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Inhaled insulin effective in type 2 diabetics
  By David Douglas
NEW YORK (Reuters Health) - Use of inhaled insulin appears to provide glycemic control comparable to that achieved with subcutaneous injection in patients with type 2 diabetes, Danish researchers report. As lead investigator Dr. Kjeld Hermansen told Reuters Health, "Treatment with inhaled insulin is a promising non-invasive alternative to insulin injections."
Dr. Hermansen of Aarhus University Hospital and colleagues, note in the January issue of Diabetes Care that, the AERx insulin diabetes management system delivers precisely sized insulin aerosol droplets during optimal breathing conditions. It is known to be well tolerated. However, the researchers point out that to be a feasible treatment alternative it has to be as effective and safe as subcutaneous injection.
To investigate, the team randomized 107 patients with a mean age of 59 years and a mean diabetes 2 duration of about 12 years to AERx or subcutaneous insulin treatment. The AERx group used fast-acting human insulin immediately before meals, the subcutaneous group injected the agent 30 minutes before meals. Both groups had subcutaneous injections of NPH insulin at bedtime.
At the end of the 12-week open-label trial, there were no significant differences in HbA1c between groups. However, fasting serum glucose was significantly lower in the AERx group (8.9 mmol/L) than it was in the subcutaneous group (10.8 mmol/L).
The incidence of adverse events was similar in both groups and there were no major safety problems.
Thus, the researchers conclude that used preprandially, the inhaled insulin system is as effective as subcutaneous injection in achieving glycemic control. Nevertheless, they also observe that "further studies are needed to specifically investigate the long-term safety of this system."
Diabetes Care 2004;27:162-167.
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