Tech Corner: Inhaled Insulin - Everything You Need to Know

Inhaled Insulin: Everything You Need to Know

Offering a revolutionary approach to managing blood glucose levels, inhaled insulin provides a more convenient and less invasive method for individuals with diabetes. By delivering rapid-acting insulin powder directly to the lungs, this alternative to traditional insulin injections ensures a quicker onset of action, enhancing flexibility in managing mealtime insulin requirements. Its potential to improve adherence to insulin therapy and enhance overall diabetes management makes it a significant advancement in diabetes treatment. This article aims to explore the benefits, considerations, and future implications of this innovative insulin delivery method.

Understanding Inhaled Insulin Therapy

Inhaled insulin, also known as inhalable insulin, is insulin in powdered form delivered to the lungs with an inhaler. It represents a significant shift in insulin delivery, differing in route of administration, dosing units, patient eligibility, and required safety testing at periodic intervals. Although it appears to be equally effective as injected insulin, it is not considered superior and is unlikely to be cost-effective due to additional costs. The idea of inhalable insulin was first introduced by German researchers in 1924, following years of failure and the use of new technologies to turn insulin into a concentrated powder suitable for inhalation.

Compared to the subcutaneous route, inhaled insulin requires a higher dose to achieve a therapeutic response due to inefficient absorption. The administration of inhaled insulin involves the use of a thumb-sized inhaler, providing increased dosing flexibility. It contains recombinant human insulin dissolved with powder (fumaryl diketopiperazine), which is rapidly absorbed upon contact with the lung surface. Both components are almost completely cleared from the lungs of healthy individuals within 12 hours of inhalation. In contrast to previous inhaled insulin products, only 0.3% of insulin remains in the lungs after 12 hours.

Inhaled insulin is a drug-device combination product, which is rapid-acting and administered at the beginning of each meal. It is a treatment option for both Type I and Type II diabetes, particularly for patients whose blood sugar is not maintained with lifestyle interventions or oral hypoglycaemic agents. Clinical trials have demonstrated proof of principle for pulmonary delivery of insulin for diabetics, with the lungs providing an attractive alternative for systemic administration of therapeutic polypeptides, including insulin.

Smoking appears to enhance insulin absorption, and inhaled insulin is rapidly absorbed upon contact with the lung surface. It is important to note that inhaled insulin is not suitable for everyone, and healthcare providers will give specific instructions on how to take and adjust each dose based on individual activities and needs.

Inhaled Insulin

Inhaled insulin, such as Afrezza, offers a unique approach to managing glucose levels in individuals with type 1 or type 2 diabetes. It is administered through an inhaler, providing rapid-acting insulin delivery at the beginning of each meal. The inhaled insulin is designed to start lowering blood sugars in approximately 12 minutes, offering glucose management in the moment.

Additionally, it provides dosing flexibility and may be particularly beneficial for individuals who struggle with injections. However, it's important to note that inhaled insulin is not a replacement for long-acting insulin in individuals with type 1 diabetes .

Smoking has been found to enhance insulin absorption, which may impact the effectiveness of inhaled insulin. While inhaled insulin appears to be equally effective as injected insulin, it may not be considered cost-effective due to additional costs associated with the drug-device combination.

Therefore, healthcare providers should provide clear instructions on how to take and adjust each dose based on the individual's activities, ensuring safe and effective use of inhaled insulin for glucose management.

Inhaled Insulin and Lifestyle Factors

Inhaled insulin, also known as inhalable insulin, is insulin in powdered form delivered to the lungs with an inhaler. It represents an alternative in insulin delivery, differing in route of administration, dosing units, patient eligibility, and required safety testing at periodic intervals. A review that was completed in 2007 concluded that while inhaled insulin appears to be equally effective as injected insulin, it is not superior and is unlikely to be cost-effective due to additional costs. Compared to the subcutaneous route, a higher dose of inhaled insulin is required for a therapeutic response due to inefficient absorption.

The administration of Exubera, a previous inhaled insulin product, involved the use of a bulky device with limited dosing flexibility. Smoking has been found to enhance insulin absorption. Additionally, there is a significant decrease in the Diffusing Capacity of Lungs for Carbon Monoxide (DLCO) relative to subcutaneous insulin. Inhaled insulin contains recombinant human insulin dissolved with powder (fumaryl diketopiperazine). Once inhaled, technosphere insulin is rapidly absorbed upon contact with the lung surface. It is delivered with a thumb-sized inhaler, providing increased dosing flexibility. Both insulin and powder components are almost completely cleared from the lungs of healthy individuals within 12 hours of inhalation. In contrast to Exubera, only 0.3% of inhaled insulin remained in the lungs after 12 hours. Inhaled insulin is a rapid-acting drug-device combination product, administered at the beginning of each meal. It treats diabetes by increasing the body's insulin levels and comes in an inhaler, with instructions provided by a healthcare provider. However, individuals who smoke or have lung diseases such as asthma or COPD should not use inhaled insulin.

Conclusion

Inhaled insulin presents a promising alternative for individuals with diabetes who may struggle with traditional insulin delivery methods. The potential benefits of inhaled insulin, such as convenience and improved glycaemic control, make it an attractive option for many patients. However, it is essential for individuals considering inhaled insulin to consult with their healthcare professionals to determine if it is the right choice for their diabetes management.