Jewels Doskicz, RN, is a freelance writer, patient advocate, health coach, and long-distance cyclist. She and her daughter both live healthfully with type 1 diabetes.

Insulin plays one of the most important roles in our life with diabetes—it keeps us alive. So when our insulin choices expand, our quality of life follows suit.

Our newest option, Afrezza, a rapid-acting, inhalable insulin manufactured by the MannKind Corporation, could be a great alternative for people with diabetes who may not mind having a cough for the convenience.

Inhalable insulin is an undeniably quick and easy solution for dosing at meals. With a tagline of “Simple as 1–2–3—Breathe!” Afrezza definitely has its appeal, but it isn’t without its drawbacks.
Some patients and healthcare providers have been apprehensive about its use—and also report their insurance companies have been dragging their feet with coverage.

The benefits of Afrezza

Afrezza is an insulin powder that is inhaled through the mouth and quickly absorbed by the lungs. It functions as a fast-acting insulin, peaking in 12 to 15 minutes with lasting effects for up to three hours. It’s available in different strengths, including four-, eight-, and twelve-unit cartridges.
“The biggest pro is how quickly it works, mirroring quick-acting carbs much more closely than pumped insulin or shots have worked for me,” said Mike Barry, a type 1 diabetic living in Illinois.

This carries a big bonus during fun activities like long bike rides, explains Barry. “Being able to clear ‘on-board’ [active] insulin in an hour or two, instead of four, makes for a more enjoyable, happier life experience with diabetes.”

Insulin can be the limiting factor for many people when it comes to living an active life with diabetes. “The speed of action and of clearing insulin on board is useful to any person with diabetes and is particularly critical for people looking to exercise,” Barry adds.

Afrezza is also a great option for those needle-phobic folks who have been putting off insulin for far too long. There is still a need for long-acting insulin, though; Afrezza doesn’t take its place.

Possible unwanted side-effects of Afrezza

“The biggest con for me has been the pulmonary situation. Afrezza has brought me a constant cough,” shares Barry. “This seems more pronounced with eight-unit cartridges but also occurs with four-unit cartridges.”

Barry has found available dosing sizes to be too large when trying to make a small blood sugar correction, and has experienced a few “misfires” when he wasn’t sure if the dose was received.
Barry has found “the utility and celerity [speed] of puffed Afrezza to be unmatched with other current insulin delivery systems,” an impressive accolade.

MannKind warns of the following most common possible side effects:

  • Low blood sugar
  • Cough
  • Sore throat
  • Headache
  • Diarrhea
  • Tiredness
  • Nausea

Afrezza can also cause bronchospasms [spasms of the lungs] and carries an elevated risk of lung and heart disease, as well as decreased potassium levels.

How do I get a prescription?

See your healthcare provider and ask if Afrezza may benefit you. But first, here are a few things you should know and do:

  • Afrezza should not be prescribed if you have chronic obstructive pulmonary disease (COPD), asthma, if you currently smoke, or have quit smoking in the past six months.
  • In addition to receiving a physical exam, it is recommended that patients have a breathing test (spirometry) to rule out lung issues.
  • Be sure to inform your provider if you have any history of lung issues, have kidney or liver disease, are planning a pregnancy, are currently pregnant, or are breastfeeding.
  • Afrezza is only recommended for ages 18 and older.

MannKind offers a patient savings card increasing the affordability of Afrezza for many of us.

Have you tried inhalable insulin? We’d love to hear what you think of it. Add your comment below.