Experiences With Inhaled Insulin in a Real-World Sample of Adults With Type 1 Diabetes in the T1D Exchange Registry

The purpose of this study was to (1) describe characteristics of people who have used inhaled insulin (Afrezza), (2) explore their experiences with obtaining and using inhaled insulin, and (3) assess perceived impacts of inhaled insulin on quality of life (QoL) related to diabetes management.

A cross-sectional survey was collected from adults with type 1 diabetes (T1D) or latent autoimmune diabetes (LADA) who currently use or previously used inhaled insulin. Participants were recruited from the T1D Exchange Registry. All participants responded to survey questions regarding their experiences with inhaled insulin; responses were compared between current and past users using Welch's t tests or were summarized using descriptive statistics.

The sample included 151 respondents (89 current users and 62 past users), most of whom used a continuous glucose monitor (96%) and self-reported an A1C <7% (77%). On a 5-point scale, the most important consideration for continuation of inhaled insulin reported among current users was perceived effectiveness in lowering glucose levels (M = 4.8), while the most important consideration for discontinuation among past users was the out-of-pocket cost (M = 3.4). Using a 5-point Likert scale, overall QoL ratings were higher (mean difference = 0.8, 95% CI, 0.61.0]) among current users (M = 4.3) compared with past users (M = 3.5).

In a real-world sample of people with T1D and LADA, current users felt that Afrezza positively impacted their daily lives. Still, barriers to access remain. Efforts to reduce financial and obtainment obstacles may support broader use of inhaled insulin.