PMID- 18054735
OWN - NLM
STAT- MEDLINE
DCOM- 20080226
LR  - 20111117
IS  - 1521-690X (Print)
IS  - 1521-690X (Linking)
VI  - 21
IP  - 4
DP  - 2007 Dec
TI  - Inhaled insulin.
PG  - 555-71
AB  - Inhaled insulin has attractive pharmacodynamic properties with a fast onset of 
      action which should lead to improved postprandial blood glucose concentrations. 
      Comparisons with regular subcutaneous (sc) insulin in clinical studies, however, 
      showed lower fasting blood glucose concentrations. Overall, clinical efficacy of 
      inhaled insulin was comparable to that of regular sc insulin. Treatment with 
      inhaled insulin was safe and well tolerated, with slight and reversible changes 
      in lung function parameters and a rise in insulin antibodies (not associated with 
      any clinical or safety parameters) as main adverse effects. Treatment 
      satisfaction in open-label studies was higher with inhaled than with sc insulin, 
      indicating that inhaled insulin might help to overcome one of the major hurdles 
      of diabetes therapy, i.e. a timely initiation of insulin therapy. The first 
      inhaled insulin formulation was approved in the US and Europe in January 2006, 
      but some countries granted reimbursement only for selected patients, or did not 
      reimburse treatment with inhaled insulin at all because of the high treatment 
      costs. These are due to the rather low bioavailability of approximately 8-15%. 
      Therefore, further research is needed to improve the bioavailability of inhaled 
      insulin: e.g. through optimization of the inhaler, the insulin formulation, or 
      the inhalation technique. In view of the potential for further improvement, 
      inhaled insulin may become a very attractive alternative to sc insulin, in 
      particular in patients in whom insulin therapy has to be initiated and/or 
      intensified.
FAU - Arnolds, Sabine
AU  - Arnolds S
AD  - Profil Institut fur Stoffwechselforschung GmbH, Hellersbergstr. 9, D-41460 Neuss, 
      Germany. sabine-arnolds@profil-research.de
FAU - Heise, Tim
AU  - Heise T
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Netherlands
TA  - Best Pract Res Clin Endocrinol Metab
JT  - Best practice & research. Clinical endocrinology & metabolism
JID - 101120682
RN  - 0 (Blood Glucose)
RN  - 0 (Exubera)
RN  - 0 (Insulin)
RN  - 0 (Insulin Antibodies)
SB  - IM
MH  - Absorption
MH  - Administration, Inhalation
MH  - Asthma/physiopathology
MH  - Blood Glucose/metabolism
MH  - Clinical Trials, Phase II as Topic
MH  - Clinical Trials, Phase III as Topic
MH  - Diabetes Mellitus, Type 1/drug therapy
MH  - Diabetes Mellitus, Type 2/*drug therapy
MH  - Hypoglycemia/chemically induced
MH  - Insulin/*administration & dosage/adverse 
      effects/metabolism/pharmacokinetics/therapeutic use
MH  - Insulin Antibodies/analysis
MH  - Pulmonary Disease, Chronic Obstructive/physiopathology
MH  - Respiratory Tract Infections/physiopathology
RF  - 92
EDAT- 2007/12/07 09:00
MHDA- 2008/02/27 09:00
CRDT- 2007/12/07 09:00
PHST- 2007/12/07 09:00 [pubmed]
PHST- 2008/02/27 09:00 [medline]
PHST- 2007/12/07 09:00 [entrez]
AID - S1521-690X(07)00059-0 [pii]
AID - 10.1016/j.beem.2007.07.004 [doi]
PST - ppublish
SO  - Best Pract Res Clin Endocrinol Metab. 2007 Dec;21(4):555-71. doi: 
      10.1016/j.beem.2007.07.004.