Inhaled insulin is now considered “standard of care"

[peppy]

"Inhaled insulin is now considered “standard of care” for diabetics, according to updated guidelines from the American Diabetes Association."

www.youtube.com/watch?v=POiyZVwjabQ

mnkd.proboards.com/post/264563

Pharmacologic Therapy for Adults With Type 1 Diabetes
Recommendations
9.1 Treat most adults with type 1 diabetes with continuous subcutaneous insulin infusion or multiple daily doses of prandial (injected or inhaled) and basal insulin. A

9.2 For most adults with type 1 diabetes, insulin analogs (or inhaled insulin) are preferred over injectable human insulins to minimize hypoglycemia risk. A

9.3 Early use of continuous glucose monitoring is recommended for adults with type 1 diabetes to improve glycemic outcomes and quality of life and minimize hypoglycemia. B

9.4 Automated insulin delivery systems should be considered for all adults with type 1 diabetes. A

9.5 To improve glycemic outcomes and quality of life and minimize hypoglycemia risk, most adults with type 1 diabetes should receive education on how to match mealtime insulin doses to carbohydrate intake and, additionally, to fat and protein intake. They should also be taught how to modify the insulin dose (correction dose) based on concurrent glycemia, glycemic trends (if available), sick-day management, and anticipated physical activity. B

diabetesjournals.org/care/article/47/Supplement_1/S158/153955/9-Pharmacologic-Approaches-to-Glycemic-Treatment

"(https://doi.org/10.2337/dc24-S009)
Recommendation 9.2 was updated to reflect preference of insulin analogs or inhaled insulin over injectable human insulins to minimize hypoglycemia risk for most adults with type 1 diabetes.
Recommendation 9.3 was added to include early use of CGM for adults with type 1 diabetes, and Recommendation 9.4 was added to indicate consideration for use of AID systems for adults with type 1 diabetes.
Recommendation 9.5 was expanded to include educating adults with type 1 diabetes on how to modify their insulin dose based on concurrent glycemia, glycemic trends, and sick day management."

[radgray68]

Can it be really happening? I’ve never paid much attention but now I can’t wait to hear what becomes of this year’s ADA conference.

[dh4mizzou]

If this is accurate does being part of the SoC imply insurance coverage will follow?

[lennymnkd]

How are the people of proboards not jumping all over this 😀 ? Down a penny has to be a catch..

[peppy]

I do not think much changed. The other ADA guidelines have mentioned inhaled insulin, by memory, in a sentence of its own.

2018
mnkd.proboards.com/post/149627

mnkd.proboards.com/post/151768

[cretin11]

Very good news segment. We used to see similar local news segments fairly often "back in the day" and we'd get excited about the snowball effect of word getting out and Afrezza gobbling up market share. Good times!

[peppy]

May 3, 2024 12:01:48 GMT -5 cretin11 said:

Very good news segment. We used to see similar local news segments fairly often "back in the day" and we'd get excited about the snowball effect of word getting out and Afrezza gobbling up market share. Good times!

 This "news segment" mentioned insurance coverage. She intimated better insurance coverage for Afrezza.

[cretin11]

Yes she did speculate on that but she also mentioned some of the obstacles we’ve dealt with for years and still exist.

[agedhippie]

May 3, 2024 11:30:40 GMT -5 dh4mizzou said:

If this is accurate does being part of the SoC imply insurance coverage will follow?

No, it's been in the SoC for a while. You can find it in section 9 of the SoC as inhaled insulin.

[lennymnkd]

So at the end of the day standard of care is all BS too ..semantics
When will it end ?

[agedhippie]

May 3, 2024 13:30:40 GMT -5 lennymnkd said:

So at the end of the day standard of care is all BS too ..semantics
When will it end ?

Basically yes (IMHO), it is really about deskilling.

The SoC enables a doctor who doesn't cover the area to have a guide to the consensus amongst doctors who do cover the area when he treats someone. If you get an endo who knows what they are doing they will deviate from the SoC where they think they can do better. A case in point was my old endo who had lots of Type 1s on metformin when the SoC explicitly said not to do that. I suspect that VDex deviate from the SoC as well because they know what they are doing.

In the immortal words of Pirates of the Caribbean, "The code is more what you'd call 'guidelines' than actual rules."

[sayhey24]

May 3, 2024 11:30:40 GMT -5 dh4mizzou said:

If this is accurate does being part of the SoC imply insurance coverage will follow?

Read the passage - 9.2 For most adults with type 1 diabetes, insulin analogs (or inhaled insulin)

The key word is "or".  If it said  -For most adults with type 1 diabetes, inhaled insulin should be used
then you would get the insurance - my God they even put it in paratheses.  The "or" give the insurance companies an out and analogs are good enough.

[sayhey24]

May 3, 2024 13:30:40 GMT -5 lennymnkd said:

So at the end of the day standard of care is all BS too ..semantics
When will it end ?

The SoC provides justification for insurnace coverage.  Just look at the GLP1 section under the T2s.  As soon as that happened GLP1s got insurnace coverage.

Doctors don't have to follow it but most do for liability purposes especially now since most doctors are working for corporations who do not want liability issues.

[lennymnkd]

So it seems to me the physicians probably don’t want to deal with the learning curve of AFREZZA , and baby sitting a good portion of the patient’s
But a question I have after all this time / is there any financial benefit/ incentive doing it the more cumbersome way with AFREZZA
( follow the money) can something be done to entice them to prescribe or is that unethical… subjective… I guess ..but the world we live in .

[cretin11]

Lenny: VDEX