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Inhaled insulin: Efficacy and pulmonary security

Ricardo Campos Cerda , Alfredo A Reza Albarrán , Jaime Eduardo Morales Blanhir





2006, Number 2

2006; 65 (2)






ABSTRACT

About 177 million people are affected by diabetes mellitus (DM) worldwide. DM is one of the 5 leading causes of overall mortality in developed countries. Uncontrolled DM is associated with higher morbidity and mortality. More than 18 million people are affected by type 1 diabetes in USA, the higher percentage being kids, adolescents and young adults. Individuals suffering from type 1 DM (10% of total) are often unwilling to use insulin in their treatment. Type 2 DM has increased over the last decades, due in part to the increase in life expectancy, a higher incidence of obesity and changes in life style including a decrease in physical activity. In the US 19% of the population over 65 years is diagnosed as diabetic and the reported incidence is 8,000 new type 2 DM cases per year. It has been reported that patients with type 1 and type 2 DM benefit from a strict blood glucose control, as evidenced by a higher percent of survival and less frequent complications (peripheral neuropathy, retinopathy, cardiovascular and renal diseases). To achieve this objective, treatment strategies are very important, however, the lack of adherence to treatment has been observed for several years. In those patients requiring insulin therapy either as monotherapy or in combination with other hypoglucemic agents, that lack of acceptance of this treatment prevents the patient from achieving an adequate control of blood glucose levels. Inhaled insulin is a new therapeutic option in a strict and regulated control of blood glucose levels in DM patients. This method of delivery provides a pharmacologic effect similar to endogenous insulin, dose administration is similar to the usual insulin scheme and/or other hypoglucemic agents. In addition, there is a higher degree of acceptance, ease of use, the method is non-invasive with few collateral effects compared to subcutaneous insulin. Encouraging results are shown in patients with type 1 and type 2 DM, either as monotherapy, combined therapy with hypoglucemic drugs, or as rescue therapy in patients exhibiting lack of control. In patients without lung disease, short and long term studies have confirmed the safety profile in the control of blood glucose, without abnormalities in lung function. Clinical experience suggests that inhaled insulin is a safety and efficacy therapeutic option in patients with type 1 and type 2 DM.

KEYWORDS

Inhaled insulin, diabetes mellitus, subcutaneous insulin, efficacy, safety, pulmonary function.

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2006, Number 2

2006; 65 (2)