Inhaled insulin is effective for patients with type 2 diabetes, who fail to obtain adequate blood sugar control with diet and exercise. Researchers from the University of Texas Health Science Center, San Antonio, investigated whether administration of inhaled insulin before meals would prove better than rosiglitazone treatment in lowering blood sugar. They studied 402 patients with type 2 diabetes who had suboptimal control of blood sugar based on diet and exercise. Significantly more patients receiving inhaled insulin achieved a hemoglobin A1c target below 8.0 percent, a measure of blood sugar, than patients who took rosiglitazone (83 percent vs. 58 percent, respectively). More patients taking inhaled insulin also achieved hemoglobin A1c levels below 7 percent (44 percent vs. 18 percent). Insulin use was associated with a greater number of low blood sugar episodes, but there were no severe low blood sugar episodes in either treatment group. Reductions in fasting plasma glucose and 2-hour post-meal blood sugar levels were similar in the two treatment groups, the results indicate, but 24-hour self-monitored blood sugar improvements were better with inhaled insulin than with rosiglitazone treatment. Additional studies are currently underway to further confirm these findings. This indicates that inhaled insulin, as initial monotherapy, could be a safe and effective therapy for people with type 2 diabetes who do not achieve adequate (blood sugar) control through diet and exercise alone.
Diabetes Care,
August 2005