Insulin puffers story

Wilson da Silva · Joined: 26 Jul 2007 Posts: 1

Thought the following might be of interest ...

Insulin puffers as effective as injections

Trials with experimental insulin inhalers show they are as effective
as injections - and that diabetics much prefer them, an analysis of
existing studies has found.

http://www.abc.net.au/science/news/stories/s909977.htm

Archived from group: misc>health>diabetes

mike gray · Joined: 26 Jul 2007 Posts: 1

willbill wrote:

>
> the story accurately reflects the aversion
> of the large majority of people to syringe shots
>
> the site's positive spin on inhaled insulin
> is a good example of big pharma
> marketing money at work. Sad

>
> is it any wonder that Aventis and Novo
> have spent millions on new 1x background
> insulins (glargine/Lantus in the case of Aventis)
> that they can get new patents on

I'm a bit confused. First the story was that big pharma prevents new
treatments to milk their current products. Now the story is that big
pharma is spending big money on new products to replace old. Which is it?

And where can I buy stock in big pharma.

Nico Kadel-Garcia · Joined: 26 Jul 2007 Posts: 3

willbill wrote:

> the story accurately reflects the aversion
> of the large majority of people to syringe shots
>
> the site's positive spin on inhaled insulin
> is a good example of big pharma
> marketing money at work. Sad

??? Now wait a minute. If workable, it is in fact an exciting
possibility. The developers do keep publishing very promising articles
and papers about it.

They just don't seem able to get enough control over dosage in vivo to
actually use the stuff.

> is it any wonder that Aventis and Novo
> have spent millions on new 1x background
> insulins (glargine/Lantus in the case of Aventis)
> that they can get new patents on

That's a very separate matter....

Nico Kadel-Garcia · Joined: 26 Jul 2007 Posts: 3

William C Biggs, MD wrote:

> Nico,
>
> IMHO, the reason we don't see inhaled insulin on the market today is not
> dosage, but the two related concerns.
>
> First, one patient (out of thousands tested) developed pulmonary fibrosis.
> People can develop pulmonary fibrosis spontaneously, and this could be
> coincindence. But this prompted a call for additional testing.

Hmm. I can certainly see where this would be an important cause for
additonal testing. I wonder what else they were sniffing, or if there
were other complicating factors?

> Second, there is the issue of antibodies. The titer of insulin antibodies in
> the blood is higher in inhaled insulin vs injected insulin.

*Hmmm*. That's interesting. I don't think that's an important issue for
most of us Type 1's.

> At the last ADA meetings in New Orleans, there was a symposium about these
> issues. The take home message was a) nobody else has had fibrosis and b)
> the antibodies don't appear to be a manifestation of any harm.

Cool.

> Once the additional testing is complete, if there are no additional cases of
> fibrosis and if there are no new adverse effects noted, then the FDA should
> approve this.

Again, cool. But there are other big if questions. I'd like to see the
papers myself on dosage, especially for overnight use for people like me.

> As far as the dosing issue, it's actually not as bad as you describe. In
> fact, inhaled insulin has some of the best times to peak of any delivery
> method, allowing the dose to be given during or just after a meal. It is
> also cleared rapidly, reducing the hypo risk pre-meal.

Dose != speed of onset. I'm using Humalog, and successfully taking my
insulin at meal time. But overnight is a bit tricky, as is the time
between lunch and my rather late supper. If it clears more quickly, then
I'm screwed at about 5pm. And taking *another* dose at that time of a
really fast-acting insulin seems a bit awkward.

> Assuming no new adverse effects on the clinical testing underway, I predict
> that 5 years from now the majority of type 2's converting to insulin will
> use a basal insulin like glargine or detimir plus inhaled insulin.

I dunno, I've been seeing claims like that for 10 years now. One guy I
played paintball with about 5 years ago (at my bachelor party!) was
working on it and claiming they'd have FDA approval within six months.
It took me a while to stop laughing: maybe he said something that silly
just to ruin my aim, but I still shot him.....

