# New Treatment



## Carolm (Dec 26, 2015)

I just was sent information about a new powdered insulin inhaler called Afrezza.  Anyone heard anything about this?


----------



## AlisonM (Dec 26, 2015)

Yes, it's an inhalable insulin. I have serious doubts as to it's usefulness because I know from personal experience how hard to can be to get the correct dose from an inhaler. If you don't time the breath in exactly and have the inhaler in the right position, you waste much of the dose. To work correctly for most of us, insulin doses have to be measured as closely as possible, something that will be impossible with an inhaler IMO.


----------



## Carolm (Dec 26, 2015)

That is what I was wondering about...how to insure that each dose inhaled is the full dose.  Did you try out an inhaler?


----------



## AlisonM (Dec 26, 2015)

I've needed an inhaler on occasion in the past for attacks of asthma and both my mother and maternal grandmother were asthmatics. It's almost impossible to ensure a set, measured dose using an inhaler. Also, according to research, the cost of producing the stuff apparently outweighs any benefits, which are virtually non-existent when compared to traditional injections or pumps.


----------



## Carolm (Dec 26, 2015)

I use an asthma inhaler every day, plus Ventolin when and if needed, so am familiar with inhalers, too.  I guess I was hoping for a really tremendous Xmas present!


----------



## AlisonM (Dec 26, 2015)

Carolm said:


> I use an asthma inhaler every day, plus Ventolin when and if needed, so am familiar with inhalers, too.  I guess I was hoping for a really tremendous Xmas present!


Sorry Carol, I don't think that will be it.  Would be nice if it worked, but there are other more workable solutions on the way, such as beta cell transplants that might actually be a cure.


----------



## Carolm (Dec 26, 2015)

Thank you!  I always like something to look forward to.
Carol


----------



## Sandy Mayo (Dec 29, 2015)

Hello All!

Thought I could chime in here as I know two people currently using the new inhaled insulin (Afresa?). Alison is absolutely correct about inhaler dosing not being as precise as injections but there seems to be a method to that madness with this technology! Unfortunately I do not have the scientific background to explain it but I can tell you it has changed my friends day to day lives quite drastically as they do not concern themselves with timing anymore (something I noticed as an outside observer). My advice would be to dig a little more into this new technology if you are interested. A quick google search also will probably point you to several patients who are using it successfully. I found this one in a couple of seconds http://www.afrezzajustbreathe.com/ (Not sure if its official from the company that produces it or not but seems to show condensed testimonials and maybe even explanations of how it works so well compared to injections). Seems to be quite a breakthrough for those constantly injecting and trying to time and predict meals!  

Anyways, I saw this and thought I could maybe help! Good luck to you!

-Sandy


----------



## Andy HB (Dec 31, 2015)

... and cue DeusXM? 

(I seem to remember similar occurrences in the past when this product is mentioned. That is, a new member suddenly appears and their only act is to extoll the virtues of it.)

Sorry to be so suspicious but, Sandy, do you intend to contribute more fully as a member of this forum? Other than the friends you mentioned, what is your connection to diabetes?

Like the cute puppy, by the way. Is it yours or just some random one?


----------



## Matt Cycle (Dec 31, 2015)

Hmmm.  Aside from the things AlisonM has already mentioned (which are fairly crucial) it only comes in 4, 8 and 12 unit doses (not a lot of flexibility). You would still need to inject your long-acting (it's only available as a short acting insulin).  Not suitable for people with asthma or other lung conditions.  Even on their own website it states there was an increased incidence of lung cancer in those using it compared to other medicines - but too few to know if it was caused by Afrezza. 

I like new ideas and fantastic if it works properly and is comparable with injected insulin but I'll need a lot more convincing.


----------



## robert@fm (Jan 1, 2016)

I wonder if Sandy Mayo is perhaps a sockpuppet of SPAMcott.  (Cynical, moi?) And I bet McDonald Fart will be bombing Afreza, just as soon as the bombers get back from Agrabah...


