My cousin, the PhD pharmacist is all excited about inhaled insulin. Well, I sort of snort at the idea. Here’s why…
First, I was diagnosed with asthma and on inhalent drugs for a while, and found them very inconvenient and that they didn’t work well. You had to breath in this tube, and I always felt like the powder was getting all over the place. I will grant you though, that the asthma was caused by GERD, and that was the primary reason I never felt that the inhalents worked.
I’m also in a fairly unique position, as I’ve been through oral medication, multiple daily injections, and am now on an insulin pump.
Here’s the problem with oral medication: You have to take a pill once a day, follow a diet and exercise on a regular basis. If I could actually DO that, there is a highly likelihood that I would not be diabetic. It also takes a LONG time before you see any results.
Here’s the problem with multple daily injections (MDI). You have to give yourself shots three – four times a day, eat at the exact same times, maintain the exact amount of exercise. If you take too much insulin, you have to eat more food. Since you are eating more food, you gain weight, adding to the insulin resistance, and you end up chasing your tail. FYI: If I could do the, eat at the exact same time and maintain the same energy level, thing, I probably would not be diabetic right now. (See a pattern — I have never been a do the same thing at the same time kinda of gal).
I’m predicting that inhaled insulin is going to follow the MDI path. I certainly don’t see it following my therapy of choice.
My choice — the insulin pump — requires the following:
- Wake up, test your blood sugar, push a few buttons if the fasting blood sugar is too high.
- Get around to eating breakfast, decide what you want to eat, do a quick calculation on carbs (pump does that now), and push a few buttons.
- Two hours after eating, check blood sugar and if high, push a few buttons.
- Decide you want something to eat, push a few buttons
- Pump buzzes after two hours, check blook sugar and if high, push a few buttons
- Decide I want to work out in a few hours, turn on the temporary basis, but if forget about that, eat a couple of carbs and work out.
- Eat dinner, push a few buttons
- Pump buzzes after two hours, check blood sugar and if high, push a few buttons.
I much prefer to pushing a few buttons to giving myself shots. Plus, I can adjust by .05 units of insulin instead of being stuck with whole units.
The real plus of the pump, is that I’m only stuck with an insulin mistake for a couple of hours, rather than being stuck with it for 12 hours. (Or is it 24 hours on Lantus — I always did Humalog 75/25).
Actually insulin mistakes when you are on MDI can cause days of roller coasting before you get control back. Roller coastering — low blood sugar, treat it, then high blood sugar, treat the high, etc. always results in overeating. If I do roller coaster on the pump, we’re talking a coaster ride of a few hours versus days.
However, I will admit for being happiest with an A1C under 6.5, and that lots of diabetics get along well with an A1C of 7.0 or higher.