Insulin...Getting Better All the Time

DOCTOR'S VIEW ARCHIVE

Medical Author: Ruchi Mathur, M.D.
Medical Editor: William C. Shiel, Jr., MD, FACP, FACR

Insulin. Many patients dread the thought of taking it. It requires injection into the body and must be monitored diligently. To some, insulin can represent having to accept an unwanted disease.

We've come a long way in treating diabetes and tailoring insulin to suit a patient's specific needs. We have insulins that peak at different times (to allow for precision and flexibility) and we have refined delivery systems to include the insulin pump. Recently, much research has focused on the development of inhaled insulin.

Inhaled insulin is a powerful form of insulin that is delivered through the lungs. Initially, investigators have had trouble with effectiveness and concerns about possible lung damage. Last month, a group of scientists from the University of Vermont presented data at the American Thoracic Society meeting. They studied 140 patients over a 24 month period and looked at blood sugar control and lung function. While the study is ongoing, they found that inhaled insulin appears to maintain control of blood sugars without adverse effects on the lungs.

We are well aware that tight control of blood sugars helps to prevent and retard the progression of complications of diabetes such as eye, heart, and nerve disease and kidney damage. While type 1 diabetics face no option but insulin therapy, many type 2 diabetics are reluctant to consider insulin, even though attempts at lifestyle change and oral medications have not been sufficient to control their blood sugar levels. The reluctance is often due to fear of discomfort and the stigma associated with insulin use. Inhaled insulin will provide an attractive alternative to injections.

We can expect more advances in insulin therapy over the next few years. With pharmaceutical companies very interested in this research, one or more inhaled insulin products for consumers with diabetes will likely be developed within the next 3 years. While consumers and manufacturers are eager to see an inhaled insulin on the market, further work on the safety and efficacy of this form of therapy is well worth the wait.