Disease, Medication and Healthy Lifestyle

Posts Tagged ‘Injections’

Article by Mark Anastasi

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Article by Lynn Woods

There’s good news for insulin dependent diabetics who rely on fast-acting mealtime insulin injections to keep their blood sugar under control. MannKind Corporation has the go-ahead to continue clinical testing of its investigational inhaled insulin, AFREZZA. The drug maker and the FDA met to confirm the protocols for two new studies, one in type 1 diabetics, and one in type 2 diabetics.

AFREZZA is an ultra-rapid acting inhaled insulin which uses patented technology to deliver powdered insulin from a thumb-sized device into the lungs. The lungs are an effective option for delivering diabetes medication, largely because of their huge surface area (about the size of a tennis court).

MannKind focuses on the discovery, development and commercialization of therapeutic products for patients with diseases such as diabetes and cancer.

Now in late stage clinical investigation, AFREEZA is its lead product candidate. Shares of the company jumped 20% at the news that the design of the follow-up clinical trials had been confirmed.

MannKind has been seeking approval for its new generation diabetes medication since March of 2009, but was asked twice to run additional clinical trials in order to provide the FDA with more information. One of the approval delays was due to the drug maker updating the design of its insulin inhaler after applying for approval of the earlier design. The FDA was concerned that there was not enough data to support a switch to the new generation device, and asked that both models be tested together.

Clinical trials of the initial design of the insulin inhaler were promising. Participants reported being pleased with the innovative insulin delivery device, and experienced less hypoglycemia and weight gain than did controls using a standard combination of long-acting insulin glargine and twice a day 70 30 insulin injections.

Insulin can’t be taken orally, as digestive juices break it down before it can be used by the body. Currently, the only means of delivering insulin are subcutaneous insulin injections or intravenously. Because AFREEZA is a short-acting mealtime insulin, type 1 diabetics will need to combine it with long-acting insulin injections for complete diabetes control.

Dr. Larry Deeb, a pediatric endocrinologist from the University of Florida College of Medicine, says that failure to comply with regular insulin dosing is one of the major issues in diabetes, often because of the discomfort and inconvenience of insulin injections. Deeb says that finding an alternative insulin delivery method is crucial, especially for children and the needle-phobic.

Should it be approved, AFREEZA would be the second inhaled insulin to hit the market. Pfizer received approval to market a similar product, Exubera, several years ago, but, surprisingly, the product never caught on with diabetics, and was withdrawn from the market a year later.

AFREZZA is easier to use, faster acting and boasts better bioavailability than Exubera, enabling diabetics to achieve more satisfactory insulin levels using smaller amounts. Despite Exubera’s unexpected failure, AFREEZA is expected to be a blockbuster diabetes drug when it becomes available.

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If you have experience with feline diabetes you know how hard it can be to watch your furry family member suffer through weakness, vet appointments, diet changes and, possibly the most challenging of all, insulin injections. Knowledge of proper cat insulin injection techniques can make your life and your cat’s life easier. If you have any questions or concerns talk to your vet.

Prepare the Insulin

Start by filling the insulin syringe slightly more than your cat’s dose
Tap the insulin syringe to remove air bubbles
Slowly push the plunger until you have the correct dosage of insulin in the syringe

Prepare Your Cat

Create a routine to make your cat comfortable. At first he will likely try to get away, but eventually he should become familiar with the process, and you may even be able to train him to come when it is time for his insulin injection. Start by giving him lots of attention and affection, and maybe even a small treat. It is probably best to keep the insulin syringe out of your hands at first, so that he does not get scared. When you are ready to give your cat insulin, get on his level – don’t come at him from above or he will feel threatened. Now it is time to find the injection site.

Injection sites

The scruff (top of the neck) is the most commonly used injection site for insulin for cats, however it may not be the best. The amount of skin and muscle in this area can slow absorption of the insulin, and can be more painful for the cat.

Other options for injection are the flank (between the ribs and the legs), the side or underside of the belly, and the side of the chest. Absorption tends to be quickest when given in the side or underside of the belly.

Insulin Injection

Each cat is different, and the proper type, dose and frequency of insulin for cats need to be determined by a veterinarian. Once you know the proper insulin dosing and have determined the best place for injection, place your thumb and index finger approximately an inch apart and pinch the skin to create a “tent”. Make sure you are not grabbing any muscle.

The insulin injection should go into the hollow space under the “tent” of skin. It should not go into the skin itself, or into the muscle. If your cat is long-haired make sure that you can see the skin and that you are not giving him a “fur shot”.

When you are giving the insulin injection be confident, smooth and fast. It is the puncture part that hurts, so go quickly through that part; you can slow down a bit while you inject the fluid.

Above all, be gentle and kind when giving your cat insulin, especially at first, and praise him when it is all done.