Study: afrezza improved prandial glucose control over novolog

Interesting study published just the other day demonstrating afrezza improved prandial glucose control over novolog.

I just happened to stumble upon this right after reading your post

https://www.liebertpub.com/doi/10.1089/dia.2018.0200

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Interesting study, @Sam!

Imho it deserves it’s own thread. Would you mind starting one with it?

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I came back and read through the study. Thanks so much for posting this @Sam. I found a lot of comfort in reading this:

“The baseline or end-of-the-study FEV1 did not differ by treatment group.”

I found it interesting that the exclusion criteria included using Levemir.

" Major exclusion criteria included: pregnancy, any pulmonary disease, severe hypoglycemia that required assistance in the last 3 months, currently smoking or marijuana use, using insulin detemir or Neutral Protamine Hagedorn (NPH) as basal insulin, and a need for >18 U of prandial insulin per meal (Table 1)."

I was surprised that they used a 1:1 conversion for determining mealtime insulin (see Table 2 of the study). The correction doses are exactly in line with what I would use though. Later in the results portion of the study it looks like the doses were increased: " Equivalent TI units are generally 1.5 to 2.0 times the injectable insulin units to reach a similar potency in clinical practice.19,20 Bolus doses in the TI group increased about two-fold in this study, consistent with the expected dose conversion ratio based on GIR data."

The % of time in range is low though across all groups (defined as between 70-180). See graphs below.

“Patients were defined as compliant if ±90% of postmeal TI dosages were taken per protocol, with at least one of the postmeal inhalations taken if indicated per meal. The purpose of this posthoc analysis was to generate hypotheses and plan for a future, larger clinical trial.”

image

Looks like their results showed no weight gain! Maybe they didn’t treat themselves as much as I did :smile:

…the study was funded by Mannkind, so we may need to take the results with a grain of salt.

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Somehow we never split this thread… Great study!