Inhaled Insulin as Good as Injections for Diabetics
Editor's Note: The FDA approved the inhaled insulin drug Exubera in 2006,
but in October 2007 the drug company Pfizer said it was halting sales of the
drug because of financial reasons.
May 20, 2001 (San Francisco) -- For diabetics, an inhaled
powder could make a dramatic difference in quality of life. The experimental
substance is a new form of insulin that is rapidly released into the blood
through the lungs. This approach won't replace insulin shots completely, but it
may reduce them from three or four a day to just one at night.
The powder is administered though a device about the size of a
cell phone. The patient cocks the handle that fills the lower chamber with
compressed air. Then a blister pack of powdered insulin is inserted and
ruptured and the patient inhales the powder and air mix.
"Patients prefer it. Quality of life studies have been
done, and patients prefer this hands down," says William Cefalu, MD,
associate professor of medicine at the University of Vermont College of
Medicine. Cefalu, a diabetes specialist, has been studying the powder in
diabetics to see how it compares with standard insulin injections or oral
In three trials conducted over a two-year period, Cefalu
compared the safety and effectiveness of the powder in about 200 patients. Each
trial lasted three months. He presented his findings Sunday at the
international conference of the American Thoracic Society.
"Inhaled insulin appears to work as well as the
[skin-injected] insulin on blood sugar control during these three-month
studies," says Cefalu.
In type 1 diabetes, the body fails to produce any insulin, the
hormone that controls blood sugar, or glucose, levels in the body. Most people
with this disease develop it as children. Type 2 diabetes, typically diagnosed
in older adults, frequently is associated with obesity and is characterized by
insulin resistance -- when the body doesn't respond well to insulin.
It's crucial for diabetics to keep their glucose levels under
control to avoid complications like blindness, kidney damage, and amputations.
For tight control, patients have to take insulin shots often, an unpleasant
"Inhaled insulin offers the first real alternative to that
because it allows ... multiple treatments of insulin without the
injections," says Cefalu, whose studies have been financed by Pfizer, one
of the companies developing the inhaled powder.
The studies also show that the powder is actually better than
shots for type 2 diabetics who ultimately have to take insulin.
While the powder goes deeply into the lungs, tests found no
significant breathing problems, including among people with mild asthma.
"The major breakthrough is the formulation: the fact that
this is a dry powder and that once vaporized, particle size is minimal,"
says Cefalu. Still, the powder wouldn't be recommended for those with
pneumonia, and it would need to be evaluated in people with chronic heart
Cefalu declined to say whether the FDA will review the powder
soon, although several other pharmaceutical companies are pursuing a similar
strategy. The Pfizer drug has been in development since 1996.