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
In Type 1 diabetes,
or insulin-dependent diabetes, the immune system destroys cells
that produce insulin. People with the disease, which most often
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
and weight loss. Some people with this form of diabetes do take
insulin injections to help process blood sugar, or glucose, however.
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
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
note that an ongoing study comparing inhaled and injected insulin
will determine whether inhaled insulin will become a safe and effective
to injected insulin.
company Pfizer provided financial support for the study.
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."
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,"