A Review: The Prospect of Inhaled Insulin Therapy via Vibrating Mesh Technology to Treat Diabetes

Abstract

Background: Inhaled insulin has proven to be viable and, in some aspects, a more effective alternative to subcutaneous insulin. Past and present insulin inhaler devices have not found clinical or commercial success. Insulin inhalers create a dry powder or soft mist insulin aerosol, which does not provide the required uniform particle size or aerosol volume for deep lung deposition. Methods: The primary focus of this review is to investigate the potential treatment of diabetes with a wet insulin aerosol. Vibrating mesh nebulisers allow the passive inhalation of a fine wet mist aerosol for the administration of drugs to the pulmonary system in higher volumes than other small-volume nebulisers. Results: At present, there is a significant focus on vibrating mesh nebulisers from the pharmaceutical and biomedical industries for the systemic administration of pharmaceuticals for non-traditional applications such as vaccines or the treatment of diabetes. Systemic drug administration using vibrating mesh nebulisers leads to faster-acting pharmaceuticals with a reduction in drug latency. Conclusions: Systemic conditions such as diabetes, require the innovative development of custom vibrating mesh devices to provide the desired flow rates and droplet size for effective inhaled insulin administration.

Keywords: diabetes; inhaled insulin; vibrating mesh technology.

Figure 1

Current vibrating mesh technology. (i) PARI eFlow rapid vibrating mesh nebuliser [68]. (ii) Aerogen Aeroneb Pro vibrating mesh nebuliser [66]. (iii) Aerogen Solo II vibrating mesh nebuliser [66].

Figure 2

Volume median diameter (VMD) and volume flow rates of the Dance 501 collected distal to the Alberta throat with a simulate inspiratory flow rate of 10 L·m⁻¹. The VMD is sufficient; however, the flow rate is inadequate and required multiple breaths and breathing techniques to administer a dose. The volume median diameter (VMD) to percentage respirable dose (%RD) of the Dance 501.