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Inhaled Insulin for Type 2 Diabetes Shows Mixed Results

Inhaled insulin, taken before meals, can improve blood glucose control for people with type 2 diabetes who have not had good results with short-acting injected insulin that is taken in addition to the baseline insulin administered throughout the day and night, according to a new review of the body of published research.
br> People who use insulin to manage their type 2 diabetes typically have to take extra insulin at mealtimes to regulate the glucose response to food. They can use short-acting injected insulin or inhaled insulin.

The review examined several clinical issues surrounding the use of inhaled insulin by patients with type 2 diabetes. It looked at how inhaled insulin compares to injected insulin as a mealtime insulin supplement for patients who are already using injected insulin daily.

The report also compared use of inhaled insulin by type 2 diabetes patients who had not previously taken insulin in any form. Inhaled insulin was compared to the effectiveness of oral antidiabetic drugs used alone and to antidiabetic drugs used with inhaled insulin.

In patients with type 2 diabetes, inhaled insulin worked as well as short-acting injected insulin to control blood glucose over three months, according to the review. However, inhaled insulin users had more trouble controlling low blood glucose hypoglycemia a common complication of diabetes medication.

Insulin is associated with hypoglycemia, said John Buse, M.D., president-elect of the American Diabetes Association. That is its most common and potentially serious complication in all of its formulations.

Among patients who had not previously taken insulin in any form, inhaled insulin alone was more effective than oral diabetes medication at controlling blood glucose levels at the three-month follow-up. When patients took oral medication plus inhaled insulin, higher rates of hypoglycemia occurred.


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