Inhale insulin? Drugmaker bets kids with diabetes will want to skip the needle.

Mealtimes can be tricky for kids with diabetes. They need insulin to regulate their blood sugar, but many don’t like needles — or the attention.

A drug recently tested at the Johns Hopkins Hospital in Baltimore and multiple other sites around the country may offer help: inhaling the insulin.

Insulin delivered through an inhaler, like those for asthma, worked just as well as injected insulin in the study, said Dr. Risa Wolf, director of the Johns Hopkins Pediatric Diabetes Center, who helped oversee the local testing.

“But another big finding was satisfaction was very high for inhaled insulin,“ she said. “For kids who need multiple injections a day, it’s a nice alternative.”

The drug Afrezza, developed by the California biopharmaceutical company MannKind, is a powdered version of insulin, delivered from a portable inhaler and absorbed quickly into the bloodstream through the lungs. On the heels of the study, the U.S. Food and Drug Administration approved its use in kids ages 6-17 at the end of May.

It’s the second try for Afrezza, which was approved more than a decade ago for adults but had little uptake. The study suggested, and others believe, demand would be higher from young people.

There are about 364,000 Americans under age 20 diagnosed with diabetes, mostly Type 1, in which the body doesn’t produce lifesaving insulin, according to the American Diabetes Association. Almost 1 in 3 teenagers has pre-diabetes, putting them at risk of Type 2 diabetes, commonly associated with obesity.

Wolf said kids can be prickly about needles and teens can be sensitive about having to use shots or a wearable pump that delivers insulin under the skin.

There are other potential benefits, Wolf said. Inhaled insulin activates fast, so kids can take a puff and have a snack right away. It also clears fast so they can go right into sports or exercise without feeling fatigued from low blood sugars.

This could make kids less apt to skip a dose, which can lead to a dangerous spike or hospitalization. Over the long term, uncontrolled diabetes can cause heart and kidney damage, blindness and nerve damage.

But Wolf and others said kids will likely face some of the same issues as adults. Afrezza isn’t a replacement for daily, long-acting insulin, administered through those shots or a pump, and working in use at mealtimes could take practice and counseling. Insurance approvals can take time.

Cost, at hundreds of dollars for an inhaler, was also seen as burden. But MannKind said it is taking steps to control costs, such as limiting the out-of-pocket price to $35 for most patients on commercial plans, even for those who don’t fall under a state cap, including one in Maryland.

Michael Castagna, MannKind CEO, acknowledged challenges that arose with the adult version during calls with investors in May. But he said officials are working to address them.

Besides costs, he cited efforts to increase doctors’ awareness of Afrezza by working with pediatric diabetes centers, some of which participated in the recent study, to ensure they know about the benefits.

Others, including Marissa Hitchcock, the clinical director for Children With Diabetes, a nonprofit that provides education and support to families of those with Type 1 diabetes, see Afrezza as another tool.

She said hurdles aren’t insignificant, especially working Afrezza into daily routines and tangling with insurance. Hitchcock, who has lived most of her life with Type 1 diabetes, said the best bet for the new therapy is likely teens, who struggle with feeling different and often have irregular eating schedules. She cited a colleague who felt relief when her daughter, who just started on Afrezza, insisted on going to the beach with friends and without her insulin pump.

“Diabetes is really hard,” Hitchcock said. “Everything affects your blood sugar levels. The more options we have to meet our goals the better.”