Inhalable insulin

Yeah, I mean, there's a lot of amazing new technologies coming out in the landscape, you know, that we know with, like, FCL, longer wear time adhesives, uh, you know, interoperability with a bunch of different, uh, systems, um, utilization of, uh, of, um, closed loop systems with other types of medications and indications.

I mean, we al- so, we know a lot of people that use GLP-1s with, with their pumps, but, like, you know, how does that impact device usage? Um, you know, different insulin, uh, administration methods, like Afrezza, and how does that get employed into a closed loop system? Um, so ton of really amazing stuff.

And then of course, always just improving the hardware, um, and software of existing pumps.

So working, [laughs] you know, that's a lot, that's a lot of things to work with.

Uh, there's a video out there, you talk about, you know, the, the system and all that kind of stuff.

Um, do you also use Afrezza? Is that right?

I do.

Okay.

I, I, I love Afrezza.

Okay.

I think it is, uh-

Yep.

I mean, the one catch is that your pump doesn't know that you've had that insulin, but it will see the glucose dropping.

So it works very, very fast, but the catch with Afrezza is also that it clears very fast.

So normally what's recommended is that you would have a second dose after 90 to 120 minutes.

But in a way that makes it easier because let's say you're expecting to need around, I don't know, 12 units of insulin, let's say, with your Afrezza, because it's only about half as effective as injected insulin, that you would have, you know, two thirds.

So you'd have the eight units up front and then you save your four units and you see, oh, glucose is a bit high.

So I'll have the other four units.

So here's another insulin situation or scenario for you.

The reason that I, even today really, don't really pre-bolus that much is is because I was utilizing a secondary insulin in Afrezza.

And if you don't know anything about Afrezza, it is an inhaled insulin, right? So Novolog, Humalog, All those insulins, they go in a pump, or you have to take a shot with a pen or a syringe, with a mobile, and they work the way we just talked about with the activation, 15 to 20 minutes, the duration, or the peak and the duration, right? Afrezza is completely different because it works way faster, right? So the activation of Afrezza is between, this is what the research, this is at least what I heard when I started Afrezza, is between 60 seconds and three minutes.

I give it a little bit of a minute buffer.

Really, they say 60 seconds.

Maybe I'm doing a micro dose, which just means I'm taking more insulin later.

I'm going to set a timer for like 45 minutes, maybe an hour later and take more insulin.

I really enjoy micro dosing on Afrezza and here's the reason why.

Do they need the 10 to 15-minute head start? Yes, they do.

And then we talked about fast insulins and Afrezza, LeumGev, and Fiasp.

Carb counts being off.

We talked about how 20-year veterans missed carbohydrate counts by at least 15 grams.

Um, but fortunately, that, that has now changed, and there is an, an FDA-approved label, and that came as a result of, uh, the Inhale1 study that we were able to complete, um, which was a randomized controlled trial, a relatively large study, uh, two hundred and thirty, uh, youth with type one diabetes primarily, although we did in- include a handful of folks with type two diabetes.

Um, a hundred and seventeen got randomized to using Technosphere or an, uh, Afrezza inhaled insulin, um, with a long-acting basal, um, and a hundred and thirteen randomized to, uh, continuing their rapid-acting analog injected insulin.

Um, importantly, the study didn't, um, include folks who were actively using insulin pump.

Um, so, so children who were on a pump had to, had to come off their pump and go back to multiple daily injections to be eligible.

Mm-hmm

... has safety concerns.

And so we have to remind them, you know, Afrezza, this specific inhaled insulin, has been around for many years.

It's been approved in adults for over 10 years.