes.

As for a cure...if anything, Britain is going to be the first country to cure diabetes and will be the first country to mass distribute the cure. Because the NHS isn't wasting funds on treatments that are designed purely to line the pockets of drug companies (such as Pfizer with their inhaler), that money can be better spent on researching what's really needed in diabetes - a total cure.

Then there's the fact that any cure for diabetes will work out far cheaper for the NHS than funding insulin for patients. That's the real beauty of the state healthcare system - it totally and utterly destroys the ability of drug companies to just milk conditions instead of curing them. That's why Britain and Canada are the only countries in the world that have already half-cured diabetes in patients through islet transplants.

The insulin inhaler is nothing more than a cynical attempt to distract people with diabetes from demanding a cure. Bravo for NICE and the NHS for seeing through the corporate BS and making the best decision for people with diabetes.

[Sparkle]

Yes I rang London Radio today (Vanessa Feltz) as she was talking about inhaled insulin and the first thing she said was 'Are you one of the overweight diabetes people?' - can you believe that! I did say that the testing of blood is more painful than the injecting to be honest but I think it was lost on her!

I feel better now about it not being available on NHS anyhow!

[seacomp]

Originally Posted by DeusXM

They are actually of no use whatsoever in treating diabetes because they simpy don't offer the flexibility or effectiveness of injected insulin.

It's minor that I agree, but important that most diabetes experts agree. The most enthusiasm for inhaled insulin is among ignorant science reporters.

[DeusXM]

The most enthusiasm for inhaled insulin is among ignorant science reporters.

That's because injections scare the **** out of people. Let's face it, all of us when we were dxed with T1 thought 'oh no, how on earth am I ever going to be able to inject myself'. But because you don't have a choice you just get on and do it and after about a week you're not even thinking about it.

The only real use for an insulin inhaler is for those who are newly dxed and faced the same problem the rest of us did. But that's actually more of a hinderance. The longer you stay out of the jabbing game, the more daunting it's going to be. As far as I'm concerned, the best thing my nurses did for me when I was in hospital following dx was give me a fist full of syringes and tell me to get on with it.

Yes I rang London Radio today (Vanessa Feltz) as she was talking about inhaled insulin and the first thing she said was 'Are you one of the overweight diabetes people?' - can you believe that!

Wow...that's rich coming from her of all people!

[Sparkle]

exactly ! Am going to post something on her website - bit sad I know but bloody cheek of her! She should know the difference anyhow between type 1 and 2 if she is doing a programme on insulin ! Apart from being chopsy!

[DeusXM]

At the very least you'd think she'd be familiar with the words 'pot', 'kettle' and 'black'.

[Sparkle]

ha! Joke is , prob like you, I wasn't overweight and got more skinney before diagnosis! I hate it when people think all of us diabetics are overweight - her next line was going to be 'you brought it on yourself and why should the NHS support you' I think.....silly cow . Been lucky so far hasn't she ?! Made about 6 jokes re: cake eating during the show!

Not everyone with T2 is overweight either are they? Diabetes is totally misunderstood here esp. T1.

[JediSkipdogg]

Originally Posted by DeusXM

The only real use for an insulin inhaler is for those who are newly dxed and faced the same problem the rest of us did. But that's actually more of a hinderance. The longer you stay out of the jabbing game, the more daunting it's going to be. As far as I'm concerned, the best thing my nurses did for me when I was in hospital following dx was give me a fist full of syringes and tell me to get on with it.

Kinda off the main topic here but that is my biggest worry. Doctors are going to prescribe this for newly diagnosed diabetics. They will use it for about a year or so and then find out their A1C is still in the 9 or 10s. So the doctor will then tell them they need to go on shots.

That to me causes a huge medical problem which can end up in more lawsuits. Patients will either be really upset and think their condition is worsening or the real bright ones will think for the past year they were prescribed a useless medicine. At which point patients will start getting the lawyers out and suing doctors and psizer (however you spell it) for long term problems they will develop down the years for having a high A1C for such a long time when it should have been brought down.

[Pitzi]

I still remember the first time I had to inject myself, I was shaking so violently out of fear that I jabbed half of my thigh to pieces. Then I realised it didnt hurt half as bad as I thought it would be. Now it's such a part of my life that the day a cure will be found (I pray every day for the sake of all of us that they do) I will still be looking for syringes to stab myself with

[Sparkle]

Not here they won't! Be on jabs for a long time yet.

Maybe for the best.

[DeusXM]

At which point patients will start getting the lawyers out and suing doctors and psizer (however you spell it) for long term problems they will develop down the years for having a high A1C for such a long time when it should have been brought down.

Exactly. I want my NI contributions to pay for helping sick people get better, not to fund compensation payouts. And clearly the NHS must be aware of such opinions.

Now it's such a part of my life that the day a cure will be found (I pray every day for the sake of all of us that they do) I will still be looking for syringes to stab myself with

Yeah, that's going to be a very weird day. Even after I'm cured I still think I'm going to spend the rest of my life thinking every couple of seconds about my blood sugar and what I've just eaten and so forth.

Here's a thought though - the day they find a cure and get it out to all of us, you're all invited to a party at my place, where it'll be mandatory for each guest to drink a gallon of regular soft drink and a eat whole chocolate cake. And then we can have a massively unsanitary and unsafe bonfire made up of all our test strips and needles and pens and vials and cartridges and all the rest, and then we'll toast marshmallows on that bonfire.

BYOB, mind you.

[seacomp]

Originally Posted by DeusXM

The only real use for an insulin inhaler is for those who are newly dxed and faced the same problem the rest of us did.

That's going to be the most common use, but as you and other point out, it is an invalid use. The only valid use that I can see is with Type 2s who would benefit from an insulin supplement.
That is T2s who still have some pancreatic function but can not adequate control their BG on oral meds would benfit from adding insulin to get better control. Most T2s will avoid that step for the longest time because they are afraid of the shots.
Using inhaled insulin as a supplement here would make sense, especially since you don't want or need the inhalled insulin to perfectly cover a meal just part of it. The dosage considerations are much less vital in this particular application.
However, the risk of hypoglycemia is still there and to some extent even worse, since it is unlikely that the user would really be trained in fundementals of insulin use.
Imaging someone who normally has a large stack of pancakes covered in syrup for breakfast everyday taking, for instance 9 units of inhaled insulin. Then one day he or she decides to have just bacon and eggs, no toast, no potatoes, no carbs. Hello Emergency room.
(Yes, I realize that this is sort of off topic. Sorry.)

[klpants]

Originally Posted by DeusXM - Indeed, the NHS seems to understand people with diabetes far better than even Diabetes UK

Ha Deus, Don't even get me started on Diabetes UK!! I once attended a fundraising event organised by them and the food provided was sugar laden ****, I couldn't beleive it, they seemed surprised too that I had to inject!!