Senkise Vagyok · Joined: 26 Jul 2007 Posts: 1

In article , Wilson da
Silva wrote:

> Trials with experimental insulin inhalers show they are as effective

YES, they have tried it on *THREE* (sic) patients...

> as injections - and that diabetics much prefer them, an analysis of
> existing studies has found.
>
> http://www.abc.net.au/science/news/stories/s909977.htm

--
Senkise Vagyok nemo@umb.u-strasbg.fr
To get to real sender replace nemo with me

William C Biggs, MD · Joined: 26 Jul 2007 Posts: 1

Senkise,

I think you misread the posting.

There were six STUDIES.

Three STUDIES with type 1 patients, and three STUDIES with type 2 patients.

Not three patients.

Actually, the Cochrane paper stated "Six randomised controlled trials were
found and the overall number of participants was 1191.".

"Six trials have been done on giving short-acting insulin by inhalation
instead of injection. Much of the evidence has not yet been published in
full. The results so far suggest that inhaled insulin gives similar levels
of glycated haemoglobin; overall the incidence of hypoglycaemia also appears
similar, but patients prefer inhaled to injected. The quality of evidence is
not great - only two studies appeared to use the same basal insulin in the
inhaled and injected groups. We need longer studies to see if there are any
side-effects in the lung. More insulin has to be given by inhaled than by
injection to achieve the same effect, and the cost-effectiveness remains to
be assessed."

From: http://www.cochraneconsumer.com

Cheers,

William C Biggs, MD

"Senkise Vagyok" wrote in message%nemo@umb.u-strasbg.fr...
> In article , Wilson da
> Silva wrote:
>
> > Trials with experimental insulin inhalers show they are as effective
>
> YES, they have tried it on *THREE* (sic) patients...
>
> > as injections - and that diabetics much prefer them, an analysis of
> > existing studies has found.
> >
> > http://www.abc.net.au/science/news/stories/s909977.htm
>
> --
> Senkise Vagyok
nemo@umb.u-strasbg.fr
> To get to real sender replace nemo with
me

Herman Rubin · Joined: 26 Jul 2007 Posts: 7

In article ,
Nico Kadel-Garcia wrote:
>Griff Griffith wrote:

>> Any news story that refers to Type II diabetes as "a milder form" deserves
>> to be immediately sent to the trash can. "Mild" diabetes is like "mild"
>> pregnancy. If a journalist can't get that right, then how can you trust
>> any of the rest of the piece?

>Griff? I hate to tell you this, but it is in fact milder. It's the
>difference between nearsighted and flat-out blind. Us Type 1's don't
>have *any* insulin to work with, at least after the honeymoon phase.

This is the case, but the insulin resistance in Type 2 can
require far more to handle it than plain Type 1's need. At
this time, we do not know that much about insulin resistance.

It is even possible to be both.

--
This address is for information only. I do not claim that these views
are those of the Statistics Department or of Purdue University.
Herman Rubin, Department of Statistics, Purdue University
hrubin@stat.purdue.edu Phone: (765)494-6054 FAX: (765)494-0558

Nico Kadel-Garcia · Joined: 26 Jul 2007 Posts: 3

Griff Griffith wrote:

> Any news story that refers to Type II diabetes as "a milder form" deserves
> to be immediately sent to the trash can. "Mild" diabetes is like "mild"
> pregnancy. If a journalist can't get that right, then how can you trust
> any of the rest of the piece?

Griff? I hate to tell you this, but it is in fact milder. It's the
difference between nearsighted and flat-out blind. Us Type 1's don't
have *any* insulin to work with, at least after the honeymoon phase.

Griff Griffith · Joined: 26 Jul 2007 Posts: 1

Any news story that refers to Type II diabetes as "a milder form" deserves
to be immediately sent to the trash can. "Mild" diabetes is like "mild"
pregnancy. If a journalist can't get that right, then how can you trust
any of the rest of the piece?

