{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T16:48:57Z","timestamp":1792514937770,"version":"4.5.0"},"reference-count":48,"publisher":"SAGE Publications","issue":"1_suppl","license":[{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100014598","name":"MannKind Corporation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100014598","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Technology &amp; Therapeutics"],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"<jats:p>Reliance on endogenous insulin remains a significant challenge for individuals with type 1 diabetes (T1D). Although current rapid-acting insulin analogs (RAA) and ultra-rapid-acting insulin analogs (URAA) can provide effective postprandial glycemic control, inaccurate calculation of carbohydrates and mistiming of insulin injections can result in postprandial glucose spikes or early hypoglycemia. Their long duration of action also raises concerns about insulin stacking, which may result in late postprandial hypoglycemia. Unlike injected or infused rapid-acting insulins, Technosphere\u00ae insulin (TI) may bypass the slower absorption and hepatic degradation associated with subcutaneous delivery, ensuring faster systemic availability; however, definitive studies have not been conducted. This characteristic of TI aligns closely with the timing of ketone body production, enabling timely intervention to prevent progression to full-blown ketoacidosis. The RAA and URAA profile characteristics are also problematic for individuals who engage in regular physical activity, often resulting in hypoglycemia, hyperglycemia, or both. This article reviews the challenges and potential dangers associated with managing T1D and discusses how TI, the only commercially available inhaled insulin, may overcome the inherent limitations of current RAA and URAA therapies.<\/jats:p>","DOI":"10.1177\/15209156251408036","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T04:16:49Z","timestamp":1770005809000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Potential Applications of Inhaled Insulin in Diabetic Ketoacidosis Prevention and During Exercise: Two Case Presentations"],"prefix":"10.1177","volume":"28","author":[{"given":"Michael C.","family":"Riddell","sequence":"first","affiliation":[{"name":"School of Kinesiology and Health Science, York University, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher G.","family":"Parkin","sequence":"additional","affiliation":[{"name":"CGParkin Communications, Inc., Henderson, Nevada, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren V.","family":"Turner","sequence":"additional","affiliation":[{"name":"School of Kinesiology and Health Science, York University, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Halis Kaan","family":"Akturk","sequence":"additional","affiliation":[{"name":"Barbara Davis Center for Diabetes, Aurora, Colorado, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/1932296816658055"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1326.2011.01500.x"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/dia.2007.0212"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrd2153"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.27.1.239"},{"issue":"1","key":"e_1_3_2_7_2","article-title":"A Phase 1, Open-label, randomized dose proportionality study of Technosphere\u00ae Insulin Inhalation Powder (TI) doses up to 80 U administered with the Gen2 Inhaler in Healthy Subjects","volume":"62","author":"Baughman RA","year":"2013","unstructured":"Baughman RA, , Amin N, , Watkins E, et al. A Phase 1, Open-label, randomized dose proportionality study of Technosphere\u00ae Insulin Inhalation Powder (TI) doses up to 80 U administered with the Gen2 Inhaler in Healthy Subjects. Diabetes, 2013; 62(Suppl. 1):A251 abstract 982-P. Available from: https:\/\/diabetesjournals.org\/diabetes\/article\/62\/Supplement_1\/A217\/14422\/Clinical-Diabetes-Therapeutics?searchresult=1","journal-title":"Diabetes"},{"key":"e_1_3_2_8_2","unstructured":"MannKind FDA document MannKind Corporation. Afrezza highlights of prescribing information. 2016. Available from: http:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2014\/022472lbl.pdf [Last accessed: January29 2016]."},{"key":"e_1_3_2_9_2","unstructured":"FDA Briefing Document. Endocrinologic and Metabolic Drug Advisory Committee. 2014. NDA 022472. AFREZZA (insulin human [rDNA origin]) inhalation powder: An ultra-rapid acting insulin treatment to improve glycemic control in adult patients with diabetes mellitus. 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