Taking an inhaled form of insulin before meals and a single injection of life long acting insulin daily provides blood sugar control comparable to that of a conventional all-injection insulin regimen in type 2 diabetics. Researchers from the Baylor University Medical Center in Texas, USA, conducted a study that involved 299 patients withdiabetes who previously took at least two daily insulin injections to control blood sugar. Half the participants switched to inhaled dry-powder insulin before each meal and a single injection of ultralente insulin at bedtime for 6 months. The others continued to receive all of their required insulin by injection. Results showed that blood sugar levels improved to a similar degree in the inhaled and subcutaneous insulin groups. However, 47 per cent patients in the inhaled insulin group achieved target glucose levels than the 32 per cent in the subcutaneous insulin group. Episodes of excessively low glucose occurred slightly less in the inhaled insulin group, and there were no differences in severe adverse events. There have been concerns that inhaled insulin affects the lungs, but there were no major differences in the comprehensive pulmonary testing done during the study. However, mild-to-moderate cough was reported more frequently in the inhaled insulin group, but it occurred less often as the study progressed. In addition, patients treated with inhaled insulin gained significantly less weight than the patients treated with injected insulin. Further long-term studies of inhaled insulin are required.
Diabetes Care,
October 2004