Afrezza: Fast-Acting Inhaled Insulin! Can it Tame High Blood Sugar?

How Does Afrezza control blood sugar levels?

Afrezza is an Insulin Human Inhalation Powder. It is manufactured to stand different from any other meal-time insulin. It uses an insulin inhaler to deliver fast-acting insulin to the lungs and bloodstream via an insulin powder. When it's taken before the meal, it lowers blood sugar in about 12 minutes. Being like the quick entry, it also leaves the body fast within 1.5- 3 hours depending on the dose. ⁽²⁾

Technosphere technology is used to deliver Afrezza. It is composed of two components: Human insulin (in its basic form) and Fumaryl DiKepto Piperazine (FDKP), which is an inert component. This technology carries the insulin powder particles into the alveoli, (tiny air sacs in the lungs) where they dissolve and are rapidly absorbed across the alveolar walls. ⁽¹⁾

As the absorbed FDKP is inert, it is not metabolized in the body and gets excreted through the kidneys.

According to the pharmacodynamics of this ultra-fast inhalational insulin, it has a more rapid onset of action and shorter duration of action compared to other rapid-acting insulin analogs. In glucose clamp studies, the maximum glucose infusion rate was 53 minutes for Afrezza, 108 minutes for analog insulin, and 3-4 hours for regular human insulin.

Effectiveness of Afrezza in controlling Blood Sugar:

1. HbA1c Reduction: In a two-year study, it showed up with a similar reduction in HbA1c level compared to usual scores.⁽³⁾

2. Reduced Hypoglycemia Risk: A multisite parallel-group study was conducted to compare the safety and efficacy of Afrezza in type 2 diabetes patients with inadequate glycemic control versus usual care. At the end of the study, it was found that total hypoglycemic rates were significantly lower in patients treated with Afrezza than usual care.

3. Flexibility: It's ultra-rapid action allows for the right dosing when food arrives, thus providing better control for unexpected meals.

4. Lower post-meal blood sugar rise: In clinical trials, Afrezza users experienced a significant reduction in post-meal blood sugar spikes as to those using Novolog. After one hour of meal, users had blood sugar levels 38 mg/dL lower than Novolog users, and after two hours, they were lower at 18 mg/dL.⁽⁵⁾

Afrezza, thus controls your blood sugar level without the need for mealtime injections. Before you take your inhaler, make sure you understand how Afrezza works in lowering blood sugar levels. Consult your health provider to know whether Afrezza is required to manage your diabetes.

References:

1. Bergenstal, Richard M., et al. 2015. “Efficacy and Safety of Inhaled Insulin (Afrezza) in Patients with Type 2 Diabetes: A Randomized, Open-Label, Controlled Trial.” Diabetes Care 38, no. 4 (2015): 617–623. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455463/. Accessed February 9, 2025.

2. MannKind Corporation. “About Afrezza.” Afrezza. Accessed February 9, 2025. https://afrezza.com/about-afrezza/.

3. Medical News Today. “Afrezza.” Medical News Today. Accessed February 9, 2025. https://www.medicalnewstoday.com/articles/afrezza.

(Input from various media sources)

(Rehash/Dr. Ansila S/SSK)