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Afrezza as an injectable?

Discussion in 'Insulin' started by tim2000s, Apr 17, 2015.

  1. tim2000s

    tim2000s Type 1 · Expert
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    Thinking about the the launch of Afrezza and the involvement of Sanofi, I wonder whether an injectable version of it as a new very fast acting insulin will be forthcoming. As a monomer insulin, it will be absorbed quickly without the protein separation and could be used by Sanofi to replace/be introduced alongside their current fast acting.

    Just a thought!
     
  2. capsicum

    capsicum Family member · Member

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    Afrezza is ultra rapid acting because it is going direct into the bloodstream via the lungs, instead of subcutaneous.

    Humalog/Apidra is also fast if injected intravenously (here's a thread where they experiment with doing just that: http://www.diabetesforums.com/forum/topic/62716-intravenous-insulin-injections/ ). You're not going to get the fast in/out like Afrezza subcutaneously however.
     
  3. tim2000s

    tim2000s Type 1 · Expert
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    On the other hand, Afrezza is a monomer insulin and not tied to a protein in hexamer form, unlike the analogues. As a result, in theory at least, in an injectable form the body should be able to use it more efficiently than the analogues as there is no separation from the protein required. It should therefore be significantly faster than any of the analogues, even in a suspended injectable form.

    That's where Sanofi comes in, I think. Tie that to a pump using an artificial pancreas algorithm and you are approaching insulin with a normal reaction time. Even into a set (injection port) you should see a benefit. I look forward to enhanced MDI!
     
  4. capsicum

    capsicum Family member · Member

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    Afrezza is human insulin, which has long been available on the market Humulin. Human insulin forms dimers and hexamers in solution. Humalog and Apidra are structurally engineered forms of insulin with amino acid substitutions that prevent hexamers forming. What you are proposing is Humulin, which is much slower than Homolog/Apidra.

    I wrote up this description of how Afrezza works on another site:

    1) Insulin is a hormone - a chemical that sends a signal or message to other parts of the body.

    2) When you inject rapid acting insulin under the skin at mealtime, the accumulation of insulin called a depot is dispersed over the course of more than eight hours. It begins to have an effect in 45-60 minutes.

    3) However insulin isn't secreted under the skin naturally. Normally a few minutes into eating mealtime, a sudden spike of insulin is released into the bloodstream directly into the liver portal vein. This message, called "first phase release" tells the liver to stop secreting glucose into the blood, and absorb glucose to keep it constant for more than an hour.

    4) That message doesn't happen when you inject rapid-acting insulin. Instead glucose levels are attempted to be managed by elevating insulin levels for an extended period, but a pancreas doesn't work that way.

    5) Afrezza is inhaled, and is released into the bloodstream in seconds. It restores the normal function of the liver at mealtime, by giving the normal message from the pancreas.

    Nothing else does this, and that's why it's exciting. Blood levels of insulin at 70 minutes after inhaling Afrezza are the same as 3 hours after injecting Humalog.
     
  5. robertconroy

    robertconroy Type 2 · Well-Known Member

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    I'm trying Afrezza. So far, it seems superior to injected insulin. It acts faster and clears the body faster and good news I've been losing about a pound a day. I inhale 3 8 unit cartridges before each meal. It may cause some lung problems, but since I use medical cannabis, I probably won't have any. The company that makes it is Mannkind and marketed by Sanofi. Godsend for type Is and I'm a type 2 so we'll see how it goes, but so far - stellar product! Probably the best drug for diabetes ever developed.
     
  6. tim2000s

    tim2000s Type 1 · Expert
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    Are you in the UK?
     
  7. brendan101

    brendan101 Type 1 · Well-Known Member

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    An excellent question Tim2000s and no answer received. I believe it is in the UK atm. I am seeing my endo tomorrow to query this.
     
  8. brendan101

    brendan101 Type 1 · Well-Known Member

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    Is there anyone else like me in the UK and using Afrezza?
     
  9. tim2000s

    tim2000s Type 1 · Expert
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    Earlier in the year someone posted about Afrezza being trialled in the UK - I don't recall who that was. When I asked about it with an endo in June they said that it wasn't currently licensed for use in the UK.

    According to the New Medicines UK site, it is still in Phase 3 Clinical Trials:

    http://www.ukmi.nhs.uk/applications/ndo/record_view_open.asp?newDrugID=4631
     
  10. robertconroy

    robertconroy Type 2 · Well-Known Member

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    No, I'm in the US. I've opened up a new thread about Afrezza - inhaled insulin.
     
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