In adults patient with type 1 or type 2 diabetes mellitus, do Afrezza® Technosphere Inhale Insulin safe and effective to use in control blood glucose compared to subcutaneous insulin?
Background:
Insulin is an anabolic and anticatabolic hormone made by beta cell in the pancreas. It plays major roles in diabetes mellitus treatment. Insulin treatment is usually offered as subcutaneous injections with syringes, insulin pens or an insulin pump. New technique for the delivery of insulin continue to be discovered, including oral, transdermal, and inhalation delivery.1
Inhaled insulin Exubera® it is the first FDA-approved inhaled insulin product by Pfizer on January 27, 2006 and market withdrawal by the manufacturer on October 2007 due to the dose equivalence was confusing and/or inaccurate and unknown drug safety especially in the lungs.2,3
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Evaluate pharmacokinetics, and the safety profile compared to subcutaneous insulin. Identify drug related problem to understand pulmonary safety.
Literature Search:
A literature search using EMBASE and PubMed database was conducted on Wednesday November 12, 2014. The keywords used in the search included “Inhaled Insulin", "Technosphere Insulin”, "Afresa " and " Afrezza " used "And" to combined the keywords. The research retrieved 79 results. Once the search was limited to humans, English language and randomized controlled trials, the research retrieved 36 results. After excluded the duplicate articles, and include article particular on Technosphere inhale Insulin. The research retrieved 15 results. Ten literatures were excluded from the results. Six of them were review articles. Four of the results article not relevant for our question. However, five of remaining articles were used. Two of them assess efficacy.4,5 and the remaining three to evaluate safety and
It is necessary to consider changing from an oral diabetes medication to insulin injections after
Eventually by the beginning of December, they were finally ready to try this regimen on people. Then, John Macleod decided that isletin was not easy to say because it did not roll off of the tongue that well. Thus, so the name changed from isletin to insulin. In the beginning of January of 1922, a young boy with diabetes was the first human treated with insulin. The boy was in the hospital and continued to receive treatments. When the treatments were almost finished, he was more active, stronger, and looked better. Insulin was successful on humans too (The History). Therefore, it became extensively available. In order to have
In a 52 week randomized clinical study, patients with either type 1 diabetes or type 2 diabetes were treated using insulin glargine or insulin degludec. The study focus was on the effectiveness, safety and how well the patients tolerated the insulin degludec. One area of the study that was of particular interest was the occurrence of hypoglycemic events and mainly nocturnal hypoglycemia. The results of this study were then analyzed and the findings interpreted to compare insulin glargine and insulin degludec.
Insulin is a hormone, produced in the pancreas, responsible the metabolism of glucose in the body. Ultimately, insulin maintains homeostasis of blood glucose levels. Patients with altered insulin function or production may develop diabetes. Type 1 diabetes mellitus is characterized by insulin deficiency. Type 2 diabetes mellitus develops from a patient’s resistance to insulin function. Exogenous insulin is used in replacement therapy for diabetes management, restoring levels of insulin for use in glucose metabolism. A variety of insulin preparations are currently FDA approved and on the market. Different insulin are classified by time
My main focus was to solve the dreaded diabetes disorder by insulin. Not only me, I give this credit to all the other researchers who had assisted me on decontaminating insulin. The first couple of trials placed on diabetic patients was actually conducted by Leonard Thompson. According to the public, the success of these tests was huge. As you know, there has been worldwide demands for insulin in which some were at a stage that if they don’t get cured, they will never be saved. To make this occur, Best and I had injected insulin into a dog. From this we had found out that it had decreased levels of high blood glucose. Afterwards, we had thought of separating the isletin part of the dog’s pancreas. Then we had used it in human treatment with Collip and Macleod. To make sure our experiments were correct, Collip had tested insulin once again and had assisted us with cleansing it as well. Firstly, we had a medical success with a boy who had diabetes and overall he was cured after the treatment. This had then been an overall success in which the product was distributed
Insulin is a hormone that is produced in the pancreas to regulate the amount of glucose in the blood. The pancreas of an individual suffering from diabetes either does not produce insulin or only produces very little insulin. Before 1922 diabetes was a feared disease with no cure.
