AFREZZA: Hope for a Faster Acting Insulin
Recently, David wrote about BD's shorter (4mm) needles. In February, I wrote an article about the partnership between JDRF and BD to develop microneedle technology. Microneedles are important to the development of the Artificial Pancreas. What researchers have found is that part of the success for the Artificial Pancreas is the time it takes for insulin uptake. The faster the insulin can begin to work, the better our chance to see a flatline in our blood sugar control. But needles are only part of the solution to better control. Insulin effectiveness is the real key to success for those living with diabetes, and so the development of new rapid acting insulin is necessary for the development of the Artificial Pancreas!
On August 23, 2010 MannKind Corporation announced a partnership with JDRF to test its novel ultra rapid acting insulin AFREZZA for clinical trial with the Artificial Pancreas. This will be a two year study of patients with type 1 to look at the effectiveness of AFREZZA with a closed loop system. While I had seen the name floating around the diabetes internet for its inhaled clinical trial, I had not seen it as an injectable and suddenly my interest in this insulin was peaked! It'd more versatile than the current rDNA insulins.
AFREZZA is a novel insulin that is inhaled and has proven as effective as Eli Lilly's injectable Humalog. This is a big deal as many log time diabetics have scar tissue from years of MDI (multi day injections and infusion sites for pumps), but it has also been used as an injectable. In a 16-week research study, patients who inhaled AFREZZA had significantly lower rates of hypoglycemia, lower blood sugar after meals and lower fasting blood sugar rates compared to those who took Humalog. But, for some reason, MannKind has not been able to win approval from the FDA.
One thing I know is that the uptake for Apidra is approximately 40 minutes for me. My endocrinologist has been astounded by the slow response my body has to it, but report after report from my Dexcom confirms that I'm not exaggerating! I would be very interested in this versatile approach to insulin that is both inhaled and injectable to see which may have better response time.
I'm still hoping for some future for polymer based insulins, but it looks like SmartInsulin still is more than five years away. That said, more efficient insulin is the best bet!