Inhaler over injections: SA clinical study could make insulin inhaler available to kids

Children with Type 1 and Type 2 diabetes can now enroll in the trial

SAN ANTONIO – It’s common knowledge that diabetics receive their insulin through injections or pumps.

However, many people don’t know of a new option: inhalable insulin.

The inhaler called Afrezza, created by Mannkind, has been FDA approved for adults, but not yet for kids.

San Antonio’s Diabetes & Glandular Disease Clinic (DGD) Clinic is one of 40 clinics nationwide conducting this study, which still needs participants.

“It’s estimated that probably about a fourth of the population in future years will have Type 2 diabetes and a fourth will be pre-diabetic,” said Dr. Mark Kipnes, Director of Research at DGD Clinic San Antonio.

Kipnes said a daunting part of a diabetes diagnosis includes the constant insulin injections.

That’s why the approval of the insulin inhaler for adults 18 and up was a huge milestone.

“The people who use it, they like the lack of injections. They like the rapidity. They like the ability to correct their dose. If it’s still high, they can take another dose without having hypoglycemia,” Kipnes said.

He said the inhaler was originally expensive and there were some insurance barriers, but some of those hurdles have been crossed and adults now have better access to the inhaler.

Kipnes made it clear that the major advantage was how fast the inhaler works.

“Injected insulin takes about 30 minutes to take effect and peaks in an hour or two. Inhaled insulin starts to work in about 12 minutes and depending on the dose, peaks in 35 to 45 minutes,” he explained.

Kipnes said that the inhaler is only a “meal insulin.”

“Most times patients need insulin before every meal, as well as a long acting. They still have to take a shot either in the morning or at night to keep their sugar normal between meals in during the nigh,” he said.

However, Kipnes said an inhaler would take most of the burden away. Patients don’t have to take a shot before every meal. They can inhale before every meal.

This would be a game-changer for children who constantly have to pause their school day and activities for injections.

Certified Diabetes Educator and clinical trial lead Terri Ryan gave KSAT 12 News a demonstration of the inhaler.

Ryan held up the inhaler, explaining that it can be used for two weeks.

“Two come in a box and they use two per month and then a pack of cartridges. The cartridges come in different strengths depending on how much insulin they need,” Ryan said.

“We just pop the cartridge out of the foil packet. This cartridge can stay at room temperature for three days. It can be in the refrigerator up until the expiration date,” she said.

“We have an inhaler device that we open, and then the inhaled cartridge goes in,” she said, opening the small inhaler.

Ryan said there is one important thing to do before using the inhaler.

“Prior to inhaling, we want to take a sip of water because this is a powder, and it can cause a cough,” she said, explaining that is the main side effect of the inhaler.

“I’m going to take a nice, slow, deep breath, tilting the cartridge down slightly. And we’re finished,” Ryan said.

Kipnes and Ryan also offered a tour of the clinic, which is a one-stop shop. Downstairs is the pediatric clinic, the research facility, and the lab.

Once kids are signed up for the study, they go through two parts, each lasting six months.

“It’s 26 weeks of either inhaled or injections. And then the last 26 weeks, everybody will be on inhaled,” Kipnes said.

Kipnes and his team are proud that local children could eventually help make the inhaler available to families across the country.

The team is actively recruiting children ages 4-17 for the study, so anyone who is interested can call (210)-615-5549 or visit the DGD Clinic website.

About the Authors:

Courtney Friedman is a KSAT anchor and reporter. She has an ongoing series called Loving in Fear, confronting Bexar County’s domestic violence epidemic. She's also covered Hurricane Harvey, the shootings in Sutherland Springs and Santa Fe, and tornadoes throughout Texas. She’s a California native and proud Longhorn who loves calling SA home.

Luis Cienfuegos is a photographer at KSAT 12.