Much discussion has been had about the afrezza prescribing guidelines that new patients should perform an FEV1 spirometry in order to rule out preexisting lung disease. Apparently FEV1 spirometry seems like a pretty big deal to some if they are not familiar with what it actually is. In reality, it is anything but. An FEV1 spirometry is simply a measurement of how much air a person can exhale in 1 second. This can be done with a simple and inespensive handheld device that measures the air flow for precisely one second while the patient blows into it as rapidly as they can. The Forced Exhalation Volume in one second is then compared to an index that takes into account factors such as height, weight, gender, ethnicity, etc and compares your resullts to the expected value for someone with the same variables as the patient. If the patient has a profoundly lower than expected forced exhalation volume in 1 second (FEV1) than expected, it could be indicative of pulmonary dysfunction and further investigation might be warranted. The FEV1 test can be done by any medical provider. It does not require special training or skills or costly equipment, it takes about as much time as checking the patients blood pressure.
When afrezza was first being prescribed there was a lot of hoopla about what a big deal the respiratory testing guidelines were. In some cases they were actually a bigger deal than they needed to be, because most diabetes doctors didn’t have handheld spirometers and just sent their patients for more advanced and costly pulmonary function testing than was indicated. However, the recommended FEV1 screening is what is recommended in the prescribing guidelines and it is a very simple screening procedure that can be done in virtually any primary care clinic without a bunch of undue hassle.