06/01/2007Inhaled Insulin for Adults with Diabetes

Majeed Paduvana, MD, FACP

Recently, Inhaled Insulin (Exubera by Pfizer) was approved by FDA for the treatment of adults with Type 1 or 2 diabetes.  Inhaled insulin is the first new delivery method since the discovery of insulin almost a century ago.  It offers a less painful and more convenient therapeutic option to more than five million Americans with diabetes who require insulin.

Key Points about Inhaled Insulin:

• It can be combined with oral diabetic medication or long acting insulin injection.
• Inhaled insulin has the potential to enhance the rate of acceptability of insulin treatment.
• In clinical trials inhaled insulin was as effective as injected insulin in lowering HbA1c levels.
• Since Exubera is inhaled and absorbed through the lung, safety is a concern.
• The FDA has developed medication guide for patients.
• Pulmonary function test, i.e. Spirometry, will be needed for all patients before starting Exubera and periodically thereafter.
• Patients who smoke or stopped smoking less than 6 months ago, and those with poorly controlled asthma, emphysema are not candidates for inhaled insulin.

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