Inhaled Insulin Afrezza for Kids as a More Convenient and Rapid Acting Alternative to Multiple Daily Injections: The Questions Parents Are Asking After the FDA Approval
Pediatric endocrinologist and INHALE-1 study investigator Dr. Anna Cymbaluk joins Dr. Steve Edelman, pediatric study participant Philip, and his dad Jim to talk through what the approval of inhaled insulin means for families weighing their options for diabetes management.
With Dr. Steve Edelman (TCOYD founder), pediatric endocrinologist and INHALE-1 study investigator Dr. Anna Cymbaluk, study participant Philip, and his father Jim.
So much of living well with type 1 diabetes (T1D) comes down to timing, and mealtime insulin is where that timing gets hardest. Pre-bolusing twenty to thirty minutes before eating is something even the most engaged patients struggle to do consistently, and for a kid at a school lunch table with twenty minutes to eat and friends to keep up with, it can feel close to impossible. The recent FDA approval of inhaled insulin for children, adolescents, and teens ages 6 to 17 opens up a more convenient option around mealtime dosing, one that starts working in minutes and clears the system in 1 to 2 hours to avoid delayed hypoglycemia. This conversation brings together the clinical side and the lived side of inhaled insulin as an option for kids: a study investigator who followed a teenager in the study, a teen who used it through high school, and a parent who did his own homework for his son before saying yes. Together they get into the questions families tend to ask first, including the real benefits over subcutaneous insulin and any side effects on developing children.
inhaled insulin afrezza stats
10 to 12 minutes
How quickly inhaled mealtime insulin starts working, and because it moves in and out fast, it can be dosed as often as hourly.
About 1-2 hours
VS 3 to 4 hours – inhaled insulin clears the body in roughly an hour, compared with the 3 to 4 hour window of injected rapid-acting insulin, which is why injections call for more pre-meal timing.
over 10 years
Inhaled insulin has been FDA approved for adults since 2014, with ongoing post-market safety surveillance reported to the FDA.
LESS weight gain
Was reported in the inhaled insulin group compared with the injection group during the INHALE-1 pediatric study.
Higher treatment satisfaction
Kids using inhaled mealtime insulin in the INHALE-1 study reported greater satisfaction with their regimen than those on injections.
Dr. Anna Cymbaluk is a pediatric endocrinologist and a clinical investigator in the INHALE-1 study, the trial that supported the pediatric approval of inhaled insulin. Philip took part in the study during high school and is now an undergraduate at UC San Diego. Jim, Philip’s father, brings the perspective of a parent who researched the therapy closely before enrolling his son. Dr. Steve Edelman, TCOYD founder, endocrinologist, and a longtime person living with type 1 diabetes, hosts this enlightening conversation.
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FACTS About Inhaled Insulin Afrezza
- Inhaled insulin is fast on and fast off. It is absorbed almost immediately and clears the system quickly, allowing for dosing at the start of a meal or even after eating, instead of 20 minutes before, and for quick correction doses when the timing of a meal isn’t predictable.
- The approval was built on a pediatric study. The INHALE-1 study followed children and teens specifically, comparing a standard injection regimen against an inhaled mealtime insulin regimen and tracking glucose control, body weight, safety, and satisfaction.
- Lung function was monitored closely throughout. Researchers measured baseline lung function and at three-month intervals during the entire study. FEV1, the main pulmonary function marker used in this study showed no difference between injectable or inhaled insulin.
- Pediatric data mirrors what was seen in adults. Specialists point to more than a decade of adult use under FDA post-market surveillance, and showed no significant issues with lungs.
- It isn’t the right fit for everyone, and screening is part of the process. Inhaled insulin is generally not recommended for children with a recent history of acute asthma treatment, current cigarette smoking, or users of vapes.
- A short-lived dry cough was the most common side effect. Some people develop a dry cough when they first start, and for many, it eases with technique over time.
- It works on top of a long-acting basal insulin. Inhaled insulin covers mealtime and correction needs; a once-daily basal insulin stays part of the routine.
What can we do if our Endo is not willing to help us get this.. they say they have to research more.
Can the adults use this insulina?