Insulin Inhaler for Diabetics! What a great idea!  If you or your physician is considering starting you on this inhaler you need to be aware of the following warning in the product enclosure:

Afrezza® is contraindicated in patients with chronic lung disease such as asthma or COPD. Prior to initiating therapy, patients should be evaluated with a medical history, physical examination and spirometry (FEV1) to identify potential underlying lung disease. Acute bronchospasm has been observed following Afrezza® dosing in patients with asthma and patients with COPD. The long-term safety and efficacy of Afrezza® in patients with chronic lung disease has not been established.

Afrezza® has been shown to cause a decrease in lung function as measured by FEV1. In clinical trials lasting up to 2 years, Afrezza treated patients experienced a small (40 ml) but greater FEV1 decline than comparator treated patients.Therefore, pulmonary function should be assessed with spirometry at baseline, after the initial 6 months of therapy and annually thereafter even in the absence of pulmonary symptoms. More frequent lung function assessment should be considered in patients with pulmonary symptoms, e.g., wheezing, bronchospasm, breathing difficulties, or cough.

If you have history of Asthma during childhood or at any time in the past that you think yu have ‘outgrown’ you may still have subclinical asthma. Many patients with Allergic Rhinitis, Seasonal Allergies, or so called Sinus problems have subclinical asthma that is detectable only with special Lung Function Tests. Similarly if you are an ex-smoker you may have subclinical COPD.

As stated in the second para of the product enclosure above, even if you do not have predisposition to Asthma or COPD, you will need baseline Lung Function Testing and follow up evaluation every six months to a year thereafter.

We offer the following services to anyone considering Insulin Inhaler for Diabetes:

  1. Screening for Asthma, COPD or Chronic Lung Disease even if you have no symptoms.
  2. Baseline evaluation as well as ongoing monitoring of the Pulmonary Status including FEV1 as long as the patient is on Afrezza. After each evaluation we will send a report to your Diabetes doctor with a copy of the spirometry as well as our opinion as to whether there has been any interval change in the your pulmonary status.
  3. To make an appointment at any of our five locations nearest to you call us, or have your doctor’s staff contact us at 304-343-4300 or have your doctor FAX the relevant information to 304-343-5473 with . We will be happy to make the rest of the arrangements for you.

We look forward to serving you.