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Inhaled Insulin Appeals to Diabetes Patients

More Would Take Insulin if Inhaler Approved, Company-Funded Study Shows

By Daniel J. DeNoon
WebMD Health News

Reviewed by Brunilda Nazario, MD

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.

March 9, 2005 -- Inhaled insulin appeals to people with type 2 diabetes, an international study shows.

Pharmaceutical giants Pfizer and Aventis funded the study. The firms seek FDA approval for their inhaled insulin product, Exubera. Pending safety tests, no inhaled insulin product is currently on the market. Pfizer is a WebMD sponsor.

But the findings, from a respected international team of diabetes researchers, show that inhaled insulin will play at least one major role in diabetes care. Patients who won't take insulin shots -- even when their doctors tell them to do so -- would take the inhaled form of the hormone, says researcher Nick Freemantle, PhD, of the University of Birmingham, U.K.

"Doctors often talk of the difficulty of having patients take what is often the inevitable next step -- taking insulin at meal time," Freemantle tells WebMD. "This study suggests that making insulin available in an inhaled form may help break down those barriers. When people need insulin to get their diabetes under control, it becomes a less dramatic, less painful step."

Freemantle's team enrolled 779 adults with type 2 diabetes. Despite treatment, blood tests showed that their diabetes was poorly controlled. Researchers offered half the patients standard treatment, including insulin injection. The other patients were offered the same thing, but were also asked whether, if it became available, they would take inhaled insulin.

The bottom line: The option of inhaled insulin made it three times more likely that a patient would choose insulin therapy. Among those offered inhaled insulin, 43.2% chose insulin treatment. Among those offered only insulin injections, only 15.5% took the insulin option.

The findings appear in the February issue of Diabetes Care.

The study findings don't surprise Eugene Barrett, MD, PhD, immediate past president of the American Diabetes Association, and director of the Diabetes Center at the University of Virginia Health System. Barrett has consulted for Pfizer but has not done any such work for more than a year.

"Inhaled insulin would be more acceptable for some patients," Barrett tells WebMD. "There is an issue -- more for some patients than others -- with following a doctor's advice to take insulin. For some patients, an inhaled insulin preparation would be useful because they are afraid or apprehensive about giving themselves injections. Some people with type 2 diabetes delay or procrastinate -- they just won't go on insulin. But most times, if you get them over that, they recognize it is not as big a deal as they thought."