0
Summaries for Patients |

Inhaled Insulin with or Instead of Oral Medications for Type 2 Diabetes FREE

[+] Article and Author Information

The summary below is from the full report titled “Inhaled Insulin Improves Glycemic Control When Substituted for or Added to Oral Combination Therapy in Type 2 Diabetes. A Randomized, Controlled Trial.” It is in the 18 October 2005 issue of Annals of Internal Medicine (volume 143, pages 549-558). The authors are J. Rosenstock, B. Zinman, L.J. Murphy, S.C. Clement, P. Moore, C.K. Bowering, R. Hendler, S.-P. Lan, and W.T. Cefalu.


Ann Intern Med. 2005;143(8):I-28. doi:10.7326/0003-4819-143-8-200510180-00001
Text Size: A A A

What is the problem and what is known about it so far?

Type 2 diabetes mellitus (adult-onset diabetes) interferes with the body's ability to store energy from food, resulting in high blood sugar levels that can lead to problems, such as kidney failure, blindness, and heart disease. Insulin helps the body to convert food to stored energy and keeps blood sugar levels within the normal range. In type 2 diabetes, body tissues are resistant to the effects of insulin and patients lack effective insulin levels that are required to keep their blood sugar levels normal. Some patients can overcome the abnormalities by taking prescription pills, while others must take insulin injections at least once daily. Researchers have been exploring ways to give insulin to diabetic patients other than by injection. One alternative is inhaled insulin, whereby patients breathe insulin into their lungs by using a special device.

Why did the researchers do this particular study?

To find out whether inhaled insulin improves the control of type 2 diabetes in patients who do not achieve good control with pills alone.

Who was studied?

309 patients with type 2 diabetes who were taking pills and had poorly controlled diabetes. The researchers defined poor control as a hemoglobin A1c level between 8% and 11%. Hemoglobin A1c levels indicate blood sugar levels over the past 3 months. An important goal of diabetes treatment is to lower hemoglobin A1c levels to 7% or less.

How was the study done?

The researchers assigned patients at random to continue taking the diabetes pills, to add inhaled insulin before meals to the pills, or to stop taking the pills and take only inhaled insulin before meals. Study patients adjusted inhaled insulin doses according to blood sugar levels. After 12 weeks, the researchers compared the changes in hemoglobin A1c levels in the 3 groups. They also examined side effects, including weight gain, and episodes during which blood sugar levels were too low.

What did the researchers find?

Improvements in hemoglobin A1c level were best in the group that took inhaled insulin with the pills, second-best in the group that took only inhaled insulin, and worst in the group that took only pills. Mild weight gain, episodes of low blood sugar levels, and mild cough were more frequent in the inhaled insulin groups. Lung function was similar in all groups.

What were the limitations of the study?

The authors did not compare inhaled insulin with injected insulin. In addition, whether patients would continue to show improved blood sugar levels or have side effects if they used inhaled insulin for longer than 12 weeks is not known. Of note, the inhaler device is currently large and allows dosing of 2.5 to 3.0 units of insulin. Injected insulin currently allows for finer adjustments in dose than inhaled insulin.

What are the implications of the study?

Inhaled insulin may be a treatment option for type 2 diabetes when patients do not achieve good control by using pills alone.

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Related Point of Care
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)