--
Griff Griffith
T2 since December 1990
Basal/bolus insulin & Metformin since May 2003
=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+=+

"Wilson da Silva" wrote in message@posting.google.com...
> Thought the following might be of interest ...
>
> Insulin puffers as effective as injections
>
> Trials with experimental insulin inhalers show they are as effective
> as injections - and that diabetics much prefer them, an analysis of
> existing studies has found.
>
> http://www.abc.net.au/science/news/stories/s909977.htm

cookoonest · Joined: 26 Jul 2007 Posts: 3

Insurance Companies sure see a difference between Type 1 and 2.

They specifically ask the question "Do you have Type 1 - Insulin Dependent
Diabetes" on all applications for life insurance.

There are no questions such as this regarding "Type 2".

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Mack · Joined: 26 Jul 2007 Posts: 15

On Tue, 05 Aug 2003 22:59:16 GMT, Nico Kadel-Garcia
wrote:

>Griff Griffith wrote:
>
>> Any news story that refers to Type II diabetes as "a milder form" deserves
>> to be immediately sent to the trash can. "Mild" diabetes is like "mild"
>> pregnancy. If a journalist can't get that right, then how can you trust
>> any of the rest of the piece?
>
>Griff? I hate to tell you this, but it is in fact milder. It's the
>difference between nearsighted and flat-out blind. Us Type 1's don't
>have *any* insulin to work with, at least after the honeymoon phase.

this type 1 disagrees.

All types not just type 1 and type 2, are equally bad, as equally
difficult to manage and will all equally kill or cripple the person
living with it.

Mack
Type 1 since 1975
http://www.alt-support-diabetes.org
http://www.insulin-pumpers.org

In tribute to the United States of America and the State
of Israel, two bastions of strength in a world filled with strife and
terrorism.

Eldritch · Joined: 26 Jul 2007 Posts: 1

Nico Kadel-Garcia wrote:
> Griff Griffith wrote:
>
>> "Mild" diabetes is like "mild"
>> pregnancy. If a journalist can't get that right, then how can you trust
>> any of the rest of the piece?
>
>
> Griff? I hate to tell you this, but it is in fact milder. It's the
> difference between nearsighted and flat-out blind. Us Type 1's don't
> have *any* insulin to work with, at least after the honeymoon phase.
>

Sure, if insulin production is your only criterion. I agree that the
amount of insulin production makes how you handle the disease different.
But look at the complications/consequences of the disease. Type 1 and
2's both go blind, suffer amputations, go on kidney dialysis. Is type
2 a milder form of the disease if you die of a heart attack? I'd say
both forms of the disease are deadly serious.

E

cookoonest · Joined: 26 Jul 2007 Posts: 3

If this is all true why is there such a stigma (by society) regarding Type 1
and not type 2?

I have been classified as Type 2 by my doctor but she says I should really
be a type 1. I have strongly resisted this because of the legal and
financial ramifications.

Why all this game playing? Why penalize one who is type 1 when there is so
much confusion as to what is a type 1 or type 2.

Maybe I should just put down that I have leprosy and get it all over.

"Eldritch" wrote in message$qris4$1@ID-133796.news.uni-berlin.de...
> Nico Kadel-Garcia wrote:
> > Griff Griffith wrote:
> >
> >> "Mild" diabetes is like "mild"
> >> pregnancy. If a journalist can't get that right, then how can you
trust
> >> any of the rest of the piece?
> >
> >
> > Griff? I hate to tell you this, but it is in fact milder. It's the
> > difference between nearsighted and flat-out blind. Us Type 1's don't
> > have *any* insulin to work with, at least after the honeymoon phase.
> >
>
>
> Sure, if insulin production is your only criterion. I agree that the
> amount of insulin production makes how you handle the disease different.
> But look at the complications/consequences of the disease. Type 1 and
> 2's both go blind, suffer amputations, go on kidney dialysis. Is type
> 2 a milder form of the disease if you die of a heart attack? I'd say
> both forms of the disease are deadly serious.
>
>
> E
>

Mack · Joined: 26 Jul 2007 Posts: 15

On Wed, 06 Aug 2003 16:31:53 GMT, "cookoonest"
wrote:

>If this is all true why is there such a stigma (by society) regarding Type 1
>and not type 2?

what stigma is placed on us by :society"?

