New oral inhaler may replace insulin injections for diabetes patients | Quantumrun

New oral inhaler may replace insulin injections for diabetes patients

Alfred E. Mann (chairman and CEO of MannKind) and his team of medical developers are making a strong effort to ease the burdens of diabetes patients. Earlier this year, Mannkind released an oral insulin inhaler by the name of Afrezza. The small pocket-sized oral inhaler can be used as a substitute for insulin injections among diabetes patients.

Diabetes dangers

A total of 29.1 million Americans suffer from diabetes, according to the 2014 National Diabetes Report. This equates to 9.3% of the U.S. population. Of the 29 million currently living with diabetes, 8.1 million are undiagnosed. Those numbers are even more alarming when one realizes that over one-fourth (27.8%) of people living with diabetes are not aware of their illness.

Diabetes has proven to be a dangerous disease that greatly affects the life of patients who have it. The risk of death for adults with diabetes is greater than 50%, according to the National Diabetes Report. Roughly 73,000 patients were required to have a limb amputated due to their illness. The threat of diabetes is real, and finding a proper and practical treatment for the disease is imperative. Diabetes was the seventh leading cause of death in the United States in 2010, claiming the lives of 69,071 patients.

The burdens of diabetes will not only affect those who are currently diagnosed with the disease. According to the Center of Disease Control and Prevention (CDC) 86 million, more than 1 out of 3 Americans currently suffer from pre-diabetes. Currently 9 out of 10 Americans are unaware that they have pre-diabetes, 15-30% of people with pre-diabetes will have type 2 diabetes within five years.

The dangers of diabetes along with the alarming statistics it carries makes Mann's invention, Afrezza, relevant and enticing to those who already suffer from type 1 or 2 diabetes. By regulating high blood sugar levels, this can assist a patient in living a normal life with diabetes.

What are the benefits?

What are the benefits of Afrezza? What makes it different from insulin injections? These are questions that were answered during a speech by Mann, at John Hopkins School of Medicine.

As to how the powder insulin inhaler works, Mann described "We mimic what the actual pancreas does, we peak [insulin] in 12 to 14 minutes in the blood... it’s essentially gone in three hours”. This is relatively short in comparison to normal insulin clearance. Described on Health.com, short acting insulin is to be taken between thirty minutes to an hour before a patient’s meal, and it peaks after two to four hours. 

Mann goes on to say, “It’s that insulin that hangs on after you’ve digested the meal that causes almost all of the problems with insulin therapy. It causes hyperinsulinemia, the hyperinsulinemia causes hypoglycemia, because of the hypoglycemia you have to get the fasting glucose level up. In the meantime you’re eating snacks all day, and your liver is pumping out glucose to keep you from going into a coma, and that’s what causes weight gain in diabetes, it just starts and goes on forever because you don't have prandial insulin."

These claims by Mann regarding Afrezza, coincides with the findings of an international study conducted on type 2 diabetes patients from the United States, Brazil, Russia and Ukraine. Researchers concluded in the double-blind, placebo controlled study that patients who were assigned Afrezza, were subject to minimal weight gain, and saw a substantial decrease in postprandial blood glucose levels.

Publicizing Afrezza

In efforts of educating patients and medical personnel of the benefits of Afrezza, MannKind has delivered 54,000 sample packs to physicians. By doing so, MannKind hopes that this will create a more profitable and beneficial 2016 for diabetes patients, as well the company. By delivering sample packs, it creates a stronger rapport between Afrezza and medical professionals, which will also allow MannKind to establish a doctor-education seminar series, as well as incorporating Afrezza into Sanofi's Coach – a free diabetes management program for patients.

The future of Afrezza seems to be much brighter than its short past. Since Afrezza's launch on February 5th, 2015, the insulin inhaler has only brought in $1.1 million in revenue. This raised doubt amongst those on Wall Street who looked to score big on this medical invention.

The sluggish financial beginning of Afrezza, may also be attributed to the screening patients must go through before they can be prescribed Afrezza. Patients must undergo a pulmonary function testing (spirometry), in order to determine if the drug can be used by those with a pre-existing lung condition.

Personal accounts of Afrezza

Great things have been said by diabetes patients who have been prescribed and medicate with Afrezza as their primary source of insulin. Websites such as Afrezzauser.com have expressed their delight with the drug. Dozens of YouTube videos and Facebook pages have sprung up over the past few month, describing health improvements due to the insulin inhaler.

Eric Finar, a type 1 diabetes patient for 22 years, has been outspoken in his support of Afrezza. Finar has posted numerous YouTube videos about the health benefits of Afrezza, and claims his HbA1c (a measure of long-term sugar levels in the blood), has since dropped from 7.5% to 6.3%, his lowest HbA1c ever, since using Afrezza. Finar hopes to further lower his HbA1c to 5.0% by continued Afrezza use.

Creating an alternative

By creating awareness amongst patients and medical professionals, the future seems to be bright for Afrezza. Many who suffer from diabetes can utilize the insulin intake alternative, helping to improve health outcomes. This will also prove to be a medical breakthrough for those diabetics who fear needles, or are hesitant to medicate in public before a meal.

According to a FDA document, “One-third of all health care providers report that their insulin-using patients are concerned about their injections; a similar number of people …report dreading them. Lack of compliance … is a problem in both T1DM (type 1 diabetes mellitus) and T2DM patients, as noted by frequent dose restriction or frank omission of insulin injections.”

Impact 

The threat of diabetes is real, and finding a proper and practical treatment for the disease is imperative. Many who suffer from diabetes can now utilize the insulin-intake alternative Afrezza, helping to improve health outcomes.

Forecasted start year: 
2016 to 2017

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