Afrezza, the trademarked name of the inhaled insulin, has an interesting video available entitled, "Timing is Everything (just click on the link to view it)." In its clinical trials, the manufacturer (Mannkind Corporation) claimed that the inhaled insulin had a much faster onset of action than the fast-acting analogs (Novalog, Humalog and Apidra). My primary concern lies in the potential adverse effects the drug may have on lung tissue, particularly long term. The accuracy of dosing may be another potential problem as absorption of any inhaled medication could vary somewhat from one dose to another.
Afrezza already carries warnings that it should not be used by those patients suffering from asthma and COPD. Most people who have been diabetic for any extended period of time often wind up with beta cell dysfunction that deprives them of the ability to maintain basal insulin secretion. Many others lack the ability to produce, store, and secrete first phase prandial insulin and must rely almost exclusively on the much slower secretion of second phase insulin response. The latter, of course, results in post prandial spikes and surges because of the differences in timing between the insulin needed and food digested. Afrezza claims to address this weakness of injectable insulins.
Here's a warning (that may be sugar-coated) posted on the manufacturer's website: "In clinical trials of up to two years duration in Type 1 and Type 2 adult patients with diabetes, observed changes in lung function were small, did not progress and resolved when AFREZZA treatment was discontinued. The most common respiratory side effect experienced with AFREZZA in trials was a mild, transient, non-productive cough. Discontinuation due to cough was uncommon."
Despite potential drawbacks, the inhaled insulin may provide doctors with a valuable tool for those diabetic patients who really need to supplement with insulin but have unfounded fears of needles which has been the deal-breaker in the past.
Another anti-diabetic drug that has failed to receive the attention that it deserves is an SGLT2-inhibitor marketed under the name of Invokana. This once-a-day medication works on the kidneys and essentially "tops off" serum glucose levels at the 140mg/L mark. Any serum glucose in excess of 140mg/L is kicked out of the system (excreted via the urine) and thus the medication can provide valuable protection against complications (because most complications become most damaging and progressive when blood glucose levels exceed the 140 mg/L tipping point).View Thread
I have only taken one (1) flu shot in my entire 72 years of life and that was when I was taking care of my mother and the visiting nurse insisted on giver her the vaccine. She gave me one during the same visit. Aside from that single, solitary occasion, I have never had another flu shot. I have also not caught a cold or the flu for over thirty-five (35) years until the 3rd quarter of last year. I finally caught a cold — an extremely virulent strain — but got over it in less than 5 days (compared with the relative that I was visiting who took over three weeks to get over his). My streak of flu-less years remains unbroken.
In any event, if you read the article cited in the thread, it stated that the "higher risk" factor for diabetics was elevated by a mere 6%; that's hardly anything to get excited about. There's a natural alternative that seems to work for a large segment of the population and that's simply vitamin D, the sunshine vitamin. Here's an article that supports the taking of vitamin D to ward off rhino viruses but I find that high dose vitamin D actually bolsters the entire immune system. There are plenty of articles online that suggest that it also helps in diabetes (just Google it or use whatever search engine you prefer). The research is "iffy," however, and you can find articles both pro and con such as the two articles that I hyperlinked (both the pro and con articles are hosted on WebMD).
Bottom line? If you have a strong immune system, you might want to experiment a little. Some doctors (like my own endo) actively encourages it but only for patients like me who don't have any other serious health issues. Other doctors are super cautious and advise against taking or doing anything that is affiliated with the word "natural" or "holistic." I won't give any medical advice as to what you should do. However, I can tell you what I do (it has worked for me for over 35 years until the single slippage that I experienced in 4th quarter 2013 and that was a cold, not the flu). I take a 2000 IU capsule of vitamin D3 with each meal three times a day (T.I.D.). That provides me with a total of 6,000 IU daily from the vitamin D3 capsules alone. However, I also get additional vitamin D from my daily multivitamin, calcium supplement, and food - making the total amount of daily vitamin D supplementation somewhere in the 7,000 IU to 8,000 IU range. To guard against overdosing (100ng/ml is the safe upper limit), I get an annual 25-hydroxy vitamin D test done every year. My personal target goal is 80 ng/ml but my blood tests have ranged from 67 ng/ml to as high as 83 ng/ml over the past six or seven years. I have also suffered from lifelong asthma but it has been in almost total remission since my vitamin D levels have climbed above the >60ng/ml level. Flu vaccine? I personally don't seem to need it but each person has different issues and responses so do what works for you (and, of course, consult with your own physician).
Flute, I enjoyed your description of atti_editor's photo. We must be twins or, at the very least, long lost cousins. View Thread
I, too, have been classified as a Type 1.5 and I am not considered overweight,was just measured at 14.5% body fat (using calipers with tests repeated 3 times over multiple body areas), do not have a belly, love handles or muffin top. However, like yourself, my beta cells just don't produce sufficient insulin (probably none by now). However, I do use insulin judiciously, exercise regularly, carefully regulate my carb intake, and have been rewarded with an A1c that measured 5.0 shortly after my return from the Far East (my previous A1c was 5.2 taken six months prior). That was a bit surprisingly as I did experience a few high B.S. readings during my trip as the result of over-indulging in some of the 5-Star buffets that I had been invited to (yes, I do know better but sometimes the social environment and plentiful food selections will tempt even the most conservative diner.
I recently finished reading Wheat Belly by Dr. William Davis. I did not eat any grain or wheat products while touring Asia and was able to eat considerably more fruit that I ever do here in the States. To be rewarded with an A1c of 5.0 makes me wonder if there's merit to Dr. Davis's claims that "modern wheat" is the major factor in obesity. I will provide a review of his book in a future thread but in the interim, do encourage everyone to read Dr. Davis's interesting viewpoints.View Thread
Mixtard 30 is human premixed insulin 30% of which is short-acting insulin and 70% is intermediate-acting, isophane insulin.
Humulin M3 is the nearest equivalent insulin to Mixtard 30. It is made by Eli Lilly and is also human premixed insulin made up of 30% short-acting insulin and 70% intermediate-acting, isophane insulin. The only pre-mixed insulin that will be available from Novo Nordisk is NovoMix 30, ananalogue premixed insulin 30% of rapid-acting NovoRapid [aspart> insulin and 70% protamine insulin aspart. This is not the same, nor even similar as NovoMix 30 has a very different peak and duration of action to Mixtard 30, as the chart below clearly demonstrates. The chart also demonstrates that Humulin M3 is more similar to Mixtard 30 than NovoMix 30.
So if you are forced to change from Mixtard 30, then the nearest equivalent insulin is Humulin M3. Clearly, Novo Nordisk will want people to stay with their brand of insulin, in this case NovoMix 30, and you may be advised to do this but remember, this is not the same. IDDT's advice is to discuss your options with your diabetes team and if you want the nearest equivalent insulin, then ask to change to Humulin M3 and not NovoMix 30.
The above information was extracted from the www.iddt.org website. If your local pharmacy doesn't carry the Humalin M3, it is not uncommon for insulin users to just purchase two separate vials in an emergency (one each of short-acting and intermediate-acting insulin and inject the dosages separately). View Thread