Nesina vs. Afrezza for Diabetes Type 2: Important Differences and Potential Risks.

Key takeaways

Alogliptin (Nesina) and Afrezza (insulin) are medications used to help manage diabetes, but they work in different ways. Alogliptin (Nesina) is a dipeptidyl peptidase-4 (DPP-4) inhibitor taken once daily to treat Type 2 diabetes by helping your body produce more insulin and less sugar. It doesn't cause significant changes in your body weight and is available as a lower-cost generic. On the other hand, Afrezza (insulin) is a fast-acting insulin inhaled through the mouth before meals to help lower blood sugar in adults with Type 1 or Type 2 diabetes. It starts working in about 12 minutes and lasts for 1.5 to 3 hours. Afrezza (insulin) is a good option if you prefer not to use injections, but it can't be used if you have breathing problems like asthma or chronic obstructive pulmonary disease (COPD). Common side effects of alogliptin include headaches and common cold symptoms (such as sneezing or runny nose), while Afrezza can cause low blood sugar, cough, and throat irritation. Additionally, Afrezza is not recommended if you smoke or have recently quit smoking.

Alogliptin

(Nesina)

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Afrezza

(insulin)

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Summary for Nesina

Prescription only

Alogliptin (Nesina) is a medication that treats Type 2 diabetes. It's added to diet and exercise to help lower your blood sugar levels. But it isn't a first-choice treatment for this condition. Alogliptin (Nesina) is typically taken by mouth once a day. Some people may experience certain side effects, such as headaches or symptoms of the common cold (e.g., sore throat or runny nose), after starting this medication.

Indications for Nesina

Type 2 diabetes

Pros and Cons for Nesina

Pros

Taken once daily by mouth
Can be taken with or without food
Is available as a lower-cost generic

Cons

Dose may change if you have kidney problems, while other similar medications, like Tradjenta (linagliptin), don't need dose changes
Not a first-choice treatment for Type 2 diabetes
Isn’t approved for Type 1 diabetes

Common Side Effects for Nesina

Upper respiratory tract infection (5%)
Common cold (5%)
Headache (4%)

Warnings for Nesina

Heart failure
Severe joint pain
Inflammation of the pancreas
Liver problems
Severe itching rash

Summary for Afrezza

Prescription only

Afrezza is an ultra rapid-acting inhaled insulin for adults with diabetes. It helps manage blood sugar levels from meals. You breathe in the medication through the mouth using the Afrezza inhaler usually at the start of meals. Common side effects are low blood sugar and cough. There's also a risk of bronchospasm (sudden narrowing of the airways), which can make it hard to breathe. So Afrezza (insulin) isn't for people with breathing problems like asthma or chronic obstructive pulmonary disease (COPD).

Indications for Afrezza

Type 1 diabetes (T1D) in adults
Type 2 diabetes (T2D) in adults

Pros and Cons for Afrezza

Pros

A good choice for people who don't want to use injectable insulin
Can help people with either Type 1 or Type 2 diabetes manage blood sugar
Starts to work in about 12 minutes and lasts between 1.5 and 3 hours, depending on your dose

Cons

Might need to use more than one cartridge of insulin for your dose (if you need more than 12 units of insulin)
Not for people who smoke or for people with breathing problems (e.g., asthma, COPD)
Not approved for children

Common Side Effects for Afrezza

Low blood sugar (up to 67%)
Cough (up to 29%)
Throat pain or irritation (up to 6%)
Headache (up to 5%)

Warnings for Afrezza

Breathing problems
Low blood sugar levels (hypoglycemia)
Changes in blood sugar levels with changes to your insulin routine
Diabetic ketoacidosis
Low potassium levels
Swelling from fluid buildup and risk of heart failure when taken with certain diabetes medications