It is well established that intensive insulin regimens reduce the risk of diabetes-related complications. However, multiple daily injections have an important impact on treatment burden and compliance. Various non-invasive formulations of insulin have been researched and the first inhaled insulin formulation, Exubera* (insulin human [rDNA origin] Inhalation Powder), was approved in the United States and European Union for the treatment of adults with type 1 or type 2 diabetes in January 2006. Comprehensive studies with Exubera have shown comparable efficacy to regular subcutaneous mealtime insulin in type 1 and type 2 diabetes, and superior efficacy to oral antidiabetic agents (OAs) in patients with type 2 diabetes with glycosylated hemoglobin (HbA 1c) > 8%. Furthermore, Exubera shows a good safety profile and improved patient satisfaction versus comparators. The key limitation of this review is that that few publications are available for other inhaled insulin formulations. Although their data also suggest favorable efficacy and safety profiles, it is currently unknown whether the key findings are specific to one formulation or a class effect. Therefore, more detailed investigations are expected in the future. In the meantime, we could speculate that inhaled insulins may improve patient acceptance of insulin-based therapeutic regimens, and thereby improve glycemic control and long-term diabetic outcomes. © 2006 Librapharm Limited.
Inhaled insulins: the present and future of diabetes therapy
DEL PRATO, STEFANO
2006-01-01
Abstract
It is well established that intensive insulin regimens reduce the risk of diabetes-related complications. However, multiple daily injections have an important impact on treatment burden and compliance. Various non-invasive formulations of insulin have been researched and the first inhaled insulin formulation, Exubera* (insulin human [rDNA origin] Inhalation Powder), was approved in the United States and European Union for the treatment of adults with type 1 or type 2 diabetes in January 2006. Comprehensive studies with Exubera have shown comparable efficacy to regular subcutaneous mealtime insulin in type 1 and type 2 diabetes, and superior efficacy to oral antidiabetic agents (OAs) in patients with type 2 diabetes with glycosylated hemoglobin (HbA 1c) > 8%. Furthermore, Exubera shows a good safety profile and improved patient satisfaction versus comparators. The key limitation of this review is that that few publications are available for other inhaled insulin formulations. Although their data also suggest favorable efficacy and safety profiles, it is currently unknown whether the key findings are specific to one formulation or a class effect. Therefore, more detailed investigations are expected in the future. In the meantime, we could speculate that inhaled insulins may improve patient acceptance of insulin-based therapeutic regimens, and thereby improve glycemic control and long-term diabetic outcomes. © 2006 Librapharm Limited.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
