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Insulin inhaler

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https://www.readbyqxmd.com/read/28718049/good-things-in-small-packages-an-innovative-delivery-approach-for-inhaled-insulin
#1
James B Fink, Lisa Molloy, John S Patton, Valdecir Castor Galindo-Filho, Jacqueline de Melo Barcelar, Luciana Alcoforado, Simone Cristina Soares Brandão, Armèle Dornelas de Andrade
PURPOSE: The design development of a small, hand held, battery operated, breath actuated inhaler as a drug/device platform for inhaled insulin posed a number of technical challenges. Our goal was to optimize lung deposition and distribution with aerosol generators producing 3-6 μm particle size distribution. METHODS: In silico modeling with computational fluid dynamics (CFD) and in vitro testing of device components were assessed using an Alberta idealized adult airway (Copley, UK) to optimize mouthpiece and aerosol path design for dose delivered distal to the trachea...
July 17, 2017: Pharmaceutical Research
https://www.readbyqxmd.com/read/28709853/evaluation-of-current-trends-and-recent-development-in-insulin-therapy-for-management-of-diabetes-mellitus
#2
REVIEW
Muhammad Sarfraz Nawaz, Kifayat Ullah Shah, Tahir Mehmood Khan, Asim Ur Rehman, Haroon Ur Rashid, Sajid Mahmood, Shahzeb Khan, Muhammad Junaid Farrukh
OBJECTIVE: Diabetes mellitus is a major health problem in developing countries. There are various insulin therapies to manage diabetes mellitus. This systematic review evaluates various insulin therapies for management of diabetes mellitus worldwide. This review also focuses on recent developments being explored for better management of diabetes mellitus. RESEARCH DESIGN AND METHOD: We reviewed a number of published articles from 2002 to 2016 to find out the appropriate management of diabetes mellitus...
July 8, 2017: Diabetes & Metabolic Syndrome
https://www.readbyqxmd.com/read/28571200/inhaled-insulin-current-direction-of-insulin-research
#3
REVIEW
Rashmi Ranjan Mohanty, Smita Das
Diabetes Mellitus (DM) is a metabolic disorder characterized by relative or absolute deficiency of insulin, resulting in hyperglycemia. Subcutaneous insulin and Oral Hypoglycaemic Agents (OHA) constitute the main treatment option for DM. Insulin is administered by injection or continuous infusion to control glucose levels mainly in Type I diabetes. Newer routes both oral and non oral, for insulin administration are current direction of insulin research as insulin injection therapy is burdensome and painful for many patients...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28568813/a-population-dose-response-model-for-inhaled-technosphere-insulin-administered-to-healthy-subjects
#4
D Rüppel, R Dahmen, A Boss, R Jäger, M Grant, R Baughman, T Klabunde
Technosphere insulin (TI), an inhaled insulin with a fast onset of action, provides a novel option for the control of prandial glucose. A euglycemic glucose clamp study was performed to compare the effects of TI and regular human insulin (RHI) on the induced glucose infusion rate (GIR) in healthy volunteers. Generation of a dose-response relationship between insulin dose and effect (expressed as AUC of GIR) was not possible from the clinical data directly. The GIR recording time was too short to capture the full effect and higher doses were not tested...
June 2017: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/28541489/respiratory-effects-and-systemic-stress-response-following-acute-acrolein-inhalation-in-rats
#5
Samantha J Snow, Marie A McGee, Andres Henriquez, Judy E Richards, Mette C Schladweiler, Allen D Ledbetter, Urmila P Kodavanti
Previous studies have demonstrated that exposure to the pulmonary irritant ozone causes myriad systemic metabolic and pulmonary effects attributed to sympathetic and hypothalamus-pituitary-adrenal (HPA) axis activation, which are exacerbated in metabolically-impaired models. We examined respiratory and systemic effects following exposure to a sensory irritant acrolein to elucidate the systemic and pulmonary consequences in healthy and diabetic rat models. Male Wistar and Goto Kakizaki (GK) rats, a non-obese type II diabetic Wistar-derived model, were exposed by inhalation to 0, 2, or 4 ppm acrolein, 4h/day for 1 or 2 days...
