Inhaled Insulin Effective Add-on for Diabetics

NEW YORK (Reuters Health) - Inhaled insulin offers patients with type 1 diabetes the potential of avoiding pre-meal injections -- without any loss of diabetes control, a study shows. "This can improve their quality of life, " Dr. Jay S. Skyler, of the University of Miami, who led the study, told Reuters Health.

In the study, taking an inhaled form of insulin before meals with insulin injections at other times during the day provided blood sugar control comparable to that of a conventional all-injection insulin regimen and was equally well tolerated.

The study involved 328 patients with type 1 diabetes who received twice daily injections of insulin and were randomized also to have premeal inhaled insulin or premeal injected insulin for a 6-month period. The results appear this month in Diabetes Care.

According to the paper, a similar number of patients in the inhaled group (23.3%) and the all-injection group (22.0%) achieved optimal blood sugar levels during the study. Post-meal blood sugar reductions were comparable between groups, but there was a greater reduction in fasting blood sugar levels in the inhaled group.

There were fewer episodes of low blood sugar or hypoglycemia in the inhaled compared with the all-injection group (9.3 versus 9.9 episodes per patient-month). However, the rate of severe episodes was greater in the inhaled group.

Both group experienced a similar weight gain of about 1.4 kg and insulin use in both groups increased slightly over the study period. Lung function was also comparable between the two groups.

Given these findings, the researchers conclude that pre-meal inhaled insulin may provide an alternative to injected insulin as part of an overall treatment plan in patients who are unwilling or unable to use premeal insulin injections.

SOURCE: Diabetes Care July 2005.