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Back To Vidyya Inahled Insulin Appears To Be Effective For Type II Diabetes Patients

Risk Is Doubled When Compared With Other Fathers

Will the needle become a thing of the past in the life of the diabetic? It appears so. The same researchers who reported last week that inhaled insulin can control blood sugar as well as injected insulin in people with type 1 diabetes now report that inhaled insulin also appears promising as a treatment for type 2 diabetes, the more common form of the disease.

In a small study, a combination of inhaled and injected insulin improved blood sugar control in a group of people with Type 2 diabetes.

In people with Type 2 diabetes, which is also known as non-insulin dependent diabetes, the body loses its sensitivity to insulin, the sugar-processing hormone.

In Type 1 diabetes, or insulin-dependent diabetes, the immune system destroys cells that produce insulin. People with the disease, which most often begins in childhood or early adulthood, must inject themselves with insulin every day to survive.

But since many people with Type 2 diabetes are overweight or obese, initial treatment usually focuses on reducing the body's resistance to insulin with diet, exercise and weight loss. Some people with this form of diabetes do take insulin injections to help process blood sugar, or glucose, however.

Despite the proven benefits of insulin injections, taking injections several times a day can be inconvenient, according to a team of researchers led by Dr. William T. Cefalu, of the University of Vermont in Burlington. A newly developed form of insulin that can be inhaled may be more appealing to some patients, so Cefalu's team conducted a 3-month study to evaluate how well inhaled insulin controls glucose levels.

The study included 26 mostly overweight and obese men and women who were taking two to three insulin injections each day to control their Type 2 diabetes. During the study, participants took inhaled insulin before each meal and a long-acting insulin injection at bedtime. Before each dose of insulin, they measured blood glucose. Each week, a physician reviewed these measurements and adjusted insulin doses if needed.

Over the course of the study, the average blood glucose level improved based on levels of glycated hemoglobin, a protein that is used to measure excess levels of blood sugar, Cefalu's team reports in the February 6th issue of the Annals of Internal Medicine.

None of the patients experienced severe hypoglycemia, a drop in blood sugar levels, and the treatment did not cause weight gain or affect lung function, the report indicates.

The investigators note that an ongoing study comparing inhaled and injected insulin will determine whether inhaled insulin will become a safe and effective alternative to injected insulin.

The pharmaceutical company Pfizer provided financial support for the study.

The results of the study need to be interpreted with caution, according to Dr. David M. Nathan, of Massachusetts General Hospital in Boston, since it did not include a "control" group of patients who were taking only injected insulin. In an editorial that accompanies the study, Nathan also points out the improvement in glucose control was "disappointingly modest."

The editorialist adds that since the absorption of insulin by the lungs is inefficient, inhaled insulin must be given in very large doses. Since the long-term safety of such high doses of insulin are unknown, "we may be exchanging the inconvenience of injections for new complications of diabetes therapy," Nathan notes.


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Editor: Susan K. Boyer, RN
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