www.youtube.com/watch?v=zC_eh34s3aQ

Link to video: Injecting Insulin

Not only were we still shell-shocked with the diagnosis and not really understanding of how to manage our son’s condition (turns out what we learned in Thailand was pretty lacking), but we had certainly never had to carry needles onto a plane.

We survived all 17 hours of the flight however and here’s how we did it:

1) Organized: We were very organized with all of our gear and snacks. We separated out all of our needles and insulin (pens and syringes) and we separated out a couple cartons of juice and some snacks. We had all of this in an individual bag.

2) Prepared with Documentation: We had 2 copies of a note from our physician there in Thailand, both in Thai and in English. The note clearly explained that our son had diabetes and that it was necessary for him to take insulin via injection at regular intervals. This note was absolutely necessary getting through security and on-board.

3) Open: We were very open at each stage of boarding our plane. Before getting to the airport we called the airline and alerted them. When we checked in, they saw the note in our file and we once again reminded them of our need to carry needles onto the plane. At security, before getting in line, we alerted the officials and they worked with us to move through the line and the bag checks. When we arrived at the gate we told them once again of our situation.

4) Persistent: When we got to the gate, the cabin crew required us to surrender our insulin and syringes, explaining to us that they would hold the medication with the head crew member. We accepted this, but before the doors of the plane closed, we sought out the cabin crew manager and had her physically show us that she had possession of our insulin. Soon after takeoff, she actually came by our seats and gave us all the medication to hold onto.

Once we were in possession of everything we needed, we simply managed as normal, giving our son his injections right in his seat. And with all long flights, we made a point of getting up and walking around in order to keep our legs and minds fresh.

There were a lot of steps to go through to get our insulin on a plane, explain our situation to the airline, and ensure we could manage our son’s diabetes in a normal fashion. But with a little forethought and persistence, we found that traveling with diabetes on a plane was not that difficult.

It includes discussion of a new device to help diagnose diabetes by reading glucose levels through the skin, a new breath-based glucose monitoring device that would hopefully replace your normal glucose monitoring pricks, and a new injection ‘well’ that provides a painless way to take your daily insulin shots.

Reducing Insulin Punctures

For months, skeptical traders have expressed concern that the diabetes drug, if approved by the Food and Drug Administration, might end up with an FDA cancer advisory. Fears that the inhaler would never take off were still lurking Tuesday, even though MannKind said that trials of its Technosphere insulin delivery system showed no elevated cancer risk.

Analysts said those concerns helped push the company’s stock down 14% to $2.92 on Tuesday. MannKind shares have fallen 54% since April 1.

MannKind’s founder, Los Angeles billionaire Alfred Mann, remains optimistic. He says independent market surveys suggest that, even with an FDA warning, Technosphere will be a “blockbuster product.” It could pull in more than $1 billion in annual sales, he said in a phone interview.

And a warning label, which would probably blanket the entire class of insulin inhalers, is unlikely, he said. Technosphere should fly through the approval process and be relatively cheap to produce, he said.
“We fill a really poorly met need,” he said. “So we don’t understand the negativity.”

MannKind said Tuesday that results from a year of study suggested that Technosphere was as effective as traditional injection treatments, according to the company. Patients with Type 1 diabetes experienced stable or lower weight and better blood sugar levels between meals, MannKind said.

The company said the drug had no negative effect on lung function, a problem that had loomed over other inhalers.

The data came with news of a collaboration between MannKind and Pfizer Inc. and anticipation of MannKind’s Sept. 23 presentation at the UBS Global Life Sciences Conference.

“These observations confirm the results of earlier studies and build on the important differentiating features of this product, including its positive effects on fasting glucose levels,” Dr. Peter Richardson, the company’s chief scientific officer, said in a statement.

But for all its promises of producing a super drug, MannKind has been battered by bad buzz for much of the year.

Pfizer stopped selling MannKind’s Exubera powder in October after abysmal sales, sparking an exodus from inhaler development by pharmaceutical companies, including Novo Nordisk in January and Eli Lilly & Co. in March.

When Pfizer revealed in April that Exubera may have caused lung cancer in six patients, MannKind’s stock promptly plunged nearly 60%.

MannKind and Pfizer said Tuesday that they hoped to transition some Exubera patients — particularly those with severe fear of needles and negative reactions to insulin injections — to the Technosphere inhalant.

If approved by the FDA, Technosphere “will find itself in the unenviable position of having to entirely rebuild a decimated market in the wake of the notorious failure of Exubera,” Cory Kasimov, an analyst with JP Morgan, said Tuesday in a note to investors.

As reported in Los Angeles Times, September 17, 2008

Before you were around someone with diabetes had you ever thought about your pancreas?  Probably not.  But once forced to understand glucose levels and insulin dosage you’re bound to really want to know what this organ was meant to do.

Essentially one of the core functions of the pancreas is to produce a protein hormone called insulin.  The production of insulin occurs continuously but fluctuates based on how many carbohydrates you are consuming.

As you eat carbohydrates they change into glucose and travel around your body.  The pancreas then kicks into action and produces just the right amount of insulin to counterbalance the glucose (amazing!).  As insulin is produced, it too travels around attaching to cell receptors throughout your body.  When glucose passes by, these insulin-laden receptors enable the cells in your body to absorb the energy or calories associated with the glucose.  The more glucose you have traveling around, the more insulin you need to absorb those calories.

Within the pancreas there are cells called beta cells that are responsible for creating your insulin.  This is where things have gone terribly wrong with Type 1 diabetes.  The beta cells have been destroyed and so the pancreas is no longer able to produce the insulin needed to help the body absorb glucose.

Without insulin in the body, a person can eat and eat but will eventually starve.  The inability to absorb the energy associated glucose (because insulin is not there on your cells) means that your body will start to look elsewhere for energy.  This is why extreme weight loss in a child is one of the warning signs of diabetes.

For those with Type 1 diabetes, because the pancreas is no longer able to produce insulin, they must provide their bodies with insulin by giving themselves injections or through a pump utilizing man-made insulin.

Though the onset of diabetes is devastating, it does help to remind us of the amazing complexity of the human body.