Lorraine Tosiello, MD; Priya Ravi, MD
Potential Financial Conflicts of Interest: None disclosed.
Tosiello L., Ravi P.; Efficacy and Safety of Inhaled Insulin Therapy. Ann Intern Med. 2006;144:533. doi: 10.7326/0003-4819-144-7-200604040-00017
Download citation file:
Published: Ann Intern Med. 2006;144(7):533.
TO THE EDITOR:
Like many general internists, we have had our interest piqued about inhaled insulin therapy for several years. Because data have eked out slowly, generally through endocrinologic publications and meetings, we were delighted to see the issue addressed recently in “our journal” (1). However, after reading the article, we were disappointed by the design of the study and wonder about the editors' decision to publish it at this particular time.
We have 3 concerns about the authors' methods. First, the study was unblinded, which could have introduced conscious and unconscious biases. This shortcoming could have been avoided if the investigators had provided a placebo inhaler to patients in the group that continued to take oral agents. Second, the control group was clearly not responding to their regimen. A more rigorous approach would have been to compare the clinical standard of care (that is, the addition of a dose of intermediate-acting insulin at bedtime). Third, the study was too short to assuage our concern about pulmonary outcomes or metabolic worsening that may result from long-term insulin therapy.
to gain full access to the content and tools.
Learn more about subscription options.
Register Now for a free account.
Copyright © 2016 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use
This PDF is available to Subscribers Only