----------



## HOBIE (Jan 2, 2016)

robert@fm said:


> I wonder if Sandy Mayo is perhaps a sockpuppet of SPAMcott.  (Cynical, moi?) And I bet McDonald Fart will be bombing Afreza, just as soon as the bombers get back from Agrabah...


Brilliant   Robert !


----------



## DeusXM (Jan 5, 2016)

Everyone, Sandy Mayo is an investor shilling the product to boost their stock.

This very thread is mentioned here, on a board for people who have invested in stock in Mannkind - http://mnkd.proboards.com/thread/4616/moderator-forum-diabetes-org-biased (you may need to register to view).

Alison, you'll be delighted to know that these investors (who of course, only have the best interests of people with diabetes at heart) are quite happy to slag you off for daring to be skeptical about Afrezza.

Interestingly, the website our friend Sandy mentions was set up by these investors - here's the whole subforum they have on their board, dedicated to running the site - http://mnkd.proboards.com/board/22/breathe

It includes a nice lengthy thread discussing the best way to write up the website so as to make it look impartial and legally secure from being challenged as a shill site for investors.

Sandy, of course, has only posted once on this board, and according to her profile, happens to be from Texas and is a carer/partner/other. 10 out of 10 for honesty, not quite such a high score if you want to look like an impartial advocate.

Matt, my understanding is that the way Afrezza works means that the total number of units seems to be less relevant than with injectable boluses - the speed of action means it wears off very quickly so you don't get the 'long tail' impact you get from Novorapid/Humalog etc. However, one thing I have read from some of the users who don't appear to be linked in with Mannkind is that because its action profile is so short, you end up needing multiple 'puffs' for meals that are slower-releasing ie. you will probably need to puff again after an hour or so for things like bread etc.

Many of the stockpumpers also seem to get very bogged down in 'freedom from injections', which as you rightly point out, doesn't actually happen as you still need at least one or two basal injections a day. There also seems to be a trend for using standard bolus insulins in combination with Afrezza, with Afrezza being used to correct unplanned spikes quickly rather than being used to manage meals entirely.

One other thing that has occurred to me is that many people posting on Twitter about Afrezza seem to also have CGMS systems. I might be wrong but I'm not sure these are widely used, even in the US. I would think there is a legitimate question to be asked about why so many Afrezza users also seem to have expensive, relatively rare hardware that can conveniently be used to 'show off' the impact of their medication on their blood sugar. It may be that because Afrezza is new and expensive, those who are using it are already demographically disposed to be well-off, early adopters of tech.

It might also be because of something more insidious. If I was a marketing person trying to promote Afrezza, giving someone a free CGMS in exchange for them relentlessly tweeting about how brilliant Afrezza was (without declaring an interest) would be a very good idea. Just a thought.

Disclaimer: Yes, I'm biased against Afrezza on the grounds that I believe the amount of money invested in it (over $1bn) dwarfs the amount invested in cure research and that had that money been spent on developing a cure, we would probably be on the home stretch to not actually having diabetes. I'm also biased thanks to the conduct of a vocal minority of investors who have successfully harassed, bullied, harangued and attacked the very people they supposedly are trying to help, while also hijacking social media and discussion boards to share their limited, inaccurate knowledge of diabetes to line their own pockets.


----------



## Northerner (Jan 5, 2016)

Personally, I think it is moot - Afrezza is very unlikely to be available on prescription here, certainly for many years to come, if ever. Even if it was, it would hold no appeal to me. I think it is a case once again of people without diabetes thinking that injecting is the greatest horror imaginable - maybe if you have a phobia, but that would be a fraction, but for the rest of us there are many more greater concerns. The point @DeusXM makes about slow-release food is also pretty relevant - I'm happy with my diet and wouldn't want to change it according to the insulin-delivery method.


----------



## AlisonM (Jan 5, 2016)

Somebody hates me?


WOOHOO!!!!

I stand by all I've said, as would anyone else with the kind of in depth, personal and familial experience of how inhalers work that I have. If MannKind and their investor's don't like that, tough. Vested interests really annoy me. I'm very relieved we won't be seeing it here for some considerable time.


----------

