Inhaled Insulin: Is It Effective?

By Ginger Vieira

The idea of being able to inhale our insulin rather than deliver it through a variety of methods that all involve puncturing the skin and stabbing our own flesh (syringes, pens and insulin pumps) is a very cool idea. But does it work? Is it really as effective as today’s methods? Personally, I wouldn’t trade my syringes for an inhaler if it means my blood sugars are going to be less controlled, so the proof would definitely need to be in the “pudding.”

While there have been several failed attempts in the development of inhaled insulin, MannKind’s Afreeza inhaler which uses “Technosphere Insulin Inhalation Powder” is getting closer to FDA approval.

At last week’s 74th annual American Diabetes Association Scientific Sessions in California, lead researchers Bruce W. Bode, MD, and Julio Rosenstock, MD, presented their results from comparing inhaled insulin with injections and oral diabetes medications.

In type 1 diabetes, the study found:

Technosphere Insulin Inhalation Powder (TI) showed equivalent HbA1c reduction for patients with type 1 diabetes compared with subcutaneous rapid acting analog (RAA) insulin and demonstrated significant differences in total hypoglycemia and weight gain.

This is all good news.

“TI provided effective glycemic control to subjects with type 1 diabetes and was not inferior in HbA1c reduction vs. insulin aspart,” explains Bode. “There was significant weight gain with insulin aspart vs. TI.”

The study also found that hypoglycemic events were lower in those using the TI, as well. Another piece of good news! Other improvements included fasting glucose levels!

The primary negative side-effect seen was a “cough.”

“This did not cause a large dropout; there was a small decrement in pulmonary function that was reversible,” Bode said. “TI had significantly less hypoglycemia no matter how you looked at it.”

In type 2 diabetes, the study found:

Similar results were found in the type 2 patients using the inhaled insulin.

“TI as the initial prandial insulin in patients with type 2 diabetes compared with one or more oral agents effectively reduced postprandial glucose excursionconsistent with its time-action profile,” explained Rosenstock. “It was associated with increased, mild hypoglycemic events and neutral body weight changes.”

However, patients with type 2 did experience more hypoglycemic events in those taking a “sulfonylurea” such as Glipizide.