This article is from the WebMD News Archive
Inhaled Insulin Effective for Diabetes
But Study Raises Concerns Over Long-Term Lung Impact
Reviewed by
Louise Chang, 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.
Nov. 7, 2006 -- Although inhaled insulin is comparable to injected insulin in controlling high blood sugar, its use should be reserved for diabetic patients who cannot or will not use needles, according to a new study.
That's because its long-term safety has yet to be established, says Lisa Ceglia, MD, of the Tufts-New England Medical Center in Boston, a researcher on the study.
"For the time being, the most worrisome concern is the effect inhaled insulin may have on lung function," Ceglia tells WebMD. The review article shows that one of the most common side effects of such therapy is increased coughing and a mild decrease in test scores that measure lung function.
"Are there other things to worry about? Possibly," Ceglia says. "But pulmonary toxicity is the issue we focused on because of the way the therapy is administered."
The findings are published in the November issue of the Annals of Internal Medicine.
Short-Term Trials
Ceglia's team reviewed 16 trials of inhaled insulin involving 4,023 patients with type 1 or type 2 diabetes.
Most of the trials lasted only 12-24 weeks. The longest trial lasted two years. It evaluated Exubera, Pfizer Inc.'s inhaled insulin delivery system. Pfizer is a WebMD sponsor.
In January 2006, Exubera became the first new insulin delivery option to be approved by the FDA since insulin was discovered in the 1920s. Pfizer launched the drug in the U.S. market in September 2006.
"All of the trials were open-label, meaning that the patients knew what they were getting," Ceglia says. None of the trials used the so-called "double-dummy" technique, in which patients receive an inhaler and injections without knowing which one contains insulin.
Although that other technique may have produced more definitive results, it was not used because the trial designers considered it "logistically difficult and cumbersome."
"What these trials were designed to do is prove non-inferiority," says Larry Deeb, MD, president of medicine and science at the American Diabetes Association in Alexandria, Va. Deed was not connected with the study. "All Pfizer had to do was prove that inhaled insulin was as good as subcutaneous insulin, not that it was superior."
Inhaled Insulin Worked
Ceglia's analysis showed that inhaled insulin was "comparable" to injected insulin in controlling blood sugar. Its effects were "just slightly less" than those of injected insulin, Ceglia says.
Though injected insulin had a small advantage over inhaled insulin in reducing blood sugar, the same number of patients on either therapy achieved a benchmark of diabetes control: a hemoglobin A1c level of less than 7%.
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Is This Normal?
Get the Facts Fast!Answer:
Your level is currently NormalHigh (hyperglycemia).Low (hypoglycemia). |
If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.
People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.
If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.
People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.
Your blood sugar level is slightly high. You should call your health care provider and ask if laboratory tests to check for diabetes are needed. If you are pregnant always consult with your health care provider.
Congratulations on taking steps to manage your health.
However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.
Your level is currently normal. However, if you are concerned about diabetes speak with your physician. There may be other risk factors that increase your risk for diabetes.
Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.
Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.
One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.
Your blood sugar level may be high, depending on when you last ate. If you have not eaten for at least 8 hours, your blood sugar should be less than 100. If you've eaten within the last 2 hours, your blood sugar should be less than 140. You should call your health care provider and ask if you need laboratory tests to check for diabetes. If you are pregnant always consult with your health care provider.
Blood sugars consistently above 180 warrant prompt medical attention.
Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.
One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.
Your blood sugar level is high. You should call your health care provider and ask if laboratory tests to check for diabetes are needed. If you are pregnant always consult with your health care provider.
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