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

Key takeaways

Acarbose (Precose) and Afrezza (insulin human inhaled) are both used to manage diabetes, but they work in different ways and have distinct characteristics. Acarbose is an alpha-glucosidase inhibitor taken orally with meals to slow down carbohydrate digestion, which helps control blood sugar levels in people with Type 2 diabetes. It is less likely to cause hypoglycemia when used alone but can cause side effects like gas and diarrhea. On the other hand, Afrezza is a fast-acting insulin inhaled through the mouth before meals, suitable for both Type 1 and Type 2 diabetes. It starts working within minutes but can cause low blood sugar, cough, and throat irritation. Afrezza is a good option for those who prefer not to use injections, but it is not recommended for people with breathing problems like asthma or COPD. Unlike acarbose, Afrezza is available in a branded form and requires careful handling and storage.

Acarbose

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Afrezza

(insulin)

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Summary for Precose

Prescription only

Acarbose is a medication that's used together with a healthy diet and exercise to help control blood sugar in adults with Type 2 diabetes. It isn't as commonly used as other diabetes medications since it can lead to some unpleasant side effects like gas and diarrhea. But acarbose is less likely to cause hypoglycemia compared to other diabetes medications when used on its own. This medication is only available as the generic name acarbose since the brand name Precose has been discontinued.

Indications for Precose

Type 2 diabetes

Pros and Cons for Precose

Pros

Not likely to cause weight gain, instead it might cause weight loss
Helps control blood sugar levels after you're eating
Low risk of low blood sugar when used alone
Can be used with other diabetes medications
Available as a lower-cost generic

Cons

Must be taken multiple times a day
Needs to be taken with meals
Side effects include excessive gas and diarrhea
Not recommended for people with severe kidney problems
Typically not considered a first-choice treatment option

Common Side Effects for Precose

Excessive gas (74%)
Diarrhea (31%)
Stomach pain (19%)

Warnings for Precose

Low blood sugar when taken together with other diabetes medications
Changes in liver labs
Losing control of blood sugar

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