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waiting to exhale
frankenduf
Tuesday, May 12, 2009 at 05:25 PMre: waiting to exhale
Dr. Fran Cogen
Tuesday, May 12, 2009 at 05:37 PMUnfortunately, inhaled insulin is no longer on the market. Believe it or not, patients (adults) simply did not jump on the bandwagon as everyone had originally thought. Indeed, there were pulmonary issues involved, and it was difficult to deliver an exact dosage of insulin. Inhaled insulin was never approved for children with type 1 diabetes. The inhalers were rather large (hard enough to get kids and adults to use inhalers for asthma- and those are actually small) and it would be extremely difficult to dose appopriately especially the small doses required in children. So, I guess we will all continue "waiting to exhale" until something else appears to work effectively without demonstrable side effects! Thanks for your inquiry.
DrC
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Insulin allergy
Ann Bartlett
Tuesday, May 12, 2009 at 10:23 PMDr. C,
Allie Beatty a blogger on this site, has said that when she was diagnosed doctors could not figure out what her problems were after a long running issue, they concluded that she was allergic to synthetic human insulin. http://www.healthcentral.com/diabetes/c/498417/68504/meet-community
How often do you see a problem like this? And in fact, what are some of the symptoms for someone suffering an allergic reaction to synthetic human insulin?
Additionally, there is a new insulin, Smart Insulin that is scheduled to go into human trial in November. Do you know much about it?
These may be possible follow up blogs for you, but wanted to post the questions anyway!
Great post! Thank you!
re: Insulin allergy
Anonymous
Wednesday, May 13, 2009 at 08:47 PMAnn: thanks for your comments. Firstly, "smartinsulin": I have heard and viewed advertisements about it; however, before making any comments, I would like to review any evidence-based literature that is available. And, yes, I think a future blog about it would be in order after I have done my research!!
As for an allergy to synthetic insulin: it is very rare. As you know, in the "olden days" patients had allergies to beef or pork insulin and developed antibodies and large amounts had to be injected. I think, once again, I will need to obtain further information and see what has been published before making other remarks. I know this situation exists, but I have yet to see it my practice. Will check this stuff out!!
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True Basal Bolus During Honeymoon Period
Carolyn
Friday, September 04, 2009 at 10:43 AMDr. Cogan
My son (age 3) was recently diagnosed (2 months ago) and has been using NPH/regular. A few weeks after diagnosis, I read about Lantus/Humalog and asked if we could switch to this.
I was told it wasn't appropriate yet because he's still in a honeymoon. For a few weeks he was just getting one morning injection of NPH. Now he's getting three injections, with NPH in the morning and evening, and small amounts of R with breakfast and dinner. He's still in the honeymoon based on the small amounts of insulin he gets. And his numbers are still all over the place.
Yesterday, I was told we may be able to switch to Lantus/Humalog on a modified basal/bolus. But it seems to me that doing a true basal/bolus makes the most sense, particularly in the honeymoon, so that you can respond to the random insulin output of his own pancreas.
What are your thoughts?
Thanks, Carolyn
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whatever happened to inhaled insulin?- i'm guessing it went bust due to sporadic release into the blood- not to mention unknown long term effects of insulin on the lung tissue- i wonder if it was ever used with children/type 1s? (disclaimer- probably no new drugs should be used with children, unless necessary, but i'm curious if this ever was, especially with the analagous administartion of asthma meds via inhalers)