Inhaled Insulin

We will be using inhaled insulin in the office before long. Several of our patients did volunteer in the early studies and contributed greatly to the new product. Initially it was quite a hassle but more recently it is quite well accepted by the patients who have used inhaled insulin.

Compared to insulin injections inhaled insulin has a similar rate of onset time to peak action, but a longer duration of action. After inhalation of insulin, only 10 percent is absorbed so this inefficiency no doubt contributes to the higher cost of this system.

In both type 1 and Type II diabetes, when combined with appropriate basal insulin, equivalent glycemia was obtained.

Long-term effects of the lung are yet unknown. Contraindications to the use of this system are smokers, asthma and chronic obstructive pulmonary disease. It is used before meals and can be used with a basal insulin. It is not as easy to use as the usual inhalers you may know and the patient must use glucose testing as before.

In type 1 diabetes, it may be difficult to calibrate inhaled doses because the minimum amount is equivalent to three subcutaneous units. Problems with hypoglycemia are unchanged.