New Diabetes Treatments Show Promise
Inhaled Insulin, Lizard-Saliva Drug Offer New Options
No More Needles
In a separate three-month trial involving 309 patients, the inhaled insulin
Exubera was compared with treatment with two blood sugar-lowering drugs or in
combination with the two treatments.
The groups receiving Exubera either alone or in combination with the two
diabetes pills achieved better blood sugar levels than those taking oral
medications use to enhance insulin secretion or increase insulin
But mild weight gain was seen in patients taking the inhaled insulin and was
similar to that seen with injected insulin.
Exubera therapy resulted in more low-blood-sugar episodes (hypoglycemia)
than those taking the combination oral drug alone. The study was paid for by
Exubera manufacturers Pfizer Inc. and the French company Sanofi-Aventis. Both
companies are WebMD sponsors.
An FDA advisory panel recently approved Exubera, and experts tell WebMD that
they expect the treatment to be commercially available soon.
Patients would be expected to embrace an alternative to insulin shots, and
studies have shown that, in theory, this is the case. But the experts say
acceptance of inhaled insulin is far from certain.
That is because the insulin-delivery device is relatively large -- about the
size of a standard flashlight -- and it must be used before every meal.
"Most people picture an asthma inhaler, but this is much bigger,"
diabetes treatment expert Richard Comi, MD, tells WebMD.
There is also some concern about the long-term toxicity of inhaled insulin,
says Rizza. And Comi expressed concerns about whether smokers and patients with
lung problems will be candidates for inhaled treatment.
The inhaled insulin comes in a dry powder delivery system similar to some
asthma inhalers. When it hits the lungs, it's absorbed directly into the
bloodstream, allowing it to take effect faster than injected insulin.
Time Will Tell
Rizza and Comi agree that only time with tell if patients will flock to the
two new diabetes treatments.
"I can tell you that my patients have told me that they would love to
exchange their needles for inhaled insulin, even if its delivery is somewhat
cumbersome," says Comi, who is chief of endocrinology at New Hampshire's
Dartmouth Hitchcock Medical Center. "But I think it is impossible to know
what patient acceptance will be until [these treatments] are out