Spotlight on inhaled human insulin (exubera((r))) in diabetes mellitus.
Inhaled human insulin (Exubera((R)) [insulin human (rDNA origin)] Inhalation Powder) has recently been approved in the EU and the US for preprandial use in adult patients with diabetes mellitus. This formulation of insulin has a more rapid onset, but similar duration, of glucose-lowering activity compared with subcutaneously administered regular human insulin.Preprandial inhaled human insulin provided glycemic control that was comparable to preprandial subcutaneous regular insulin when added to long- or intermediate-acting subcutaneous basal insulin in patients with type 1 diabetes. Inhaled human insulin is also effective when administered alone, when combined with oral antihyperglycemic therapy, or when combined with basal subcutaneous insulin in patients with type 2 diabetes. Comparable rates of hypoglycemia occurred in patients treated with inhaled human insulin and in those treated with subcutaneous regular human insulin. Patients treated with inhaled human insulin demonstrated a greater decline in pulmonary function (forced expiratory volume in 1 second, carbon monoxide diffusing capacity) than patients treated with comparator antihyperglycemic agents; the mean difference between the treatment groups that favored the comparators was noted within the first several weeks of treatment, and did not change over a 2-year treatment period. This agent has also been associated with significant improvements in some quality-of-life and treatment satisfaction scores, especially when compared with subcutaneous mealtime insulin regimens.
Dunn
Christopher
C
Adis International Inc., Yardley, Pennsylvania, USA.
Curran
Monique P
MP
D000280:Administration, Inhalation; D002248:Carbon Monoxide / Q000627:therapeutic use; D003922:Diabetes Mellitus, Type 1 / Q000139:chemically induced; D003924:Diabetes Mellitus, Type 2 / Q000139:chemically induced; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D061386:Insulin, Regular, Human / Q000627:therapeutic use
D007004:Hypoglycemic Agents; D061386:Insulin, Regular, Human; D002248:Carbon Monoxide