Inhaled Insulin: Overcoming Barriers to Insulin Therapy? Srikanth Bellary; Anthony H Barnett Br J Diabetes Vasc Dis. 2006;6(3):103-108. Posted On Medscape 10/06/2006

“Inhaled Insulin: Overcoming Barriers to Insulin Therapy?” provides an overview of the methodology and effectiveness of inhaled insulin for type 1 and type 2 diabetes. Perhaps the single most important factor that has propelled research in and development of this modality has been the finding that

Quality of life scores indicate patient preference for inhaled versus injected insulin, thus increased choice may improve adherence to treatment regimens

Unresolved Issues

• Cost effectiveness studies are not available. The working hypothesis, as declared in this article, is “… that improved patient compliance with inhaled insulin will lead to better long-term outcomes and the benefits of preventing complications will outweigh the cost of treatment.”
• Several groups, including smokers, asthmatics, children, and those with acute illness, are currently excluded from the use of inhaled insulin because of insufficient clinical data.
• The inhaled insulin modality may not be effective for patients who need large insulin doses.
  Because inhaled insulin is relatively new, long-term safety is untested

Commentary

Given the prevalence of “needle anxiety” and inhaled insulin’s high patient satisfaction scores, the availability of this new format holds significant, albeit unproven, promise for compliance enhancement in this chronic disease.

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