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Inhaled Insulin

If given the choice, would you feel confident to give inhaled insulin a try?

  • Yes, without hesitation, no more injections!

    Votes: 2 14.3%

  • Yes, but along with injections (e.g., long-acting inhaled insulin only).

    Votes: 2 14.3%

  • No chance, wouldn't trust it!

    Votes: 3 21.4%

  • Not until we're absolutely certain it's just as, if not more effective as insulin injections.

    Votes: 7 50.0%
  • Total voters
    14
Anna DUK

Anna DUK

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I was just reading about the latest findings on a trial looking at the use of inhaled insulin in people living with t1 diabetes and the researchers have found 21% of people on inhaled insulin improved their HbA1c by 5mmol/mol or more. Although, 26% of the group who were trailing the inhaled insulin actually ended up with an increased HbA1c!

Inhaled insulin has not been approved for use in the UK yet but it got me thinking about how people feel of the idea. You can read a little more about the trial here: https://www.diabetes.org.uk/about-u...g-research-news-american-diabetes-association
 
I’d worry about long term lung damage.
I see this is the inhaled insulin that’s been around for about 10 years in the USA but never quite took off. There were several threads on here about it at the time, in particular, the way it was being heavily marketed. I hesitate to mention the name, because every time it appeared on a post, I seem to recall there was always some ‘new member' from the US who popped up extolling its virtues in hyperbolic terms.
 
Robin said:
I’d worry about long term lung damage.
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Yes, long term lung damage would probably be a rare side effect. I wonder how different it would be from asthma inhalers though, in terms of long-term use? I suppose the asthma inhalers are supposed to work for the lungs, whereas inhaled insulin wouldn't just 'sit' in the lungs, it'll need to go a step further to get the glucose into the cells of the body. It's fascinating to say the least.
 
If I remember correctly, wasn't inhaled insulin talked about in the UK about five or 10 years ago, and rejected because it was considered that you would have to take several times (five? 10?) the amount that you would otherwise have injected?

Anna DUK said:
I was just reading about the latest findings on a trial looking at the use of inhaled insulin in people living with t1 diabetes and the researchers have found 21% of people on inhaled insulin improved their HbA1c by 5mmol/mol or more. Although, 26% of the group who were trailing the inhaled insulin actually ended up with an increased HbA1c!
Inhaled insulin has not been approved for use in the UK yet but it got me thinking about how people feel of the idea. You can read a little more about the trial here: https://www.diabetes.org.uk/about-u...g-research-news-american-diabetes-association
Click to expand...

@Anna DUK You talk about the study being related to Type 1 persons, but your link says "Inhaled insulin and tech for type 2" in the heading, but "Type 1" in the body text. Is the heading a typo?
 
It is an interesting topic. I haven't voted because there isn't really a suitable option for how I feel, which is that I simply don't believe it would be better than what I use now. I may also have other reservations like @Robin about damaging lungs long term ..... I can live with lumpy sites but I can't live without effective lung function and also very precise dosing would be challenging as some will hit the inside of the mouth and throat, much like the contents of an asthma inhaler.

My diabetes management is very good but I still remember that I had massive disruption and frustration just swapping from injected NovoRapid to injected Fiasp which are relatively similar. It actually took me two 3 month trials, separated by about 6 months in between to be able to make the swap to Fiasp and even after the second 3 months I was ready to throw the towel in and go back to NovoRapid again but had promised myself I would stick at it for a year and thankfully a couple of weeks later I made the break through.

Such a complete change in insulin and administration of it would mean massive disruption of routine and BG levels and relearning all the strategies that I currently use and almost certainly loss of confidence in my ability to manage my diabetes well until I got to grips with it and even then I doubt I would be able to manage it as well as I do now. It would almost certainly take months, if not years to fine tune it to get the same results as I do now. Also inhaling it might be more uncomfortable than jabbing myself with a needle, which sometimes I don't feel at all. Using an asthma inhaler can be a bit unpleasant too you know. I guess it is just what you get used to if you do something multiple times everyday. The needles are so tiny and the pen injectors so easy and convenient to use and pretty discrete, I don't personally have an issue with it, even when I have had to inject 10x a day to firefight high levels because diabetes was misbehaving. It isn't about the injections for me.... even if I needed 20 a day, I would not consider that a big problem.... it is about having confidence and knowledge to manage my diabetes well and I already have that and not prepared to compromise it by trying something different.

Maybe I am unusual. I certainly have spots where injecting can be really painful for a few seconds and I would say that most injections hurt a little but some I don't feel at all, but no way would I consider trading my confidence in what I have and managing it well, for an unknown which is very radically different, simply to avoid injections, because they are the least relevant part of the process for me.
 
