Numerous attempts have been made to develop novel routes of
insulin delivery that are both effective and tolerable. Of all the potential non-invasive delivery options, pulmonary delivery is the most clinically viable. Early studies demonstrate that the inhaled
insulin is rapidly absorbed and is closer to
biological insulin than standard subcutaneous
insulin (SC). To date, inhaled
insulin (
Exubera) has been clinically assessed in more than 3500 patients with type 1 or
type 2 diabetes, some treated for more than 7 years. Several phase 3 studies of 24-week duration have demonstrated comparable glycosylated haemoglobin (HbA1c) control in patients with
type 1 diabetes treated with
Exubera vs. SC
insulin. Similar results have also been recorded in patients with
type 2 diabetes. Furthermore,
Exubera has shown clinical superiority to oral agent regimens in patients with
type 2 diabetes who failed to achieve their target HbA1c using lifestyle modification and oral agents.
Exubera was well tolerated and treatment satisfaction was high, with
Exubera being the preferred
insulin therapy in all studies. The results of these trials, and others, suggest that
Exubera may be a valuable tool to help a wide variety of patients with type 1 or
type 2 diabetes reach their recommended goals for glycaemic control, irrespective of their current
therapy.