Diabetes PubMed

It seems that bioadhesive delivery systems or water-insoluble powders with absorption enhancers are the most promising methods for intranasal delivery of insulin.

The Technosphere delivery system allows for the rapid absorption of Technosphere insulin via the lung, making this product a potential option for prandial insulin coverage in both type 1 and type 2 diabetes.

MannKind Corporation has developed a powder formulation of insulin that allows for a high percentage of the administered insulin to be absorbed via the lung. Their product, AFREZZA (Technosphere(R) insulin), is currently under review by the FDA for use in patients with diabetes.

These results support the possibility of formulating certain insulin mixtures in tandem to provide nasal insulin products that match the needs of patients with diabetes mellitus better than those currently available.

Inhaled insulin taken before meals, in conjunction with an injected basal insulin, has been shown to maintain glycaemic control comparable to that of patients taking multiple daily injections.

Attempts by other pharmaceutical companies to use intrapulmonary insulin delivery are presently being made as well as some minor attempts to use intranasal delivery systems.

The out-of-pocket cost that patients were willing to pay was the same as the amount patients pay presently for their insulin and syringes. Although Exubera is no longer on the market, the study findings can have an impact on pharmaceutical companies working on new inhaled insulin products in their efforts to care for patients with diabetes.

Treatment with AIR insulin resulted in similar improvement in glycemic control compared with insulin lispro.

The AIR inhaled insulin program was terminated by the sponsor prior to availability of any Phase 3 data for reasons unrelated to safety or efficacy. Despite early termination, this trial provides evidence that AIR insulin was less efficacious in lowering A1C and was associated with a greater decrease in DL(CO) and increased incidence of cough than SC insulin in patients with type 1 diabetes.

Added to oral therapy, premeal inhaled insulin can safely achieve < or =7% A1C in most patients with type 2 diabetes inadequately controlled while taking two or more OADs if a once- or twice-weekly structured insulin titration regimen is used.