New Methods May Mean Fewer Insulin Shots for Diabetics
May 30, 2000 -- It may soon be possible for people with diabetes to breathe
insulin into their lungs or spray it into their mouths instead of giving
themselves several daily shots, researchers say.
Jay S. Skyler, MD, who has been testing an inhaled version of insulin for
the past three years, says: "It's pretty simple. If you know how to
breathe, which most people on this planet do, you can use it."
The inhalation device, which crushes a pellet of insulin into a fine cloud
of powder that is then breathed deeply into the lungs, is one of several
alternatives to insulin shots now being tested. These methods, which also
include insulin pills and a spray inhaler, are not designed to replace the
shots entirely, but to reduce the number of daily injections needed,
Skyler, a diabetes expert from the University of Miami, says patients who
have used the inhalation device tend to like it. After an earlier study of the
device ended, 80% of the study participants with type 1 diabetes and 92% of
those with type 2 diabetes continued to use it. Five longer-term studies, aimed
at confirming its effectiveness and safety, are beginning. If approved by the
FDA, the device could be available to patients as early as the end of next
The inhalation device consists of a flashlight-sized clear tube with a slot
into which an insulin pellet is placed. Squeezing a trigger crushes the
insulin. Placing your mouth over the chamber and taking one or two slow, deep
breaths is enough to draw the powder into the lungs, where it is rapidly
absorbed into the bloodstream.
Another approach now being tested involves a much smaller device that
resembles an asthma inhaler. With this device, rather than going all the way to
the lungs, the insulin spray coats the inside of the mouth and the back of the
throat. Because it is easy for drugs to pass through the sensitive tissue
there, the insulin can get into the bloodstream quickly.
The spray mimics the body's normal secretion of insulin and, like the
inhaled insulin, appears to control blood sugar levels as well as frequent
injections. Its manufacturer, Generex Biotechnology Corp., of Toronto, says the
spray has essentially no side effects, and the only patient complaints have
been about a slight medicinal taste immediately after using it.
Arthur Krosnick, MD, a researcher involved in early tests of the device,
says patients tell him they like it because it's easy to use. "Time and
again, they have said, 'If I had my druthers, I would rather have this device
than a needle,'" he says.
Although it has only been tested in adults, Krosnick, a diabetologist and
clinical associate professor at Robert Wood Johnson Medical School in
Princeton, N.J., says the spray inhaler is simple enough that kids should be
able to use it, if studies show it works as well for them.