Inhaled form of insulin studied for children and adolescents

Norton Children’s Hospital is a study site for an inhaled form of insulin for young patients. The drug, Afrezza, already has been approved for adults.

Wendy Novak Diabetes Institute

Children and their families are supported by board-certified, fellowship-trained pediatric endocrinologists, diabetes nurse practitioners, certified diabetes educators, nurses, social workers, psychologists, pharmacists, exercise physiologists and more.

Children and adolescents with Type 1 or Type 2 diabetes may no longer need injections of insulin if a new inhaled form of insulin is found to be safe and effective.

“Some kids — especially kids who have been diagnosed recently — can have a difficult time getting used to injections. This formulation is a great alternative to help reduce that challenge,” said Kupper A. Wintergerst, M.D., chief, pediatric endocrinology, and executive director of Wendy Novak Diabetes Institute.

Dr. Wintergerst, a pediatric endocrinologist with Norton Children’s Endocrinology, affiliated with the UofL School of Medicine, and Wendy L. Novak Chair of Pediatric Diabetes Care and Clinical Research, is leading a study at Norton Children’s Hospital to see how well inhaled insulin works for children and adolescents. The drug, Afrezza, already has been approved for adults.

Because it is inhaled, insulin reaches the bloodstream much faster with Afrezza than with injectable insulin. That means it can be taken at the beginning of a meal, instead of ahead of time.

We need insulin to get energy from the food we eat. Insulin does that by allowing sugar to move from the bloodstream into cells.

People with Type 1 diabetes don’t produce any insulin at all. People with Type 2 diabetes are unable to make enough insulin or are insulin resistant, meaning cells don’t respond well to insulin and have trouble getting sugar from the blood.

With either type of diabetes, it’s hard to keep blood sugar at healthy levels. People with diabetes traditionally have needed an insulin injection about half an hour before a meal so it will be working when it needs to work.

Afrezza consists of an insulin powder in cartridges and the inhaler. After a person inhales the powder, it dissolves in the lungs and is absorbed into the bloodstream.

According to MannKind Corp., which makes Afrezza, the inhaled insulin reaches the bloodstream within a minute. According to the company, Afrezza can be inhaled at the beginning of a meal and will start lowering blood sugar levels in as few as 12 minutes.

In addition to being taken with the meal, instead of ahead of time, other potential benefits of Afrezza include better adherence and fewer low blood sugar events compared with injected insulin.

Norton Children’s Hospital is one of 40 sites nationally participating in a yearlong Phase 3 trial of the inhaled insulin to see if it is safe and effective in children and adolescents.

Following the trial, the Food and Drug Administration will decide whether to approve Afrezza for people under 18 with diabetes.

Norton Children’s Hospital has pediatric patients currently enrolled in the Afrezza trial, one of more than 10 clinical trials underway at Wendy Novak Diabetes Institute in Louisville. Norton Children’s hospital is ranked No. 23 nationally for pediatric endocrinology by U.S. News & World Report.