# Afrezza spirometry testing regimen for teens? **URL:** \ **Category:** Afrezza\ **Created:** [December 7, 2017, 8:25am UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787 "2017-12-07T08:25:25Z")\ **Posts on this page:** 17\ **Page:** 1
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [December 7, 2017, 8:25am UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/1 "2017-12-07T08:25:25Z")
I have been discussing with my endo clinic my son going on Afrezza to blunt hormone peaks (so as to limit the deep lows we get after stacking, and also, of course, limit the peaks too). It is a pediatrics diabetes clinic, so they are not familiar with the testing regimen for teens. I found a very generic set of [spirometer info on the Mannkind site](https://www.afrezza.com/hcp/spirometry-info/). Does anyone have access to other sources for the spirometry regimen that teens might need to undergo? I would love to be able to email my clinic with the full description of the MO they need to follow, so that it is an easy process for them (and therefore for us). In particular, it would be useful for me to give them a reference showing expected numbers for teenage kids, as opposed to adults. It is apparent from the studies I read (such as [this one](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2217523/)) that there are different standards to interpret the FEV1 based on what is defined as normal. I can find discussions but so far no simple tables ☹ What I have found so far: - [Vitalograph online lookup search for ERS93 adult and Polgar child](https://vitalograph.com/resources/ers-normal-values) but I don’t understand how it relates to FEV1 - [Utrecht data set giving FEV1 equation for children](https://www.sciencedirect.com/science/article/pii/S0954611110003410) (but no table calculations) - [Reference range for spirometry across all ages](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2643211/) shows the need for different cutoffs for teens (and other ages) vs adults but does not give direct tables for such reference and cut-offs. - [Simple office spirometry for primary care practitioners (PDF)](http://www.nlhep.org/Documents/simple_office_spirometry.pdf) – an easy reference manual for non-pulmonary specialists, but, again, no tables. ---
**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\ **Post date:** [December 7, 2017, 5:05pm UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/2 "2017-12-07T17:05:22Z")
Just the FeV1 is all they look at. Should be able to do it at any cvs minute clinic. Unless they have obstructive pulmonary disease it’s really a non issue. It’s something that their competitors lobbyists rammed through… To put it in perspective—- I did it with a respiratory therapist and she told me before I even blew in the tube, “I can already tell you have no deficiency because you’re not having any trouble speaking to me”. It’s a total crock don’t get bogged down in it… I don’t think the they even look at particular values it’s just to see if you can exhale a reasonable amount of air in 1 second, which unless you have major lung disease and dysfunction then you absolutely can… as long as it’s within reasonable ranges they don’t evaluate it further. If your endos office isn’t equipped to do it (most aren’t, hence the competitions lobbying for this requirement) they can simply write an order for it to be done at the hospital or lab or wherever they refer out their testing too… it’s really not a big deal. The 1 literally stands for 1 second. Which is how long the fev1 takes. I did an entire expensive and elaborate pulmonary function test and I’m pissed off about it to this day… ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [December 7, 2017, 9:20pm UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/3 "2017-12-07T21:20:18Z")
> [@Sam](#): > > Should be able to do it at any cvs minute clinic. This appears to be a state-by-state thing ☹ Here is WI, I have not found a CVS pharmacy that offers it. One of them referred me to a CVS “Minute Clinic” which is a colocated thing. I just called the central number for them and there are telling me they don’t offer the FEV-1. I am still looking for an easy (and cheap) place to go to for an FEV-1. I’ll post what in find in WI. ---
**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\ **Post date:** [December 7, 2017, 9:22pm UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/4 "2017-12-07T21:22:43Z")
You could probably also stop by any 7th grade health class and they could take care of it for you It is a total joke and the main purpose for the testing is to ensure that people’s lung function was not decreasing significantly over time as they took it with follow-up testing which has pretty well proven to not be a legitimate issue ---
**Author:** ![MM2](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/mm2/32/3032_2.png) [@MM2](https://forum.fudiabetes.org/u/MM2)\ **Post date:** [December 7, 2017, 10:49pm UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/5 "2017-12-07T22:49:25Z")
Did you contact your primary ? After the fact, I found out my primary (internal med MD), could have done it in office. Instead my endo put in order to the hospital to do it. The hospital gave me a full blown pulmonary test, and was billed a ridiculous amount. With help from my endo, who supported the fact that he ordered the simple test only, my billing was adjusted. I think it is uncommon for hospitals to get requests for the simple test. For the next test, my endo had one in his office. I think he said the equipment only cost under $100. His staff was “trained”, but they still fumbled a bit when trying to do my follow-up. Results came back fine. Since then, I have not had another test. However I only use Afrezza 3-4 times a week, 4 unit doses, mostly for corrections or special meals. ---
