Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Mar 7:2018:4568903.
doi: 10.1155/2018/4568903. eCollection 2018.

Rethinking the Viability and Utility of Inhaled Insulin in Clinical Practice

Lutz Heinemann  1 , Christopher G Parkin  2
Affiliations
Review

Rethinking the Viability and Utility of Inhaled Insulin in Clinical Practice

Lutz Heinemann et al. J Diabetes Res. .

Abstract

Despite considerable advances in pharmacotherapy and self-monitoring technologies in the last decades, a large percentage of adults with diabetes remain unsuccessful in achieving optimal glucose due to suboptimal medication adherence. Contributors to suboptimal adherence to insulin treatment include pain, inconvenience, and regimen complexity; however, a key driver is hypoglycemia. Improvements in the PK/PD characteristics of today's SC insulins provide more physiologic coverage of basal and prandial insulin requirements than regular human insulin; however, they do not achieve the rapid on/rapid off characteristics of endogenously secreted insulin seen in healthy, nondiabetic individuals. Pulmonary administration of prandial insulin represents an attractive option that overcomes limitations of SC insulin by providing more a rapid onset of action and a faster return of action to baseline levels than SC administration of rapid-acting insulin analogs. This article reviews the unique PK/PD properties of a novel inhaled formulation that support its use in patient populations with T1D or T2D.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Pharmacokinetics (a) and pharmacodynamics (b) of TI after oral inhalation of 4, 12, or 48 units.
Figure 2
Figure 2
Peak glucose lowering effect of TI (Afrezza) after inhalation of 12 units (a) is similar to 8 units SC applied insulin lispro (RAA) (b) but with faster onset and shorter duration of action.
Figure 3
Figure 3
Total glucose effect: GIR AUC as a function of dose for TI (Afrezza) and SC lispro.
Figure 4
Figure 4
FEV1 as a function of time in the study.
See this image and copyright information in PMC

References

    1. American Diabetes Association. Standards of medical care in diabetes-2017: pharmacologic approaches to glycemic treatment. Diabetes Care. 2017;40(Supplement 1):S64–S74. doi: 10.2337/dc17-S011. - DOI - PubMed
    1. Pfeifer M. A., Halter J. B., Porte D., Jr. Insulin secretion in diabetes mellitus. The American Journal of Medicine. 1981;70(3):579–588. doi: 10.1016/0002-9343(81)90579-9. - DOI - PubMed
    1. Action to Control Cardiovascular Risk in Diabetes Study Group, Gerstein H. C., Miller M. E., et al. Effects of intensive glucose lowering in type 2 diabetes. The New England Journal of Medicine. 2008;358(24):2545–2559. doi: 10.1056/NEJMoa0802743. - DOI - PMC - PubMed
    1. ADVANCE Collaborative Group, Patel A., MacMahon S., et al. Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes. The New England Journal of Medicine. 2008;358(24):2560–2572. doi: 10.1056/NEJMoa0802987. - DOI - PubMed
    1. Duckworth W., Abraira C., Moritz T., et al. Glucose control and vascular complications in veterans with type 2 diabetes. The New England Journal of Medicine. 2009;360(2):129–139. doi: 10.1056/NEJMoa0808431. - DOI - PubMed

MeSH terms