Diabetes Type 2 Support Group

Some of our members in the Type I community posted about this so I wanted to post in our Type II community:

Here is info on the inhaled insulins:
The first inhaled insulin was FDA approved Jan 2006 and is called Exubera and another is pending approval.
Inhaled insulin was approved as an alternative to subcutaneous rapidly-acting insulin. Some studies have shown that inhaled insulin causes a very rapid rise in serum insulin concentration (similar to that after subcutaneous insulin lispro and aspart, and faster than that after subcutaneous regular insulin).
The one approved inhaled insulin (Exubera) involves the use of a bulky device to burst and disperse small capsules (blisters) of powdered insulin which has limited its use. Several other manufacturers are developing inhaled insulin preparations with smaller devices.
Most studies are in poorly controlled Type II Diabetics and Inhaled insulin may also be useful in the management of type 1 diabetes (I can post some detailed results in those studies if there in interest)

There are PROBLEMS with inhaled insulin:
1) Cough is a problem and in one study the incidence of cough was 21 percent
2) The use of inhaled insulin causes a decrease in carbon monoxide diffusing capacity as monitored on Pulmonary Function Tests of study participants (we dont know the clinical significance if any of this)
3) Smoking may increase the effect of inhaled insulin so it is contraindicated in current or recent (within past six months) smokers, and in patients with asthma, COPD, or other lung disease.
4) Cost is significantly greater with inhaled insulin
5) The current clinical indications for use of inhaled insulin are being evaluated. At this time, given its higher cost, constraints in dosage flexibility, and questionable efficacy in achieving "tight" glycemic control, inhaled insulin is most appropriately prescribed for patients with poor glycemic control who have demonstrated phobia to injection therapy or injection site problems.
Thoughts?
Dr O.
Posted on 01/03/07, 12:01 am