Living with diabetes can be challenging.

To avoid spikes or plunges in blood sugar levels, you may need to carefully schedule what and when you eat, coordinating food with insulin, to regulate your sugar levels.

Injected insulin may need to be dosed every time a person eats but when the sugar is too high, you may need to wait another four hours, which adds a layer to the process.

There is an option that can make life easier for adults living with diabetes — inhaled insulin.

First approved in 2014, Afrezza® is a dry, powdered insulin that people breathe in through an inhaler. The fast-acting insulin passes through their lungs into their blood stream quickly.

“Fast-acting insulin is the type we prescribe to take with eating,” says Cheryl Boss, NP, CDE, a diabetes provider with Edward Medical Group Diabetes Center. “It’s inhaled at the beginning of the meal, and they would use it every time they eat.

“This makes life easier. Patients notice less variability in their blood sugar levels,” Boss says. “And if your blood sugar is still high an hour after the first dose, you can take a second dose. If using traditional insulin, we recommend waiting three to four hours to do another injection.”

Patients are prescribed blister packets of powder, which they would put in an inhaler. They breathe in the powder, holding their breath for three seconds, then exhale.

For those who don’t need long-acting insulin (the injectable type), Afrezza can replace injections altogether. For those with type 1 diabetes or those who require long-acting insulin, the inhaler would supplement the injected long-acting insulin.

Inhaled insulin isn’t an option for everyone. Those who shouldn’t use inhaled insulin include:

• Anyone with a history of asthma, including exercise-induced asthma
• Smokers (must be smoke-free for six months prior to starting Afrezza)
• Anyone with lung disease: asthma, bronchitis, COPD
• Anyone already on any inhaled medication
• Children under 18

Once you start using inhaled insulin, your provider will check your lung function at regular intervals, Boss says.

“Patients need to do a breathing test to get a baseline of lung function before prescribing,” Boss says. “We can do it right in the office. Then we check it again after six months, then every year after that. If the measurement decreases by 25 percent or more, they must stop using inhaled insulin.”

For those who can use it, inhaled insulin can provide some freedom in scheduling and reduce the burden of injections.

“I have active patients saying now they can give insulin before a meal, then go work out an hour later because the insulin has cleared out of their bloodstream,” Boss says. “If they’re eating three meals a day, that’s three fewer injections a day.”

The diabetes specialists at Edward-Elmhurst Health are committed to helping you and your family gain the tools you need to manage your diabetes effectively. Learn more about our diabetes care.

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