Update in the pharmacologic treatment of diabetes: focus on insulin detemir, insulin glulisine, and inhaled dry powdered insulin.
The prevalence of diabetes mellitus has increased to more than 20 million people in the United States, and current estimates indicate that one third of all Americans born in the year 2000 will develop diabetes mellitus in their lifetime. The need for diabetes therapies offering improved glucose control by mimicking normal physiological properties of glucose metabolism and improving on logistics such as ease of use, self-management, monitoring, and delivery is clear. This article, part 2 of a 3-part series, reviews newer injectable insulin preparations and examines the first-to-market orally inhaled dry powdered insulin (IDPI). The information provided is tailored to diabetes educators and includes mechanism of action, pharmacokinetics, drug interactions, clinical trials, dosage and administration guidelines, side effects, and educational pearls for each insulin discussed. A detailed patient case designed to acquaint the reader with these newer insulin products and provide an understanding of clinical issues to consider when providing diabetes education to patients is included.
Iltz
Jason L
JL
Department of Pharmacotherapy, College of Pharmacy, Washington State University, and Integrated Health Professionals, Spokane, Washington
Odegard
Peggy Soule
PS
Plein Geriatrics Certificate Program, School of Pharmacy, University of Washington, Seattle, and Evergreen Senior Health Specialists, Kirkland, Washington
Setter
Stephen M
SM
Department of Pharmacotherapy, College of Pharmacy, Washington State University, and Elder Services/Visiting Nurse Association, Spokane, Washington
Campbell
R Keith
RK
Department of Pharmacotherapy, College of Pharmacy, Washington State University, Pullman
D000280:Administration, Inhalation; D002986:Clinical Trials as Topic; D003920:Diabetes Mellitus / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D007328:Insulin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000493:pharmacokinetics / Q000627:therapeutic use; D000069057:Insulin Detemir; D049528:Insulin, Long-Acting; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic
D007004:Hypoglycemic Agents; D007328:Insulin; D049528:Insulin, Long-Acting; D000069057:Insulin Detemir; C479079:insulin glulisine