May 24, 2017: Toxicological Sciences: An Official Journal of the Society of Toxicology
https://www.readbyqxmd.com/read/28530382/diabetes-update-new-pharmacotherapy-for-type-2-diabetes
#6
Beth Choby
Multiple new drugs for managing type 2 diabetes have entered the market in the past 5 years. Guidelines from the American Diabetes Association recommend metformin for initial therapy, followed by a second drug if A1c goals are not met or initially for patients with A1c levels greater than 9%. Conversely, the American Association of Clinical Endocrinologists recommends initial management with two drugs if the A1c level is greater than 7.5%. The risk of lactic acidosis associated with metformin has been shown to be less than previously thought, with newer guidelines permitting use with an estimated glomerular filtration rate of 45 to 60 mL/min/1...
May 2017: FP Essentials
https://www.readbyqxmd.com/read/28379903/inhaled-insulin-a-clinical-and-historical-review
#7
REVIEW
Jason Chan, Angela Cheng-Lai
Insulin is the most effective blood glucose lowering agent and remains one of the cornerstones of diabetes management. However, many individuals with diabetes are either reluctant to initiate or are nonadherent to their insulin therapy for various reasons, including fear of frequent injections. Technosphere Insulin (TI) is a novel inhaled insulin powder that is approved by the United States Food and Drug Administration for the management of diabetes. The results from 2 phase III clinical trials have shown that TI was noninferior to subcutaneous insulin aspart and superior to inhaled placebo in lowering HbA1c in patients with diabetes mellitus types 1 and 2, respectively...
May 2017: Cardiology in Review
https://www.readbyqxmd.com/read/28264172/the-need-for-faster-insulin
#8
Douglas B Muchmore
Considerable progress in treatment of diabetes has been made in the nearly 100 years following the discovery of insulin, and advances in insulin therapy have improved convenience, quality of life, overall glycemic control (A1C), and risk of hypoglycemia. An unmet need remains for a mealtime insulin that can faithfully reproduce the metabolic profile that ensues following meal ingestion in healthy persons. A number of "ultra-fast" insulin programs have been initiated, and Afrezza® (insulin human; Inhalation Powder, MannKind Corporation, Danbury, CT) stands as the first such product to be approved by the US FDA...
January 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28244216/the-choice-of-euthanasia-method-affects-metabolic-serum-biomarkers
#9
Paula Pierozan, Fredrik Jernerén, Yusuf Ransome, Oskar Karlsson
The impact of euthanasia methods on endocrine and metabolic parameters in rodent tissues and biological fluids is highly relevant for the accuracy and reliability of the data collected. However, few studies concerning this issue are found in the literature. We compared the effects of three euthanasia methods currently used in animal experimentation (i.e. decapitation, CO2 inhalation and pentobarbital injection) on the serum levels of corticosterone, insulin, glucose, triglycerides, cholesterol and a range of free fatty acids in rats...
February 28, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28031777/place-of-technosphere-inhaled-insulin-in-treatment-of-diabetes
#10
REVIEW
Nasser Mikhail
Technosphere insulin (TI), Afrezza, is a powder form of short-acting regular insulin taken by oral inhalation with meals. Action of TI peaks after approximately 40-60 min and lasts for 2-3 h. TI is slightly less effective than subcutaneous insulin aspart, with mean hemoglobin A1c (HbA1c) reduction of 0.21% and 0.4%, respectively. When compared with technosphere inhaled placebo, the decrease in HbA1c levels was 0.8% and 0.4% with TI and placebo, respectively. Compared with insulin aspart, TI is associated with lower risk of late post-prandial hypoglycemia and weight gain...