John Gray said:
@Anna DUK You talk about the study being related to Type 1 persons, but your link says "Inhaled insulin and tech for type 2" in the heading, but "Type 1" in the body text. Is the heading a typo?
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Well spotted. Not a typo though, the link is related to the latest research news and another news item in this link is about tech for people with type 2. The inhaled insulin is only related to people with type 1 because that's the focus group for the research trial. :)
 
Thanks, Anna!
Would you think that the research would also apply to those Type 2 persons who were "insulin dependent"?
I inject insulin by the bucketful, and I would be worried about how much 'breathable insulin' I would have to ingest to be the equivalent of ~75 units of Levemir and 30-60 units of NovoRapid per day...
 
I’d be more concerned of the effectiveness if I developed a chesty snotty cold or flu? I’ll stick with “sick day rules” on the injectables. I have no issue with the smell of insulin. But I don’t fancy it coating my wind pipe.
 
rebrascora said:
Such a complete change in insulin and administration of it would mean massive disruption of routine and BG levels and relearning all the strategies that I currently use and almost certainly loss of confidence in my ability to manage my diabetes well until I got to grips with it and even then I doubt I would be able to manage it as well as I do now. It would almost certainly take months, if not years to fine tune it to get the same results as I do now. Also inhaling it might be more uncomfortable than jabbing myself with a needle, which sometimes I don't feel at all. Using an asthma inhaler can be a bit unpleasant too you know. I guess it is just what you get used to if you do something multiple times everyday. The needles are so tiny and the pen injectors so easy and convenient to use and pretty discrete, I don't personally have an issue with it, even when I have had to inject 10x a day to firefight high levels because diabetes was misbehaving. It isn't about the injections for me.... even if I needed 20 a day, I would not consider that a big problem.... it is about having confidence and knowledge to manage my diabetes well and I already have that and not prepared to compromise it by trying something different.

Maybe I am unusual. I certainly have spots where injecting can be really painful for a few seconds and I would say that most injections hurt a little but some I don't feel at all, but no way would I consider trading my confidence in what I have and managing it well, for an unknown which is very radically different, simply to avoid injections, because they are the least relevant part of the process for me.
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So well put @rebrascora. I can imagine many people would find changing a massive disruption. I have a friend who's just moved onto a hybrid closed loop system and has found it a very challenging transition... I know what you mean about using an asthma inhaler. I've had asthma all my life (since I was 2) and sometimes I have to admit, I really become fed-up with having to use my inhalers.
 
John Gray said:
Thanks, Anna!
Would you think that the research would also apply to those Type 2 persons who were "insulin dependent"?
I inject insulin by the bucketful, and I would be worried about how much 'breathable insulin' I would have to ingest to be the equivalent of ~75 units of Levemir and 30-60 units of NovoRapid per day...
Click to expand...
I've no doubt that if the researchers really want to see the impact (and benefits) to inhaled insulin, they should widen the focus group to all people with diabetes who are insulin dependent. I guess we'd have to watch this space.... :cool:
 
John Gray said:
I inject insulin by the bucketful, and I would be worried about how much 'breathable insulin' I would have to ingest to be the equivalent of ~75 units of Levemir and 30-60 units of NovoRapid per day...
Click to expand...
It's a good point. How does it work? Is it like for like? 1 puff = 1 unit? I have no idea but it is intriguing!
 
helli said:
I know of someone in the US who uses it along with their OmniPod.
She says it works very fast so is ideal to correct a high BG.
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I think this is interesting and as injected insulin can be quite slow to absorb for me, particularly when levels are high, then having an inhaler as an "add on" to my existing injected insulin regime would be much more attractive to me than a replacement insulin regime, assuming it was faster acting. I would certainly be prepared to try that.
 
Can I ask, has this thread been prompted by a question from the researchers to DUK?
 
rebrascora said:
Can I ask, has this thread been prompted by a question from the researchers to DUK?
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No, not at all. Was reading the news article this morning and wondered what people thought about the idea. :cool:
 
Anna DUK said:
It's a good point. How does it work? Is it like for like? 1 puff = 1 unit? I have no idea but it is intriguing!
Click to expand...

The original (same?) one had a limited number of unit variations and the minimum dose was quite big if I remember correctly. I want to say it was 4 units but I might be misremembering. I see it as a failed idea, despite all the heavy marketing at the time.
 
rebrascora said:
I think this is interesting and as injected insulin can be quite slow to absorb for me, particularly when levels are high, then having an inhaler as an "add on" to my existing injected insulin regime would be much more attractive to me than a replacement insulin regime, assuming it was faster acting. I would certainly be prepared to try that.
Click to expand...
This is how I feel. If I still needed my pump anyway I might as well stay on my pump. Also I don't like nose stuff at all. Seems odd to me.
 
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