Living with Diabetes

By Dr. Phil Aaron

     Bradley Bradshaw of Glensfork, like his late father, Travis, has diabetes. Over the past several years his sugar has slowly been creeping up. He attributes this increase as being directly related to when he quit logging and started working with his wife, Joyce, and son, Darren, at their oak furniture store on the Glensfork Road. Bradley states that sometimes his sugar is “just out of control.” This happens every now and then, even when he doesn’t eat sweets or change his activity. His brother, Brian, who still works in the log woods is not diabetic nor is his mother, Doris Baker.

     Up to the present time, Bradley’s sugar has been fairly well controlled on oral medication. As long as he does minimal exercise, watches his diet, and takes his medication, his sugar stays petty well controlled. However, when he over eats or doesn’t exercise he is asking for trouble. Recently Bradley and I discussed the future of his diabetes. His type of diabetes, which he developed later in life, is referred to as non-insulin-dependant, or diabetes type II. This is different from the diabetes in a young person who always requires insulin.

     Bradley is knowledgeable about insulin because his father took insulin. Even though he is not afraid of taking shots, he seemed very interested in hearing about the new insulin, which is taken through an inhaler.

     Diabetes is a condition in which an individual’s pancreas either does not secret insulin or the insulin secretion is impaired. This affects about seven (7%) percent of the American population, some twenty one million people. We are told that some forty one million people have pre-diabetes or will develop diabetes in the future. Worldwide there are forty eight million Europeans who have diabetes and it is a major problem all over the world.

     For the last eighty years, since the early 1920’s, the only way to take insulin has been through injections. There have been a host of oral pills, which work in combination to reduce blood sugar, but insulin has been the mainstay of individuals who have advanced diabetes.

     It now appears that this may change. A new medication “Exubrea” has been developed. Exubrea is a needle-free alternative to pills and injections. Insulin packaged as a powder is inhaled through the mouth into the lungs by using a hand held inhaler. It is expected to be available by the middle of the year at a price competitive to injectable insulin. In experimental testing the inhaled insulin has received high marks in patient satisfaction and acceptance. It is a welcome relief to those who do not like injections. The cost of diabetes every year worldwide is about three hundred billion dollars. The majority of the cost is to treat diabetes-related complications like kidney disease, problem with eyes, and the heart. Injectable insulin, which amounts to a three billion dollar market will still, be available for those who prefer this route. It is expected that inhaled insulin will have a role with both groups of diabetics. In the type I diabetics whose insulin producing cells have been destroyed and who have a complete lack of insulin. In type II non-insulin-dependant diabetics where the body does not produce enough insulin to control the blood sugar, the injectable insulin may be replaced shortly.

     A mealtime insulin puff that releases insulin through the mouth into the lungs may replace insulin shots. But this new inhaled insulin is not for all patients. It cannot be used by individuals who smoke or who have smoked in the past six months. And the lungs of individuals who use inhaled insulin must be closely monitored. However, all in all the thought that insulin is becoming available through an inhaler instead through injections is a revolutionary idea, an idea that will be welcomed by many diabetics. According to Bradley Bradshaw, when and if the time comes when the pills don’t control his blood sugar, he thinks he would like to try the new inhaled insulin.