December 15, 2016: World Journal of Diabetes
https://www.readbyqxmd.com/read/27823608/insulin-making-sense-of-current-options
#11
REVIEW
Alissa R Segal, Tejaswi Vootla, Richard S Beaser
Newer insulin products have advanced the evolution of insulin replacement options to more accurately mimic natural insulin action. There are new, modified, and concentrated insulins; administration devices calibrated for both increased concentrations and administration accuracy to improve adherence and safety; and inhaled insulin. There are new combinations of longer-acting basal insulin and rapid-acting insulin or glucagon like protein-1 receptor agonists. Existing insulin replacement designs and methods can be updated using these tools to improve efficacy and safety...
December 2016: Endocrinology and Metabolism Clinics of North America
https://www.readbyqxmd.com/read/27802272/isoflurane-and-sevoflurane-induce-severe-hepatic-insulin-resistance-in-a-canine-model
#12
Stella P Kim, Josiane L Broussard, Cathryn M Kolka
INTRODUCTION: Anesthesia induces insulin resistance, which may contribute to elevated blood glucose and adverse post-operative outcomes in critically ill patients, and impair glycemic control in surgical patients with diabetes. However, little is known about the mechanisms by which anesthesia impairs insulin sensitivity. Here we investigate the effects of anesthesia on insulin sensitivity in metabolic tissues. METHODS: Hyperinsulinemic-euglycemic clamps were performed in 32 lean (control diet; n = 16 conscious versus n = 16 anesthetized) and 24 fat-fed (6 weeks fat-feeding; n = 16 conscious versus n = 8 anesthetized) adult male mongrel dogs in conjunction with tracer methodology to differentiate hepatic versus peripheral insulin sensitivity...
2016: PloS One
https://www.readbyqxmd.com/read/27648286/impact-of-symptomatic-upper-respiratory-tract-infections-on-insulin-absorption-and-action-of-technosphere-inhaled-insulin
#13
Philip A Levin, Lutz Heinemann, Anders Boss, Paul D Rosenblit
OBJECTIVE: Uncomplicated, acute upper respiratory tract infections (URTIs) occur in patients with diabetes at a similar frequency to the general population. This study (NCT00642681) investigated the effect of URTIs on the pharmacokinetic (PK) and pharmacodynamic (PD) properties of Technosphere inhaled insulin (TI) in patients with type 1 or type 2 diabetes. RESEARCH DESIGN AND METHODS: This was a phase 2 study conducted in patients who developed a URTI while being treated with TI in a phase 3 study (N=20, mean age 50 years, 60% men)...
2016: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/27619923/cardiovascular-consequences-of-childhood-secondhand-tobacco-smoke-exposure-prevailing-evidence-burden-and-racial-and-socioeconomic-disparities-a-scientific-statement-from-the-american-heart-association
#14
REVIEW
Geetha Raghuveer, David A White, Laura L Hayman, Jessica G Woo, Juan Villafane, David Celermajer, Kenneth D Ward, Sarah D de Ferranti, Justin Zachariah
BACKGROUND: Although public health programs have led to a substantial decrease in the prevalence of tobacco smoking, the adverse health effects of tobacco smoke exposure are by no means a thing of the past. In the United States, 4 of 10 school-aged children and 1 of 3 adolescents are involuntarily exposed to secondhand tobacco smoke (SHS), with children of minority ethnic backgrounds and those living in low-socioeconomic-status households being disproportionately affected (68% and 43%, respectively)...
October 18, 2016: Circulation
https://www.readbyqxmd.com/read/27612662/s-nitrosylation-of-peroxiredoxin-1-contributes-to-viability-of-lung-epithelial-cells-during-bacillus-anthracis-infection
#15
Myung-Chul Chung, Farhang Alem, Sarah G Hamer, Aarthi Narayanan, Konstantin Shatalin, Charles Bailey, Evgeny Nudler, Ramin M Hakami
BACKGROUND: Using Bacillus anthracis as a model gram-positive bacterium, we investigated the effects of host protein S-nitrosylation during bacterial infection. B. anthracis possesses a bacterial nitric oxide synthase (bNOS) that is important for its virulence and survival. However, the role of S-nitrosylation of host cell proteins during B. anthracis infection has not been determined. METHODS: Nitrosoproteomic analysis of human small airway epithelial cells (HSAECs) infected with toxigenic B...
