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Unlocking the opportunity of tight glycaemic control. Inhaled insulin: clinical efficacy
1German Diabetes Center and Department of Endocrinology, Heinrich-Heine-University of Düsseldorf, Auf'm Hennekamp 65, D-40225 Düsseldorf, Germany. scherbaum@ddfi.uni-duesseldorf.de
Abstract:
Numerous attempts have been made to develop novel routes of insulin delivery that are both effective and tolerable. Of all the potential non-invasive delivery options, pulmonary delivery is the most clinically viable. Early studies demonstrate that the inhaled insulin is rapidly absorbed and is closer to biological insulin than standard subcutaneous insulin (SC). To date, inhaled insulin (Exubera) has been clinically assessed in more than 3500 patients with type 1 or type 2 diabetes, some treated for more than 7 years. Several phase 3 studies of 24-week duration have demonstrated comparable glycosylated haemoglobin (HbA1c) control in patients with type 1 diabetes treated with Exubera vs. SC insulin. Similar results have also been recorded in patients with type 2 diabetes. Furthermore, Exubera has shown clinical superiority to oral agent regimens in patients with type 2 diabetes who failed to achieve their target HbA1c using lifestyle modification and oral agents. Exubera was well tolerated and treatment satisfaction was high, with Exubera being the preferred insulin therapy in all studies. The results of these trials, and others, suggest that Exubera may be a valuable tool to help a wide variety of patients with type 1 or type 2 diabetes reach their recommended goals for glycaemic control, irrespective of their current therapy.
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