Ep 102: The Pediatric Endocrinologist Behind the Inhaled Insulin Pediatric Trial and The Teen Who Uses Afrezza instead of Multiple Daily Injections

With Dr. Steve Edelman (TCOYD founder), pediatric endocrinologist and INHALE-1 study investigator Dr. Anna Cymbaluk, study participant Philip, and his father Jim.

In this episode:

1:26 – The INHALE-1 trial: why it was conducted and how it was designed
3:03 – Why Philip’s family enrolled in the study after diagnosis
4:12 – Life before and after Afrezza: reducing injections and diabetes burden
6:00 – Why mealtime insulin remains one of the biggest challenges in pediatric diabetes
7:34 – Dosing Afrezza: cartridge sizes, conversions, and meal coverage
9:53 – Follow-up dosing and using CGM data to guide decisions
12:32 – Nighttime corrections, activity management, and reducing delayed lows
16:03 – Safety findings, lung-function monitoring, and cough management
21:35 – Which children and teens may benefit most from Afrezza
25:05 – Who may not be a candidate for inhaled insulin
26:03 – Sports, martial arts, and quality-of-life improvements for active kids
27:52 – Using Afrezza alongside pumps and automated insulin delivery (AID) systems

In this episode of the TCOYD Podcast, Dr. Steve Edelman is joined by pediatric endocrinologist Dr. Anna Cymbaluk, along with Philip and his father Jim, to discuss the recent FDA approval of Afrezza inhaled insulin for children and adolescents living with type 1 diabetes. Dr. Cymbaluk served as an investigator on the INHALE-1 trial, while Philip participated in the study himself, providing a unique real-world perspective on what it is like to transition from injections to inhaled insulin, and Philip’s dad, Jim provided the parent perspective as well as addressed parental concerns that might have arisen.

The conversation focuses on the INHALE-1 study and the unmet challenges that continue to exist around mealtime insulin dosing in pediatric diabetes care. Dr. Cymbaluk reviews the trial design, glucose outcomes, safety data, patient satisfaction findings, and the practical realities of introducing inhaled insulin into everyday diabetes management. Philip and Jim share how Afrezza impacted school, sports, social situations, and the day-to-day burden of diabetes, particularly around pre-bolusing, corrections, and avoiding multiple injections throughout the day.

Dr. Edelman and Dr. Cymbaluk also explore how Afrezza is dosed, how inhaled insulin differs from injected insulin, who may be a good candidate, and where it may fit alongside pumps and automated insulin delivery (AID) systems. For families looking for more flexibility, fewer mealtime barriers, and another option in the diabetes toolbox, this episode provides an honest look at the benefits, limitations, and real-world experience of inhaled insulin in children and teens.