Inhaled Insulin Just Got FDA-Approved for Kids With Type 1

In this episode of the TCOYD Podcast, Dr. Steve Edelman is joined by pediatric endocrinologist Dr. Anna Cymbaluk, along with Philip and his father Jim, to discuss the recent FDA approval of Afrezza inhaled insulin for children and adolescents living with type 1 diabetes. Dr. Cymbaluk served as an investigator on the INHALE-1 trial, while Philip participated in the study himself, providing a unique real-world perspective on what it is like to transition from injections to inhaled insulin, and Philip’s dad, Jim provided the parent perspective as well as addressed parental concerns that might have arisen.

The conversation focuses on the INHALE-1 study and the unmet challenges that continue to exist around mealtime insulin dosing in pediatric diabetes care. Dr. Cymbaluk reviews the trial design, glucose outcomes, safety data, patient satisfaction findings, and the practical realities of introducing inhaled insulin into everyday diabetes management. Philip and Jim share how Afrezza impacted school, sports, social situations, and the day-to-day burden of diabetes, particularly around pre-bolusing, corrections, and avoiding multiple injections throughout the day.
Dr. Edelman and Dr. Cymbaluk also explore how Afrezza is dosed, how inhaled insulin differs from injected insulin, who may be a good candidate, and where it may fit alongside pumps and automated insulin delivery (AID) systems. For families looking for more flexibility, fewer mealtime barriers, and another option in the diabetes toolbox, this episode provides an honest look at the benefits, limitations, and real-world experience of inhaled insulin in children and teens.

Key Topics
• The FDA approval of Afrezza for children and adolescents living with type 1 diabetes
• The design and results of the INHALE-1 pediatric clinical trial
• Patient satisfaction and quality-of-life outcomes from the study
• The challenges of pre-bolusing and mealtime insulin management in children and teens
• How inhaled insulin compares to traditional mealtime injections
• Dosing strategies, cartridge sizes, and insulin conversion considerations
• Using Afrezza for corrections, meals, and post-meal dosing
• The role of continuous glucose monitoring (CGM) when using inhaled insulin
• Safety findings, lung-function monitoring, and cough management
• Who may be a good candidate for Afrezza—and who may not be
• Benefits for active children, athletes, and those participating in sports
• Social situations, injection avoidance, and reducing the burden of diabetes management
• Using Afrezza alongside insulin pumps and automated insulin delivery (AID) systems
• The importance of having more treatment options to individualize diabetes care

Supported by an unrestricted educational grant from MannKind Corporation

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