Inhaled Insulin
Circulation 2000;101 - has an article on Inhaled insulin as effective as injections, by Cefalu, W, MD et al . Dr Cefalu presented his findings at the 82nd annual meeting of the Endocrine Society. The results of a multi-center phase II study shows that insulin that can be inhaled results in glycemic control comparable to that achieved with conventional insulin injections. A total of 70 patents with type 1 and type 2 diabetes at nine centers were randomized in an open-label study to use either the inhaled insulin before meals, with an insulin injection at bedtime, or their usual subcutaneous injections or oral hypoglycemic medication. There was a 4-week lead-in period in the study. then a 12 week treatment period. Both groups performed home glucose monitoring four times daily, had weekly insulin dose adjustment, and had prepandial glucose targets of 100mg/dl to 160 mg/dl.
The inhalation device comprises a clear plastic cylinder about 10 inches tall, the base of which holds a container of compressed air. Insulin is kept in small, single-dose sachets that are inserted into the device, punctured, and then aerosolized by the compressed air. The patient inhales once through the mouthpiece. Each sachet contains either 1 mg or 3 mg of drug, with a 1 mg sachet being comparable to a 3-unit dose delivered by syringe The researcher found that the inhaled insulin worked similarly well as injections and proved to have an advantage when used by patients with type 2 diabetes who had been on oral agents only.