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Post by johnhindepost on Aug 23, 2018 14:09:15 GMT -5
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Post by goyocafe on Aug 23, 2018 14:38:51 GMT -5
John E. Anderson, MD, Past President, The Frist Clinic, Nashville, Tennessee
DISCLOSURES
Dr. Anderson discloses that he is on the advisory boards for AstraZeneca; Abbott Diabetes Care Inc.; Boehringer Ingelheim GmbH; Eli Lilly and Company; Janssen Pharmaceuticals, Inc.; Merck & Co., Inc.; and Sanofi US. He is on the speakers’ bureaus for AstraZeneca; Janssen Pharmaceuticals, Inc.; Boehringer Ingelheim GmbH; Eli Lilly and Company; and Sanofi US. He is a Board Member for Nusirt Sciences, Inc.
ACKNOWLEDGEMENT
Editorial support was provided by Gregory Scott, PharmD, RPh, and Angela Cimmino, PharmD. The author was responsible for all content and editorial decisions.
SUPPORT
This article is sponsored by Primary Care Education Consortium and supported by funding from Mannkind Corporation.
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Post by mnholdem on Aug 23, 2018 14:41:27 GMT -5
Very informative info for clinicians. It’s a shame that STAT and other recent study findings didn’t make it into the article but overall the article answers many questions practitioners may have about Afrezza.
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Post by mango on Aug 23, 2018 15:17:20 GMT -5
Excellent article written by my Southern neighbor, John E. Anderson. My only criticisms is that he neglected to mention STAT study results and that he is on the MannKind SAB. I feel compelled to email him and/or IR to try to find out why. ———————— Subcutaneously injected insulin, even the rapid-acting insulin analogs (insulin aspart, insulin glulisine, and insulin lispro), are absorbed slowly enough into systemic circulation that the insulin concentration can remain elevated up to 6 hours after dosing. As a consequence, the time-action profiles of injectable prandial insulins do not match the absorption of prandial glucose and can put patients at risk of postprandial hypoglycemia, especially 2 to 5 hours after the meal (late postprandial hypoglycemia).8,9 Afrezza exhibits a linear, dose-related response. Time to maximum plasma drug con- centration (10 to 15 minutes) and peak glucose-lowering effect (approximately 45 minutes) for Afrezza are shorter than with regular human insulin or insulin lispro.8,21,22 This has been demonstrated repeatedly in crossover, hyperinsulinemic, euglycemic glucose clamp studies. The most recent was a study in 30 patients with T1DM in which the onset of metabolic activity for Afrezza occurred earlier than for insulin lispro (15 to 19 minutes vs 45 to 52 minutes), and the duration of action for Afrezza was approximately 2 to 3 hours shorter than equivalent doses of insulin lispro (1.8 to 6.4 hours vs 5.0 to 9.8 hours).23 Afrezza’s glucose disposal effect occurs earlier than that of SC insulin. For example, the rate of glu- cose disposal over the first 60 minutes after administration is 34% greater for Afrezza than SC regular human insulin (P < .05) and 4% less for Afrezza than SC insulin lispro (P = NS).24 Prandial insulin analogs are improvements over earlier products, and yet there are still unmet needs for optimal treatment of patients with diabetes. These include a mismatch between onset and duration of action and PPG levels, concern for hypoglycemia, dose timing, needle phobia, and treatment complexity. Compared with SC prandial insulin, the rapid-acting inhaled insulin of Afrezza leads to better control of early PPG with less weight gain and less frequent hypoglycemia, although control of late PPG remains suboptimal in some patients.    |
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Post by goyocafe on Aug 23, 2018 15:36:35 GMT -5
Excellent article written by my Southern neighbor, John E. Anderson. My only criticisms is that he neglected to mention STAT study results and that he is on the MannKind SAB. I feel compelled to email him and/or IR to try to find out why. ———————— Subcutaneously injected insulin, even the rapid-acting insulin analogs (insulin aspart, insulin glulisine, and insulin lispro), are absorbed slowly enough into systemic circulation that the insulin concentration can remain elevated up to 6 hours after dosing. As a consequence, the time-action profiles of injectable prandial insulins do not match the absorption of prandial glucose and can put patients at risk of postprandial hypoglycemia, especially 2 to 5 hours after the meal (late postprandial hypoglycemia).8,9 Afrezza exhibits a linear, dose-related response. Time to maximum plasma drug con- centration (10 to 15 minutes) and peak glucose-lowering effect (approximately 45 minutes) for Afrezza are shorter than with regular human insulin or insulin lispro.8,21,22 This has been demonstrated repeatedly in crossover, hyperinsulinemic, euglycemic glucose clamp studies. The most recent was a study in 30 patients with T1DM in which the onset of metabolic activity for Afrezza occurred earlier than