>
>I have been classified as Type 2 by my doctor but she says I should really
>be a type 1. I have strongly resisted this because of the legal and
>financial ramifications.

"insurance" companies are not society. They are out to make a buck.

>
>Why all this game playing? Why penalize one who is type 1 when there is so
>much confusion as to what is a type 1 or type 2.
>
>Maybe I should just put down that I have leprosy and get it all over.

There are differences between insulin dependent and non-insulin
dependent diabetics. With the use of insulin there comes very
distinct rapid changes in Bg levels that "most" not all type 2s don't
have to worry about.

to me it sounds more like the stigma you are referring to is your
interpretation, hang up.

ALL diabetics regardless of type are risk for all the same
complications. Blindness, kidney failure heart failure etc.

Those who use insulin are more prone to hypos. Those who cannot live
without injected insulin run the risk of serious DKA and or death if
they don't get the insulin. Type 1s are not the only ones who take
insulin.

don't confuse "stigma" with "risk statistics".

Mack
Type 1 since 1975
http://www.alt-support-diabetes.org
http://www.insulin-pumpers.org

In tribute to the United States of America and the State
of Israel, two bastions of strength in a world filled with strife and
terrorism.

cookoonest · Joined: 26 Jul 2007 Posts: 3

Have you filled out an application for Life Insurance lately?

If you have, you will know that there is great concern when you state you
have Type1 (insulin dependent) diabetes. There is no concern, and not even
any question, regarding type 2 diabetes.

Stating you have type 1 is reason for underwriters to reject your
application for a policy or at least require you to pay a much higher
premium or reduce the face value of the policy.

Its a fact that insurance underwriters DO "confuse stigma with risk
statistics".

Thats a REALITY.

"Mack" wrote in message@4ax.com...
> On Wed, 06 Aug 2003 16:31:53 GMT, "cookoonest"
> wrote:
>
> >If this is all true why is there such a stigma (by society) regarding
Type 1
> >and not type 2?
>
> what stigma is placed on us by :society"?
>
> >
> >I have been classified as Type 2 by my doctor but she says I should
really
> >be a type 1. I have strongly resisted this because of the legal and
> >financial ramifications.
>
> "insurance" companies are not society. They are out to make a buck.
>
> >
> >Why all this game playing? Why penalize one who is type 1 when there is
so
> >much confusion as to what is a type 1 or type 2.
> >
> >Maybe I should just put down that I have leprosy and get it all over.
>
>
> There are differences between insulin dependent and non-insulin
> dependent diabetics. With the use of insulin there comes very
> distinct rapid changes in Bg levels that "most" not all type 2s don't
> have to worry about.
>
> to me it sounds more like the stigma you are referring to is your
> interpretation, hang up.
>
> ALL diabetics regardless of type are risk for all the same
> complications. Blindness, kidney failure heart failure etc.
>
> Those who use insulin are more prone to hypos. Those who cannot live
> without injected insulin run the risk of serious DKA and or death if
> they don't get the insulin. Type 1s are not the only ones who take
> insulin.
>
> don't confuse "stigma" with "risk statistics".
>
> Mack
> Type 1 since 1975
> http://www.alt-support-diabetes.org
> http://www.insulin-pumpers.org
>
> In tribute to the United States of America and the State
> of Israel, two bastions of strength in a world filled with strife and
> terrorism.