Inhaled Insulin for Kids: Inside the INHALE-1 Trial

In this episode of the TCOYD Podcast, Drs. Edelman and Pettus are joined by pediatric endocrinologist Dr. Jamie Wood, medical director of pediatric diabetes at Rainbow Babies & Children's Hospital and an investigator on the INHALE-1 trial, to discuss inhaled insulin in children and its place in pediatric practice.

The conversation centers on the recent approval of Afrezza down to age six and what INHALE-1 actually demonstrated. Dr. Wood walks through the trial design, the A1C analysis, the FEV1 and pulmonary safety data, the weight and BMI findings, and the practical mechanics of dosing in a pediatric population. Rather than framing it as a replacement for injections or automated insulin delivery (AID), the discussion focuses on where this option fits, from the needle-averse newly diagnosed patient, to the teen trying to bolus discreetly during a 20-minute lunch period.

Drs. Edelman, Pettus, and Wood also get into the clinical realities that shape real-world use: the 2:1 to 3:1 conversion versus subcutaneous insulin, the set-dose cartridges and how they reframe carb counting, a refined titration approach, side effects, and how inhaled insulin can be layered alongside pumps and AID. For a population where mealtime bolusing remains one of the most stubborn unmet needs, it is a grounded look at a new tool and the patients it may help most.

Key Topics

• The recent approval of inhaled insulin for children as young as six
• How the INHALE-1 pediatric trial was designed
• A1C results and what the primary endpoint analysis showed
• Continuous glucose monitor (CGM) metrics across the two groups
• Lung-function (FEV1) monitoring and pediatric safety
• Weight and body mass index (BMI) findings
• Why mealtime dosing is a leading unmet need in pediatric type 1 diabetes (T1D)
• The set-dose cartridge approach and how it reframes meal sizes
• A real-world titration method for inhaled insulin
• Managing cough and other practical considerations
• Needle phobia and the kids who struggle most with injections
• Using inhaled insulin alongside automated insulin delivery (AID) systems
• What's coming next, including a smaller cartridge dose and a new-onset trial

This episode is supported by an unrestricted educational grant from MannKind Corporation.

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