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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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.

Subscribe for practical diabetes management tips, technology updates, and treatment breakthroughs that help people with diabetes live healthier, more flexible lives.

More diabetes resources:
Website: tcoyd.org
Blog: tcoyd.org/blog
Podcast: tcoydthepodcast.transistor.fm
Instagram: / tcoyd
Facebook: / tcoyd
Stay connected! Sign up for our monthly newsletter here!
Support TCOYD's educational programs: tcoyd.org/donate

What diabetes technology is actually helping people right now—and how do you figure out what fits best into your life?

In this 100th episode of the TCOYD Podcast, Dr. E and Dr. P are joined by diabetes nurse practitioner and educator Rachael Sood, founder of The Diabetes Collective, to talk through the latest updates in diabetes technology and what they’re seeing in real-world diabetes care.

The conversation focuses on how much diabetes technology has changed over the past few years, from hybrid closed loop systems and CGMs to new developments in sensing and automation. Rather than focusing on one “best” device, the discussion centers around finding the right fit for each person’s lifestyle, preferences, and goals.

Dr. E, Dr. P, and Rachael also talk about where technology may be headed next, including dual glucose and ketone sensors, more compatibility between pumps and CGMs, and the possibility of systems that require less hands-on work from people living with diabetes. The takeaway is encouraging: there are more tools and options than ever before, and diabetes technology continues to move toward making daily management simpler, safer, and more flexible.

Key Topics
• Choosing the right insulin pump and CGM
• Tubed vs. tubeless pump systems
• How lifestyle and personal preference shape technology choices
• The latest updates in automated insulin delivery systems
• Dexcom G7 10-day vs. 15-day sensors
• Abbott’s dual glucose and ketone sensor technology
• Medtronic’s newest technology developments
• Real-world conversations patients have about wearing devices
• Continuous ketone monitoring and DKA prevention
• The future of fully closed loop systems
• Why compatibility between pumps and CGMs matters
• Technology options for people with type 2 diabetes
• Where diabetes technology may be headed next

✨ Subscribe for practical diabetes management tips, technology updates, and treatment breakthroughs that help people with diabetes live healthier, more flexible lives.

More diabetes resources:
Website: tcoyd.org
Blog: tcoyd.org/blog
Podcast: tcoydthepodcast.transistor.fm
Instagram: / tcoyd
Facebook: / tcoyd

Stay connected! Sign up for our monthly newsletter here!
Support TCOYD's educational programs: tcoyd.org/donate