Inhaled Insulin Bests Rapid-Acting Insulin for Post-Prandial Glucose Control in Pilot Study

Kevin Kaiserman, MD
Courtesy: JDRF

Data presented at the 16th International Conference on Advanced Technologies & Treatment for Diabetes (ATTD 2023) is providing new insight into the effects of inhaled technosphere insulin when combined with automated insulin delivery (AID) systems for lowering peak glucose levels and post-prandial glucose.¹

The study, which was presented by Kevin Kaiserman, MD, a pediatric endocrinologist and Vice President of Medical Affairs in the Endocrine Business Unit for MannKind, returned results indicating inhaled technosphere insulin lowered peak glucose levels 30 minutes faster than injectable rapid-acting insulin delivered through an AID insulin pump and significantly lowered post-prandial glucose from 45-120 minutes after a controlled meal challenge test.¹

“We believe inhaled insulin is an important option for those living with type 1 diabetes to reduce their post-prandial glucose in the first 120 minutes,” Kaiserman said.² “The study revealed a faster and lower peak in glucose that may assist patients in achieving improved glycemic control.”

A pilot study of 26 adults with type 1 diabetes already using AID, the trial randomized 21 patients to receive an inhaled insulin dose to cover a standardized meal and 5 patients to the AID control group, which received AID-administered rapid-acting insulin analogue to cover a standardized meal. The ATTD 23, which was a subset analysis of the trial, was designed with the specific intent of examining the efficacy and safety of an ultra-rapid-acting inhaler insulin for the 2 hours proceeding a standard meal.¹

Of note, those randomized to technosphere insulin achieved an immediate pre-prandial dose of technosphere insulin calculated by doubling their usual rapid-acting insulin analogue doses and rounding down to the nearest technosphere insulin dose. The control group received a typical pump bolus up to 15 minutes before the meal. Investigators pointed out self-monitoring of blood glucose was measured using the Ascension Contour meter and timepoints of 0, 15, 30, 45, 60, 90, and 120 minutes relative to the meal.¹

Upon analysis, results indicated those randomized to technosphere insulin experienced lower peak glucose levels 30 minutes faster (200 mg/dl at 60 minutes) than their counterparts in the study’s control group (264 mg/dL at 90 minutes). Further analysis demonstrated those randomized to technosphere insulin experienced significantly lower mean post-prandial glucose from 45 to 120 minutes post-meal.¹

“We are steadfast in our commitment to addressing the serious unmet need to improve mealtime control for those living with diabetes,” said Michael Castagna, PharmD, Chief Executive Officer of MannKind Corporation.² “Based on the data collected from this pilot study we intend to move forward with a larger study this year to evaluate how we can reduce the diabetes burden as well as improve a patient’s ability to control their sugars in the first 120 minutes after they eat.”

References:

1. Kaiserman K. INHALED INSULIN + AID SAFELY REDUCED GLUCOSE COMPARED TO AID ADMINISTERED RAA FOLLOWING IN-CLINIC MEAL IN PROOF-OF-CONCEPT STUDY DATA SUBSET. Advanced Technologies and Treatments for Diabetes 2023. February 2023.
2. MannKind. Mannkind to give oral presentation on Meal Challenge results from the afrezza® with basal combination (ABC Study) at 16th annual ATTD conference. GlobeNewswire News Room. https://www.globenewswire.com/news-release/2023/02/22/2612958/29517/en/MannKind-to-Give-Oral-Presentation-on-Meal-Challenge-Results-From-the-Afrezza-With-Basal-Combination-ABC-Study-at-16th-Annual-ATTD-Conference.html. Published February 22, 2023. Accessed February 23, 2023.