for insulin lispro (15 to 19 minutes vs 45 to 52 minutes), and the duration of action for Afrezza was approximately 2 to 3 hours shorter than equivalent doses of insulin lispro (1.8 to 6.4 hours vs 5.0 to 9.8 hours).23 Afrezza’s glucose disposal effect occurs earlier than that of SC insulin. For example, the rate of glu- cose disposal over the first 60 minutes after administration is 34% greater for Afrezza than SC regular human insulin (P < .05) and 4% less for Afrezza than SC insulin lispro (P = NS).24 Prandial insulin analogs are improvements over earlier products, and yet there are still unmet needs for optimal treatment of patients with diabetes. These include a mismatch between onset and duration of action and PPG levels, concern for hypoglycemia, dose timing, needle phobia, and treatment complexity. Compared with SC prandial insulin, the rapid-acting inhaled insulin of Afrezza leads to better control of early PPG with less weight gain and less frequent hypoglycemia, although control of late PPG remains suboptimal in some patients. Isn’t this STAT... The most recent was a study in 30 patients with T1DM in which the onset of metabolic activity for Afrezza occurred earlier than for insulin lispro (15 to 19 minutes vs 45 to 52 minutes), and the duration of action for Afrezza was approximately 2 to 3 hours shorter than equivalent doses of insulin lispro (1.8 to 6.4 hours vs 5.0 to 9.8 hours).23 Afrezza’s glucose disposal effect occurs earlier than that of SC insulin. For example, the rate of glu- cose disposal over the first 60 minutes after administration is 34% greater for Afrezza than SC regular human insulin (P < .05) and 4% less for Afrezza than SC insulin lispro (P = NS).24 Read more: mnkd.proboards.com/thread/10394/august-addressing-unmet-prandial-insulin?page=1#ixzz5P2Gkmg6s |
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Post by mango on Aug 23, 2018 15:56:36 GMT -5
Excellent article written by my Southern neighbor, John E. Anderson. My only criticisms is that he neglected to mention STAT study results and that he is on the MannKind SAB. I feel compelled to email him and/or IR to try to find out why. ———————— Subcutaneously injected insulin, even the rapid-acting insulin analogs (insulin aspart, insulin glulisine, and insulin lispro), are absorbed slowly enough into systemic circulation that the insulin concentration can remain elevated up to 6 hours after dosing. As a consequence, the time-action profiles of injectable prandial insulins do not match the absorption of prandial glucose and can put patients at risk of postprandial hypoglycemia, especially 2 to 5 hours after the meal (late postprandial hypoglycemia).8,9 Afrezza exhibits a linear, dose-related response. Time to maximum plasma drug con- centration (10 to 15 minutes) and peak glucose-lowering effect (approximately 45 minutes) for Afrezza are shorter than with regular human insulin or insulin lispro.8,21,22 This has been demonstrated repeatedly in crossover, hyperinsulinemic, euglycemic glucose clamp studies. The most recent was a study in 30 patients with T1DM in which the onset of metabolic activity for Afrezza occurred earlier than for insulin lispro (15 to 19 minutes vs 45 to 52 minutes), and the duration of action for Afrezza was approximately 2 to 3 hours shorter than equivalent doses of insulin lispro (1.8 to 6.4 hours vs 5.0 to 9.8 hours).23 Afrezza’s glucose disposal effect occurs earlier than that of SC insulin. For example, the rate of glu- cose disposal over the first 60 minutes after administration is 34% greater for Afrezza than SC regular human insulin (P < .05) and 4% less for Afrezza than SC insulin lispro (P = NS).24 Prandial insulin analogs are improvements over earlier products, and yet there are still unmet needs for optimal treatment of patients with diabetes. These include a mismatch between onset and duration of action and PPG levels, concern for hypoglycemia, dose timing, needle phobia, and treatment complexity. Compared with SC prandial insulin, the rapid-acting inhaled insulin of Afrezza leads to better control of early PPG with less weight gain and less frequent hypoglycemia, although control of late PPG remains suboptimal in some patients. Isn’t this STAT... The most recent was a study in 30 patients with T1DM in which the onset of metabolic activity for Afrezza occurred earlier than for insulin lispro (15 to 19 minutes vs 45 to 52 minutes), and the duration of action for Afrezza was approximately 2 to 3 hours shorter than equivalent doses of insulin lispro (1.8 to 6.4 hours vs 5.0 to 9.8 hours).23 Afrezza’s glucose disposal effect occurs earlier than that of SC insulin. For example, the rate of glu- cose disposal over the first 60 minutes after administration is 34% greater for Afrezza than SC regular human insulin (P < .05) and 4% less for Afrezza than SC insulin lispro (P = NS).24 Read more: mnkd.proboards.com/thread/10394/august-addressing-unmet-prandial-insulin?page=1#ixzz5P2Gkmg6sSTAT was Afrezza and insulin Aspart... |
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