No one likes shots, even when you know that you need the medicine and it is helping you. That is why many people with diabetes were excited to learn that the Food and Drug Administration (FDA) recently approved the first-ever inhaled insulin. It is called Exubera and was approved for people with either type 1 or type2 diabetes.
HOW THE INHALED INSULIN WORKS
Exubera is a dry powder which comes in a foil blister packet. The blister is placed into an inhaler device that releases the insulin as you press a button. The insulin becomes an aerosole cloud, or vapor, that you then inhaler into your lungs where it can then get absorbed into your bloodstream. Once inhaled, Exubera works like insulin you take in an injection. The only type of insulin that is available for inhalation so far is a short acting form of insulin that is taken 10 minutes before meals. People with type 1 diabetes will still need to take a basal or longer-acting insulin shot. People with type 2 diabetes may need to take oral medications or a longer acting insulin along with Exubera. It is not approved for use in people under 18 years of age.
ASK FOR MORE INFORMATION
The idea of inhaled insulin is exciting, and is an important first step forward. If you are interested in inhaled insulin, talk with your health care professional about whether it is safe and right for you.
SOME THINGS TO KEEP IN MIND
- As with all insulins, hypoglycemia was the most common side effect. Hypoglycemia occurred the same amount of time in people taking Exubera or other short-acting insulin. Side effects include coughing, chest discomfort and dry mouth. Some people who were in the clinical trials had a small decrease in lung function but it did not get worse over two years of study. More long-term safety studies are underway.
- You need to have your lung function tested before starting Exubera, 6 months later and every 12 months thereafter.
- People who smoke or who have smoked in the past 6 months, or have asthma or other chronic lung conditions, should not use Exubera.
- People who want to take Exubera may need to carry the inhaler with them. The inhaler weighs about four ounces and is about the size of a closed eye glass case. Dosing in small unit-equivalents may be a problem, especially for people on small meal-time doses (less than 3 units/meal).
- People who take large amounts of rapid-acting insulin before meals may need to take more than one blister at a time to complete their dose.
- People will need adequate training to learn how to use Exubera and the inhaler.
- It is not clear if insurance companies will cover the cost of Exubera at this time.