**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\ **Post date:** [December 7, 2017, 11:20pm UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/6 "2017-12-07T23:20:22Z")
I really want to be clear that this is not a legitimate concern for sound medicine. This is a big pharma dirty lobbying trick. After all I’ve read up on afrezza and having followed its entire development and approval and having reaped its benefits myself— if it were my son And I was up up all night ripping my hair out, a stupid fev1 wouldn’t even be on my radar. That said, it’s not your job to educate your doctors on how to perform medical testing… they’re either willing to go off label and not give a damn about such things, or they’re not ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [December 8, 2017, 12:19am UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/7 "2017-12-08T00:19:40Z")
> [@MM2](#): > > Did you contact your primary ? I did not even think of it! In retrospect, it seems like the first step I should have taken. I’ll call tomorrow. It would have been nice to do it in a nurse clinic like @Sam was suggesting: more effective economically it seems. ---
**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\ **Post date:** [December 8, 2017, 12:27am UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/8 "2017-12-08T00:27:51Z")
> [@Michel](#): > > I did not even think of it! Argh! ---
**Author:** ![MM2](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/mm2/32/3032_2.png) [@MM2](https://forum.fudiabetes.org/u/MM2)\ **Post date:** [December 8, 2017, 3:02am UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/9 "2017-12-08T03:02:50Z")
Great, hope it works out ! ---
**Author:** ![TravelingOn](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/travelingon/32/1583_2.png) [@TravelingOn](https://forum.fudiabetes.org/u/TravelingOn)\ **Post date:** [December 8, 2017, 9:10am UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/10 "2017-12-08T09:10:43Z")
EH had it done in his endo’s office by the Afrezza rep for our area. I am not sure if you’ll be looking for the same test or not, because I can’t remember the name. It took two minutes. It was a paper tube with a fan like object in it. Seriously minimal. I would contact MannKind and see if they have someone who comes to your area and could conduct the test and training on the drug. ---
**Author:** ![Pianoplayer7008](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/pianoplayer7008/32/1507_2.png) [@Pianoplayer7008](https://forum.fudiabetes.org/u/Pianoplayer7008)\ **Post date:** [December 9, 2017, 10:49pm UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/11 "2017-12-09T22:49:33Z")
Has Afrezza been approved for children (and I missed it), or do you just have an awesome endo? I have a friend here with a t1 child (pre-teen boy so about to hit puberty and all of its challenges), and she was really interested in what I had to say about my experiences so far using Afrezza. ---
**Author:** ![Thomas](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/thomas/32/1719_2.png) [@Thomas](https://forum.fudiabetes.org/u/Thomas)\ **Post date:** [December 9, 2017, 11:05pm UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/12 "2017-12-09T23:05:05Z")
Not approved. Off-label. Actually interesting information from the FDA as pertains to Off-Label. Some elements I was not aware of. [https://www.fda.gov/forpatients/other/offlabel/default.htm](https://www.fda.gov/forpatients/other/offlabel/default.htm) Pediatric Trial NCT02527265 Primary Objective: To assess the safety and tolerability of Afrezza in children ages 4 to 17 years with type 1 diabetes mellitus (T1DM). Estimated Enrollment: 46 Actual Study Start Date: September 28, 2017 Estimated Study Completion Date: January 2021 Estimated Primary Completion Date: July 2020 (Final data collection date for primary outcome measure) > **[Afrezza Safety and Pharmacokinetics Study in Pediatric Patients - Full Text...](https://clinicaltrials.gov/ct2/show/NCT02527265)** > > Afrezza Safety and Pharmacokinetics Study in Pediatric Patients - Full Text View. ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [December 9, 2017, 11:14pm UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/13 "2017-12-09T23:14:51Z")
> [@Thomas](#): > > Not approved. Off-label. However, there are quite a few people starting to prescribe it off label, in particular in CA. My endo is aware of some of the CA endos prescribing it. So I am keeping my fingers crossed. ---
**Author:** ![Pianoplayer7008](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/pianoplayer7008/32/1507_2.png) [@Pianoplayer7008](https://forum.fudiabetes.org/u/Pianoplayer7008)\ **Post date:** [December 10, 2017, 12:19am UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/14 "2017-12-10T00:19:28Z")
Good to know! My friend was going to mention Afrezza to her son’s endo, just to hear his thoughts on it, so I’ll pass this along… ---
**Author:** ![Michel](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/michel/32/387_2.png) [@Michel](https://forum.fudiabetes.org/u/Michel)\ **Post date:** [December 12, 2017, 11:47pm UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/15 "2017-12-12T23:47:38Z")
Well, it did not work out. The endos and NPs took up the subject in the last leaders’ meeting and decided against prescribing Afrezza to a teen ☹ ---
**Author:** ![Chris](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/chris/32/382_2.png) [@Chris](https://forum.fudiabetes.org/u/Chris)\ **Post date:** [December 13, 2017, 12:28am UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/16 "2017-12-13T00:28:58Z")
Nice try Michel. I am sorry they made that decision, but I also understand why they might. We are going to be trying the same thing in January. Will let you know how it goes. ---
**Author:** ![Sam](https://yyz2.discourse-cdn.com/flex030/user_avatar/forum.fudiabetes.org/sam/32/10595_2.png) [@Sam](https://forum.fudiabetes.org/u/Sam)\ **Post date:** [December 13, 2017, 12:41am UTC](https://forum.fudiabetes.org/t/afrezza-spirometry-testing-regimen-for-teens/2787/17 "2017-12-13T00:41:27Z")
Understandable, I’m not sure I would either if I were them unless the teen was wildly out of control without—- it’d be hard for them to justify going off label otherwise I believe pediatric trials with afrezza are currently underway… I suspect it’ll be approved for kids before too much longer