Diabetes is a chronic disease characterized by inadequate insulin secretion with resulting hyperglycemia. Diabetes complications include both microvascular and macrovascular disease, both of which are affected by optimal diabetes control. Many individuals with diabetes rely on subcutaneous insulin administration by injection or continuous infusion to control glucose levels. Novel routes of insu...

The low proportion of patients achieving glycemic targets is well documented for both type 1 and type 2 diabetes. Postprandial glucose levels are often not monitored but contribute significantly to total glycemic burden. Prandial rapid-acting insulin analogues were introduced to address some of these problems but still do not provide a physiologic insulin replacement. Inhaled prandial insulins ...

A new type of inhalation aerosol, characterized by particles of small mass density and large size, permitted the highly efficient delivery of inhaled therapeutics into the systemic circulation. Particles with mass densities less than 0.4 gram per cubic centimeter and mean diameters exceeding 5 micrometers were inspired deep into the lungs and escaped the lungs' natural clearance mechanisms unti...

NEW DRUG APPROVALS Inhaled Insulin Afrezza For Diabetes The FDA has approved a rapid-acting inhaled insulin to improve glycemic control in adults with diabetes mellitus. Insulin human inhalation powder (Afrezza, MannKind Corporation) is administered at the beginning of each meal. The product’s safety and effectiveness were evaluated in 3,017 participants—1,026 with type-1 diabetes and 1,991 wit...

Insulin therapy is likely to change within the next decade. Inhaled insulin is likely to be marketed within a year. Buccal insulin also shows promise. Oral insulin therapy is in a nascent phase but holds promise. Nasal and dermal insulin formulations are also being experimented with.

OBJECTIVE To study the metabolic effect and the variability of the effect elicited by inhalation of 87.2 U insulin powder combined with an absorption enhancer. The metabolic effect was compared with that of 10.2 U regular insulin injected subcutaneously and of 5.5 U regular insulin given intravenously RESEARCH DESIGN AND METHODS In this single-center open euglycemic glucose clamp study 13 hea...

OBJECTIVE In this open-label, randomized, crossover study, pharmacokinetic and glucodynamic responses were compared in healthy subjects versus subjects with moderate chronic obstructive pulmonary disease (COPD), following administration of 12 units equivalent AIR inhaled insulin versus 12 units subcutaneous insulin lispro. RESEARCH DESIGN AND METHODS Three nonsmoking groups (n = 15 each)--hea...