scholarly journals AIR Inhaled Insulin Versus Subcutaneous Insulin: Pharmacokinetics, glucodynamics, and pulmonary function in asthma

Diabetes Care ◽  
2008 ◽  
Vol 31 (4) ◽  
pp. 735-740 ◽  
Author(s):  
M. Wolzt ◽  
A. de la Pena ◽  
P.-Y. Berclaz ◽  
F. S. Tibaldi ◽  
J. R. Gates ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Subcutaneous Insulin ◽  
Insulin Pharmacokinetics ◽  
Inhaled Insulin

scholarly journals Effect of Subcutaneous Insulin on Spirometric Maneuvers in Patients with Type 1 Diabetes: A Case-Control Study

2020 ◽  
Vol 9 (5) ◽  
pp. 1249
Author(s):  
Enric Sánchez ◽  
Chadia Mizab ◽  
Ariadna Sauret ◽  
Ferran Barbé ◽  
Raquel Martí ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Pulmonary Function ◽  
Basal Insulin ◽  
Case Control Study ◽  
Case Control ◽  
Insulin Analogues ◽  
Subcutaneous Insulin ◽  
Acting Insulin ◽  
Control Study

In order to compare spirometric maneuvers in adults according to the presence of type 1 diabetes, a case-control study including 75 patients with type 1 diabetes and 75 controls matched by sex, age, and body mass index were designed. In addition, 75 patients with type 1 diabetes were added to examine the potential the impact of subcutaneous insulin therapy on pulmonary function. Lung function measurements were assessed according to the global initiative for chronic obstructive lung disease guidelines. Basal insulin included long-acting insulin analogues and the delivered background insulin in patients with pump therapy. Bolus insulin included rapid-acting insulin analogues and the delivered insulin to cover postprandial hyperglycemias. Patients with type 1 diabetes showed lower spirometric values in comparison to the control group, together with a higher prevalence of forced expiratory volume in the first second (FEV1) <80% (10.7% vs. 2.7%, p = 0.044) and restrictive ventilatory pattern (10.7% vs. 0%, p = 0.006) The dose of basal insulin (U/kg/day) showed a negative correlation with forced vital capacity (FVC) (r = −0.205, p = 0.012) and FEV1 (r = −0.182, p = 0.026). The optimal cut-off value for identifying patients with a restrictive spirometric pattern was 0.5 U/kg/day of basal insulin. Additionally, basal insulin (U/kg/day) independently predicted the presence of both a restrictive spirometric pattern (OR = 77.1 (3.2 to 1816.6), p = 0.007) and an abnormal FEV1 (OR = 29.9 (1.5 to 562.8), p = 0.023). In patients with type 1 diabetes, higher basal insulin dosage seems to be related with an impairment of pulmonary function.

Treatment satisfaction in type 2 diabetes: A comparison between an inhaled insulin regimen and a subcutaneous insulin regimen

2002 ◽  
Vol 24 (4) ◽  
pp. 552-564 ◽  
Author(s):  
Joseph C. Cappelleri ◽  
William T. Cefalu ◽  
Julio Rosenstock ◽  
Ione A. Kourides ◽  
Robert A. Gerber
Keyword(s):  
Type 2 Diabetes ◽  
Treatment Satisfaction ◽  
Insulin Regimen ◽  
Subcutaneous Insulin ◽  
Inhaled Insulin

Inhaled Insulin: Exubera

2005 ◽  
Vol 39 (5) ◽  
pp. 843-853 ◽  
Author(s):  
Peggy Soule Odegard ◽  
Kam L Capoccia
Keyword(s):  
Type 2 Diabetes ◽  
Patient Satisfaction ◽  
Regular Insulin ◽  
Insulin Analog ◽  
Subcutaneous Insulin ◽  
Inhaled Insulin ◽  
Acting Insulin ◽  
Long Acting

OBJECTIVE: To review the pharmacology, pharmacokinetics, efficacy, and safety of Exubera, a novel, dry-powder formulation of insulin for inhalation, and describe patient satisfaction and quality-of-life data. DATA SOURCES: A MEDLINE search (1966–November 2004) was conducted using the key words inhaled insulin and Exubera for clinical trials limited to human research published in English. BIOSIS Previews and the American Diabetes Association Scientific Abstracts were used for published abstract information. STUDY SELECTION AND DATA EXTRACTION: All available human studies of Exubera were selected for review. References of identified articles were used for additional citations. DATA SYNTHESIS: Exubera is a rapid-acting insulin administered by oral inhalation before meals with long-acting insulin administered subcutaneously once or twice daily for type 1 or 2 diabetes mellitus. Exubera provides similar efficacy and improved patient satisfaction compared with standard subcutaneous insulin therapy (ie, NPH twice daily with regular insulin before meals). Efficacy has also been demonstrated for Exubera when used as adjunctive therapy with oral medications for type 2 diabetes. The onset of Exubera is more rapid and its duration of action is similar to that of regular insulin. To date, Exubera administered before meals with a once-daily long-acting subcutaneous insulin (usually Ultralente) has been compared with standard subcutaneous NPH/regular insulin regimens. Comparison of premeal Exubera plus a basal long-acting insulin analog (eg, glargine) with a regimen of premeal subcutaneous rapid-acting insulin analog (eg, lispro or aspart) plus a basal long-acting insulin analog (eg, glargine) is needed to fully evaluate Exubera. Pulmonary safety appears to be maintained for up to 4 years, although there are no data, as of this writing, on the use of this agent in patients with pulmonary conditions. CONCLUSIONS: Exubera is an effective inhaled insulin for preprandial use in type 1 or 2 diabetes. Improved patient satisfaction over injected insulin increases its potential for use earlier in the treatment of type 2 diabetes.

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