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Letter From The Editor

After a long battle and comments from many doubters the FDA has approved the inhaled insulin, Afrezza. As soon as the approval came the nay-sayers were quick to remind us of what a failure Exubera had been and there was no way that this new inhaled insulin stood a chance.

When Exubera first came out, there were about 100 of us who were flown to New York to become "train the trainers" for the product. If you remember, it was cumbersome and hard to use and converting mg's to units was tedious at best.

One of the professionals who was with me in NYC was Dr. R. Keith Campbell, RPh, FAADE, FASHP, FAPhA, CDE and Professor Emeritus at Washington State University. Dr. Campbell has lived with type 1 diabetes for over 50 years and is the guru when it comes to new insulin therapies.

This week we asked Dr. Campbell to share his research and opinions on this new inhaled insulin and why the time is right for patients to use it. In addition he has secured for us the actual package insert for the medication as well as the Medication Guide. Please read his article and if you would like to share your opinion on this new product just email me at

Just last week my daughter got the brand new LG G3 phone. It is the latest thing out there and has some new bells and whistles. We often expect technology to make things better but who ever thought that it would happen with lancing devices? Be sure to check out this week's new product, Genteel, and find out what happens when technology meets the needle.


From "Champion cross-country skier Kris Freeman faces his demons in the Olympics; expert tips for drugstore diabetes shopping; and Jim Turner asks spouses how they deal with diabetes challenges." Sundays live online at at 7 PM ET, 6 PM CT, and 4 PM PT. Keep up on the latest dLife news at
We can make a difference!

Dave Joffe, Editor-in-chiefRead More

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Novartis and Google Developing Smart Contact Lens to Monitor Blood Sugars

See this week's Item #11. 

Tool for your Practice

Prescribing Information and the Medication Guide for Afrezza 


For this week's Tool for Your Practice, we have PDF's for you of the newly FDA-approved inhaled insulin Afrezza's Prescribing Information and Medication Guide. Afrezza Prescribing Information and Afrezza Medication Guide


Product of the Week

Genteel - The First Pain Free Lancing Instrument 

genteel-imageGenteel is a radically new lancing instrument that completely replaces the more-familiar industry-standard spring-loaded devices. Genteel's patented technology allows patients to get the right amount of test blood from both fingers and alternate sites the first time, every time, without pain, or the need to squeeze lance sites. Genteel is ideal for anyone needing a small drop of test blood, such as diabetics, those on blood-thinners, or patients using at-home test kits. Genteel will be at the AADE Meeting in August at Booth #234. Stop by to test it! Genteel 



Special Feature -- AFREZZA: Treating Diabetes in a Physiologic Manner 

R. Keith Campbell, RPh, FAADE, FASHP, FAPhA, CDE

r_keith_campbellThe health care crisis created by the explosion of diabetes worldwide is one of society's greatest challenges. The IDF projects that the prevalence of diabetes by 2030 will be over 550 million patients worldwide. When one adds in the patients with "prediabetes" who presently are not often treated, the impact on health care becomes frightening. Diabetes is a family of diseases that have in common hyperglycemia. Glucose, the main fuel of the body is needed by all cells all of the time. Glucose is supplied to the entire body during meals from ingested food and between meals from glucagon stored in the liver. Insulin is supplied from the beta cells in the pancreas to utilize the glucose for the cells as the glucose levels become elevated. In a healthy person it is provided in two waves, the phase 1 at the first ingestion of carbohydrates and phase 2 to manage the extended glucose level from the meal. In type 1 diabetes the immune system destroys the beta cells and insulin is no longer secreted. In type 2 diabetes, the first phase release is blunted and the patient becomes resistant to the effect of the insulin. Also in type 2 patients, more glucose is released by the liver, incretin (gut) hormones are diminished, the kidney reabsorbs more glucose and glucose levels spike in response to the meal. Excess glucose via several changes in normal physiology create diabetes complications including retinopathy (eye), neuropathy (nerve), nephropathy (kidney) and blood coagulation disorders. Excess glucose combined with hypertension and lipid disorders result in the enhancement of heart disease and a financial burden on health care systems.... Full Story


Mobile App of the Week 



This very popular app just released a new version which has eliminated some previous bugs. Many medical professionals consider UpToDate an essential tool for their practice. The app is a clinical resource designed to assist with diagnosis and treatment. Information is presented in the form of topic reviews, each one addressing a particular clinical issue; those on treatment or management topics include recommendations. Topic reviews contain links to other related topics and are fully illustrated and referenced. You can view related charts, x-rays, photographs, movies and Medline abstracts by clicking on the associated links. There is complete access to an extensive drug database. UpToDate contains the equivalent of 50,000 pages of original, peer-reviewed text. Just follow this link for more information and to download the app for either iOS or Android.  


Test Your Knowledge Question #738

A 57 year-old man with type 2 diabetes and renal insufficiency (eGFR 36 mL/min/1.73 m2) presents to your office and you consider adding a SGLT2 inhibitor to their current regimen for diabetes. An SGLT2 inhibitor would not be a good choice in this patient since his eGFR less than the recommended cut off of:

A. 60 mL/min/1.73 m2

B. 55 mL/min/1.73 m2

C. 45 mL/min/1.73 m2

D. 40 mL/min/1.73 m2 

For the complete question and answer, just follow this link.


Diabetes In Control Has Over 14500 Studies & Articles In Our Archives

Quote of the Week!

"Many of life's failures are people who did not realize how close they were to success when they gave up."

                  ..............Thomas A. Edison 

Diabetes in Control gratefully acknowledges the assistance of the following University of Florida pharmacy doctoral candidate in the preparation of this week's newsletter: 

William Siu, LECOM College of Pharmacy

Rebecca Buck, Creighton University School of Pharmacy


Joanne Dam, LECOM College of Pharmacy


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CME/CE of the Week
Robert A. Warriner, III, MD, ABPM, FACC, FCCWS

Category: Wound Care
Credits: .75


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