Inhaled Insulin: A New Option for Kids With Diabetes

July 10, 2026

University Hospitals Rainbow Babies & Children'sExperts in Children's Health

smiling child drinking from cup at school lunch

The U.S. Food and Drug Administration (FDA) recently approved the use of inhaled insulin for children and teens with type 1 or type 2 diabetes.

“This is the first needle-free insulin option for kids in more than a century of diabetes research,” says Jamie Wood, MD, a pediatric endocrinologist and Medical Director of Pediatric Diabetes at University Hospitals Rainbow Babies and Children's and a principal investigator for the study.

About Insulin and Diabetes

Insulin is a hormone that helps the body use sugar (glucose) from the blood as fuel. Type 1 diabetes occurs when the pancreas stops making insulin completely. Type 2 diabetes happens when the body can’t produce enough insulin or isn’t able to use it properly.

“In both cases, unhealthy levels of glucose build up in the bloodstream, which can cause serious health problems and damage organs over time if the disease is left untreated,” says Dr. Wood.

How Inhaled Insulin Works

All people with type 1 diabetes, and many with type 2 diabetes, take insulin before meals to manage blood sugar spikes caused by eating, typically with insulin injections or pumps. Inhaled insulin works similar to an asthma inhaler, delivering insulin deep into the lungs, where it quickly enters the bloodstream.

“Injected insulin usually takes 1 to 2 hours to reach its peak effect of lowering your blood sugar,” says Dr. Wood. “Inhaled insulin is much quicker, reaching its peak in just 35 to 45 minutes.”

Another important difference between inhaled insulin and injected insulin is how long it stays active in the body: Inhaled insulin lasts for 1.5-2 hours, while injected insulin can take 4-6 hours to leave the body.

“When insulin stays in the body too long, it can cause low blood sugar levels, which can lead to fatigue and various other symptoms,” says Dr. Wood. “Inhaled insulin leaves the body much faster. In this way, inhaled insulin is similar to the natural insulin produced by a healthy pancreas, which peaks almost immediately and leaves the body very quickly.”

What the Research Showed

The study included 230 children ages 4 to 17 with type 1 or type 2 diabetes. Participants were randomly assigned to use Afrezza inhaled insulin or daily insulin injections for 26 weeks.

“The trial found that inhaled insulin worked just as well as insulin shots for managing blood sugar in children and teens,” says pediatric endocrinologist Sarah MacLeish, DO, who assisted with the study. “Importantly, participants who used inhaled insulin reported they were more satisfied with their treatment than those who took injections.”

Benefits for Young People

Inhaled insulin can help people of all ages. But it may be especially helpful for children and teens, who face unique difficulties managing the disease.

“It’s not unusual for kids with diabetes to experience high blood sugar levels from missing mealtime insulin injections,” says Dr. Wood. “This can happen for a number of reasons. Some kids are afraid of needles. Others are embarrassed to use their insulin syringe or pen in front of friends and classmates.”

Timing can also be difficult. Kids usually need to take insulin 15 to 20 minutes before eating. This can leave them with little time to eat during short school lunches. With inhaled insulin, they can take their dose and eat right away.

Improving Blood Sugar at Football Practice

One of patients that Dr. Wood cared for in the study was a high school football player with a severe fear of needles. He often ate meals with only protein and vegetables, skipping carbohydrates, and struggled with low blood sugar levels at practice because his insulin stayed in his body too long.

“This young man was one of the participants assigned to take inhaled insulin,” Dr. Wood says. “He was very grateful and decided to continue with inhaled insulin after the study. He no longer has to worry about needles or experiencing low blood sugar levels at football practice.”

Increasing Awareness

Despite being an approved treatment option, inhaled insulin is often overlooked. Many people with diabetes don't know it's available, and some healthcare providers may not routinely consider or discuss it.

“The American Diabetes Association now recommends that healthcare providers offer inhaled insulin as an option to their patients,” Dr. Wood says. “The new approval of inhaled insulin for children should help boost awareness, too.”