Abstract

Background: Inhaled insulin has proven to be viable and, in some aspects, a more effective alternative to subcutaneous insulin. Past and present insulin inhaler devices have not found clinical or commercial success. Insulin inhalers create a dry powder or soft mist insulin aerosol, which does not provide the required uniform particle size or aerosol volume for deep lung deposition. Methods: The primary focus of this review is to investigate the potential treatment of diabetes with a wet insulin aerosol. Vibrating mesh nebulisers allow the passive inhalation of a fine wet mist aerosol for the administration of drugs to the pulmonary system in higher volumes than other small-volume nebulisers. Results: At present, there is a significant focus on vibrating mesh nebulisers from the pharmaceutical and biomedical industries for the systemic administration of pharmaceuticals for non-traditional applications such as vaccines or the treatment of diabetes. Systemic drug administration using vibrating mesh nebulisers leads to faster-acting pharmaceuticals with a reduction in drug latency. Conclusions: Systemic conditions such as diabetes, require the innovative development of custom vibrating mesh devices to provide the desired flow rates and droplet size for effective inhaled insulin administration.

Highlights

  • Inhaled insulin has proven to be viable and, in some aspects, a more effective alternative to subcutaneous insulin

  • Afrezza In June 2014, the U.S Food and Drug Administration (FDA) approved a new formulation of the Afrezza inhaled insulin powder to act as prandial insulin requirements for non-smoking adults with diabetes who are free of pulmonary disease

  • This study demonstrated that the maximal insulin concentration (CMax) was reached in 15 min by the Technosphere inhaled insulin and in 120 min by the traditional subcutaneous insulin; CMax was 45% greater with inhaled Technosphere insulin compared to the subcutaneous insulin [36]

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Summary

Methods

The primary focus of this review is to investigate the potential treatment of diabetes with a wet insulin aerosol. Vibrating mesh nebulisers allow the passive inhalation of a fine wet mist aerosol for the administration of drugs to the pulmonary system in higher volumes than other small-volume nebulisers. Results: At present, there is a significant focus on vibrating mesh nebulisers from the pharmaceutical and biomedical industries for the systemic administration of pharmaceuticals for non-traditional applications such as vaccines or the treatment of diabetes. Systemic drug administration using vibrating mesh nebulisers leads to faster-acting pharmaceuticals with a reduction in drug latency. Conclusions: Systemic conditions such as diabetes, require the innovative development of custom vibrating mesh devices to provide the desired flow rates and droplet size for effective inhaled insulin administration

Aerosol Therapy
Aerosol Droplet Size
Aerosol Deposition Mechanisms
Anatomy of the Airways
Objectives
Insulin Therapy
Inhaled Insulin
AERx iDMS
Exubera
Afrezza
Clinical Trials
Hypoglycaemia
Weight Gain
Persistent Cough
Patient Satisfaction of Afrezza Inhalable Insulin
Insulin Administration and Dosing
Review of Inhaled Insulin Delivery Devices
Vibrating
Current
Published Clinical Trials
Findings
Conclusions
Full Text
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