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Insulin inhaler

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
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
Pierozan Paula, Jernerén Fredrik, Ransome Yusuf, Karlsson Oskar
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
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
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
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
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
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
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
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
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
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
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
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
Janet B McGill, David Ahn, Steven V Edelman, C Rachel Kilpatrick, Tricia Santos Cavaiola
UNLABELLED: Glycemic control is fundamental to the management of diabetes. However, studies suggest that a significant proportion of people with diabetes, particularly those using insulin, are not achieving glycemic targets. The reasons for this are likely to be multifactorial. The real and perceived risk of hypoglycemia and the need for multiple daily injections are widely recognized as key barriers to effective insulin therapy. Therefore, there is a clear unmet need for a treatment option which can help mitigate these barriers...
August 2016: Advances in Therapy
Lutz Heinemann, Robert Baughman, Anders Boss, Marcus Hompesch
Advances in insulin treatment options over recent decades have markedly improved the management of diabetes. Despite this, glycemic control remains suboptimal in many people with diabetes. Although postprandial glucose control has been improved with the development of subcutaneously injected rapid-acting insulin analogs, currently available insulins are not able to fully mimic the physiological time-action profile of endogenously secreted insulin after a meal. The delayed onset of metabolic action and prolonged period of effect induce the risk of postprandial hyperglycemia and late postprandial hypoglycemia...
January 2017: Journal of Diabetes Science and Technology
Giovanna Muscogiuri, Annamaria Colao
Phtalates are commonly found in several household products such as food packaging, furniture and toys. Humans are exposed to phtalates through different ways such as inhalation, ingestion and dermal contact. Due to the abundance of plastic in our society, the exposure to phtalates is ubiquitous. A growing body of evidence investigated the association of phtalate exposure with cardiovascular risk factors, i.e., obesity, type 2 diabetes and hypertension. Phtalates are thought to contribute to obesity through their binding and activation of PPARγ receptor that in turn results in the upregulation of adipocyte production...
March 2017: Archives of Toxicology
Juliet J Ray, Jonathan P Meizoso, Casey J Allen, Laura F Teisch, Ethan Y Yang, Han Yao Foong, Leela S Mundra, Nicholas Namias, Louis R Pizano, Carl I Schulman
Inflammation and hypermetabolism post burn predisposes to hyperglycemia and insulin resistance. The authors hypothesize that admission hyperglycemia predicts infectious outcomes. A retrospective review of all patients greater than 20 years of age admitted for initial burn management from January 2008 to December 2013 was conducted. Nonthermal injuries, transfers, and those without admission glucose or histories were excluded. Hyperglycemia was defined as admission glucose ≥150 mg/dl. Patients were grouped as follows: euglycemic without diabetes (control), euglycemic with diabetes (-H+D), hyperglycemic without diabetes (+H-D), and hyperglycemic with diabetes (+H+D)...
March 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Roberto Visentin, Clemens Giegerich, Robert Jäger, Raphael Dahmen, Anders Boss, Marshall Grant, Chiara Dalla Man, Claudio Cobelli, Thomas Klabunde
BACKGROUND: Technosphere(®) insulin (TI), an inhaled human insulin with a fast onset of action, provides a novel option for the control of prandial glucose. We used the University of Virginia (UVA)/Padova simulator to explore in-silico the potential benefit of different dosing regimens on postprandial glucose (PPG) control to support the design of further clinical trials. Tested dosing regimens included at-meal or postmeal dosing, or dosing before and after a meal (split dosing). METHODS: Various dosing regimens of TI were compared among one another and to insulin lispro in 100 virtual type-1 patients...
September 2016: Diabetes Technology & Therapeutics
Jixin Zhong, Katryn Allen, Xiaoquan Rao, Zhekang Ying, Zachary Braunstein, Saumya R Kankanala, Chang Xia, Xiaoke Wang, Lori A Bramble, James G Wagner, Ryan Lewandowski, Qinghua Sun, Jack R Harkema, Sanjay Rajagopalan
BACKGROUND: Inhaled ozone (O3) has been demonstrated as a harmful pollutant and associated with chronic inflammatory diseases such as diabetes and vascular disorders. However, the underlying mechanisms by which O3 mediates harmful effects are poorly understood. OBJECTIVES: To investigate the effect of O3 exposure on glucose intolerance, immune activation and underlying mechanisms in a genetically susceptible mouse model. METHODS: Diabetes-prone KK mice were exposed to filtered air (FA), or O3 (0...
August 2016: Inhalation Toxicology
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