January 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/27580306/a-novel-option-for-prandial-insulin-therapy-inhaled-insulin
#16
REVIEW
George Dailey, Aakif Ahmad, Sarit Polsky, Viral Shah
Many adults with type 2 diabetes (T2D) do not achieve or maintain glycemic targets on oral antidiabetes drugs (OADs) alone and require insulin therapy. Although initiating basal insulin is common when treatment needs to be intensified, individualization of therapy (in line with current guidelines) may lead more health care professionals (HCPs) to add rapid-acting insulin (RAI) to OAD regimens for treatment of postprandial hyperglycemia to achieve glycated hemoglobin (A1C) targets. HCPs and patients are concerned about the burden associated with injections...
November 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27579308/expression-and-purification-of-c-peptide-containing-insulin-using-pichia-pastoris-expression-system
#17
Mohammed N Baeshen, Thamer A F Bouback, Mubarak A Alzubaidi, Roop S Bora, Mohammed A T Alotaibi, Omar T O Alabbas, Sultan M Alshahrani, Ahmed A M Aljohani, Rayan A A Munshi, Ahmed Al-Hejin, Mohamed M M Ahmed, Elrashdy M Redwan, Hassan A I Ramadan, Kulvinder S Saini, Nabih A Baeshen
Increase in the incidence of Insulin Dependent Diabetes Mellitus (IDDM) among people from developed and developing countries has created a large global market for insulin. Moreover, exploration of new methods for insulin delivery including oral or inhalation route which require very high doses would further increase the demand of cost-effective recombinant insulin. Various bacterial and yeast strains have been optimized to overproduce important biopharmaceuticals. One of the approaches we have taken is the production of recombinant human insulin along with C-peptide in yeast Pichia pastoris...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27574374/commentary-why-was-inhaled-insulin-a-failure-in-the-market
#18
Jacob Oleck, Shahista Kassam, Jennifer D Goldman
No abstract text is available yet for this article.
August 2016: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/27572546/safety-of-technoshere-insulin
#19
Nasser Mikhail
Technoshere insulin (TI), Afrezza, is a form of short-acting human insulin taken by oral inhalation with meals. Compared to subcutaneous insulin aspart, TI is slightly less effective, the difference in hemoglobin A1c (HbA1c) reduction being 0.19%. Use of TI is associated with lower risk of hypoglycemia and weight gain compared with insulin aspart. Apart from hypoglycemia, cough is the most common adverse effect of TI reported by 24-33% of patients. Cough induced by TI is mostly dry, occurs within 10 minutes after inhalation and usually subsides after few weeks of use...
August 29, 2016: Current Drug Safety
https://www.readbyqxmd.com/read/27547757/comparison-of-tiva-and-desflurane-added-to-a-subanaesthetic-dose-of-propofol-in-patients-undergoing-coronary-artery-bypass-surgery-evaluation-of-haemodynamic-and-stress-hormone-changes
#20
RANDOMIZED CONTROLLED TRIAL
Didem Onk, Tülin Akarsu Ayazoğlu, Oruç Alper Onk, Mehmet Aksüt, Murat Günay, Kultigin Turkmen, Aynur Özensoy, Çiğdem Yazıcı Ersoy, Abdulkadir Çoban
Introduction. Increased levels of stress hormones are associated with mortality in patients undergoing coronary artery bypass grafting (CABG). Aim. To compare total intravenous anaesthesia (TIVA) and desflurane added to a subanaesthetic dose of propofol. Material and Methods. Fifty patients were enrolled in this study. Fentanyl (3-5 mcg/kg/h) was started in both groups. Patients were divided into two groups. The PD group (n = 25) received 1 minimum alveolar concentration (MAC) desflurane anaesthesia in addition to propofol infusion (2-3 mg/kg/h), while P group (n = 25) received propofol infusion (5-6 mg/kg/h) only...
2016: BioMed Research International
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