I was in a 2-year clinical trial (Phase 3) with the Technosphere Insulin (TI) (Afresa) in the Type 1 group. I injected Lantus for my basal and bolused the TI for my meals with the Medtone Inhaler to replace the injected Humalog I was using previously. At the beginning of the trial my A1c was 6.8 and when the trial ended my A1c was 5.9. During the trial I was not carb counting, although I estimated the size of my bolus of TI based on the approximate carbs in my meals. I managed to achieve the low A1c with very infrequent incidences of hypoglycemia. There were only 2 occurrences of significant hypos in that 2 year period, although I did have other marginal low blood sugars. I attributed some of this to the rapid onset of action and the short duration of action of the TI.

So I am not surprised by the information Al Mann has revealed about Afresa. I was disappointed when the trial ended and had to return to injected Humalog. My A1c is now in the range of 6.8 again. Recently I began pumping insulin. It would certainly be interesting to incorporate inhaled Afresa with a basal insulin delivered with a pump.