Though there are many hypoglycemic agents available for the treatment of diabetes, insulin remains an important therapy for patients with type 2 diabetes. This is because the natural history of type2 diabetes is characterized by progressive loss of beta cell function resulting into type 1 phenotype [28]. Due to this, exogenous insulin therapy is often required to achieve optimal glycemic control, even in type 2 diabetes [29]. If insulin is used appropriately, it is almost always
This article discusses the topic of medicine and explains how insulin was discovered. Michael Bliss illustrates early on in the process of discovering insulin researchers kept hoping that by injecting people with a portion of pancreas they could cause an improvement in diabetes. In the summer of 1921 Banting and Best experiment “isletin” now known as insulin, was successful, however, James Collip PH.D in biochemistry had purified insulin allowing it to be more consistent and effective. This article is from The Canadian Encyclopedia, which is a credible source because it is professionally edit and fact-checked. The author Michael Bliss also has a PH.D from the University of Toronto and provides factual content that is extremely unbiased. This
Patients may benefit from early treatment with basal insulin added to oral antidiabetic drug (OAD) through early glycemic
Type 2 diabetes, formerly known as adult-onset diabetes, developed after 35 to 40 years of age, accounting for more than 90% of diabetic patients. The ability of insulin to produce insulin in patients with type 2 diabetes is not completely lost. Some patients even have too much insulin in their bodies, but insulin has a poor effect. Therefore, insulin in patients is a relative deficiency, and it can be stimulated by certain oral drugs. Insulin secretion. However, some patients still need insulin therapy. With proper testing, treatment and lifestyle changes, healthy eating strategy, exercise and prevention of diabetes.
It is actually an alternative to injecting insulin. An insulin pump is a small devise that holds insulin and is about the size of a pack of playing cards. The pump is attached to you by a long, thin piece of tubing, with a needle at the end, which is inserted under your skin. Most people insert the needles into their stomach, but you could
However, there is a limit and the pancreas stop secreting insulin. Consequently, patients might be prescribed insulin, which is apply in a variety of ways. Insulin can be taken on a needle and syringe, which can be injective in the patients belly, thighs, or upper arm (NIDDK, 2017). Another way to obtain insulin is through an insulin pen that has a needle at its point and its filled with insulin (NIDDK, 2017). Furthermore, a patient can take insulin by inhaling powdered from an inhaler, which is place in the mouth. The insulin inhale goes directly into the lungs and moves into the blood (NIDDK, 2017). All these methods can help the body obtain insulin and reduce the blood glucose in the bloodstream. Moreover, if a person suffers from both obesity and type 2 diabetes they can undergo bariatric surgery. This surgery helps the person lose a large amount of weight and maintain glucose levels under control (NIDDK,
It is not news to anyone that one of the most known disease in the world is diabetes mellitus, people with type two diabetes produces some insulin, but not enough to keep their blood sugar at a normal level, however the one that are affected by the type 1 diabetes or childhood-onset type 1 DM do not produce insulin at all. Type 1 diabetes is usually diagnosed in children and young adults, and was previously known as juvenile diabetes. (ADA, 2015) . That circumstance puts them at greater risk for heart disease, renal disease and blindness to name a few. Sadly Worldwide, the occurrence of type 1 DM has been steadily rising, representing a significant burden on the people and to the health-care systems. Although momentous improvements in the care of T1DM patients, a subsection remain in major difficulty due to stubborn hypoglycemia. The possibility of IT offers the chance of better glycemic mechanism. Currently we are observing considerable advancement in the number and results of IT phenomenal. In type 1 DM is an autoimmune disease that causes the body the destruct the b cells in the pancreas, which are responsible for the production of insulin. As a result, supplementation of insulin is a must in the management of the disease through meticulous care of multiple daily injections to control blood glucose. Even accommodating to the treatment many do not maintain a stable blood glucose level and are at risk for metabolic problems. Ultimately replacing of β cells are the only
Pharmacokinetic studies have revealed that the peak plasma concentration of insulin lispro in the first hour after injection is twofold higher and that the time to maximum concentration of insulin lispro is less than half compared to that of human regular insulin. Compared with human regular insulin at the same time, insulin lispro leads to a lower postprandial glycaemic peak, shorter time to peak and lower total glucose excursion for the 0–4 h period. These characteristics enable insulin lispro to be injected within 15 min of starting a meal. ,
Diabetes is a systemic disease caused by a decrease in the secretion of insulin or reduced sensitivity or responsiveness to insulin by target tissue. (Beale, et al., 2011) The incidence of diabetes is growing rapidly in the United States and worldwide. An estimated 347 million people around the world are afflicted with diabetes. (Whalen, et al., 2012) According to World Health Organization (WHO), Diabetes prevalence among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014. It is the major cause of blindness, kidney failure, heart attack, stroke and limbic amputation. World Health Organization (WHO) projects that diabetes will be the 7th leading cause of death in 2030. It is a complex and costly disease that can affect nearly every organ in the body and result in devastating consequences. The leading cause of non-traumatic lower extremity amputations, renal failure, and blindness in working-age adults, diabetes is also a major cause of premature mortality, stroke, cardiovascular disease, peripheral vascular disease, congenital malformations, perinatal mortality, and disability. (Cefalu, 2000) Insulin therapy and oral hypoglycemic agents have demonstrated improvement in glycaemic control. However, Insulin therapy has some disadvantages such as ineffectiveness following oral administration, short shelf life, of the need for constant refrigeration, and fatal hypoglycaemia, in the event of excess dosage.