New breathable insulin becomes a popular choice for diabetics in the US

Recently I wrote an article about a messenger RNA (mRNA) breakthrough that researchers say could help us cure Cystic Fibrosis with nothing more than an inhaler containing a powerful gene editing tool – something that’s the tip of the proverbial iceberg when we discuss new, powerful aerosol based medical treatments and vaccines like this latest Covid-19 vaccine.

Now, soon after writing those articles I’ve come across another interesting breakthrough, this time in treating diabetes with nothing more than a spray, albeit definitely not a cure in this case.

One of the troubling medical trends is the increased number of people diagnosed with diabetes. The US Department of Health now estimates that just under eight percent of Minnesotans, or about 320,000 people have either Type 2 or Type 1 diabetes that requires insulin.

Insulins have dramatically improved in recent years along with their delivery devices, and among them is new “inhalable insulin” that more patients are now discovering and starting to use.

In a small pouch, Kevin Michelizzi keeps cartridges of insulin that require no needle and no pump. It’s an inhalable insulin called Afrezza, which contains tiny particles of the drug that enter the lungs. This allows the insulin to enter the blood stream almost instantly to help the body process the energy in blood sugar.

It’s a relatively new form of insulin delivery that pharmacist and Ridgeview diabetes educator Dr. Stephanie Redmond says can be an option for some Type 1 patients.

“I often meet patients who are taking multiple daily insulin injections,” said Redmond. “They are taking injections three to seven plus times a day, and what happens is you develop scar tissue all over your abdomen where you are continuously injecting that. And when you go to inject insulin into scar tissue, it doesn’t get absorbed, and it doesn’t work, and you’re left with a high blood sugar after you eat. So changing to an inhaled option could be a major advantage for those patients.”

It’s been a big advantage to Michelizzi who uses the short-acting inhalable insulin to keep his blood sugar levels consistently between 70 and 130. It’s not necessarily an advantage over insulin delivery through a pump, just a different option.

“I have patients who’ve been on insulin pumps for a while, and they want to go on a pump break, frankly, for the reason that they are developing scar tissue where that infusion set is," Redmond said. "I think this gives patients a sense of freedom that they don’t have to be hooked up to something. But, then again a pump has advantages that allows you to more fine-tune a dose that you are getting throughout the day.”

For Michelizzi, the new delivery system is easy and most importantly it works.

“You do have to be willing to manage your diabetes, if you aren’t then you are going to have the same problem that you have with any other tool,” he adds.

As of now Afrezza is only approved by the FDA for adults, but it is undergoing clinical trials right now in children between the age of 8 and 12, and hopes are high that it will be more widely available in the US and around the world soon.