Inhaled Insulin Benefits Type 2 Diabetics

NEW YORK (Reuters Health) - Inhaled insulin is effective therapy for patients with type 2 diabetes who fail to obtain adequate blood sugar control with diet and exercise, according to a report in the journal Diabetes Care.

Dr. Ralph A. DeFronzo from University of Texas Health Science Center, San Antonio, and colleagues 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 did patients taking rosiglitazone (82.7 percent vs. 58.2 percent, respectively), the authors report.

More patients taking inhaled insulin also achieved hemoglobin A1c levels below 7 percent (44.0 percent vs. 17.9 percent), the report indicates.

Insulin use was associated with a greater number of low blood sugar episodes, the researchers note, 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.

"To our knowledge," the investigators write, "this represents the only demonstration that American Diabetes Association goals for (blood sugar) control can be achieved in many type 2 diabetic patients using only a rapid-acting insulin."

"Additional studies are currently underway to further confirm these findings," the authors conclude. "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."

SOURCE: Diabetes Care, August 2005.