Abstract
Type 2 diabetes continues to place a major burden on the health care system of the United States and worldwide. Type 2 diabetes involves two major defects: decreased insulin production from the pancreas and increased insulin resistance. Many patients with type 2 diabetes have decreased insulin production which requires exogenous insulin therapy in order to manage their disease. Despite this need, there is often a reluctance to initiate insulin therapy from both providers and patients. One reason for this reluctance may be a fear of needles or of administering injections. Delivering insulin through the lungs has been studied for decades, with the first inhaled insulin product coming to market in 2006. This product’s launch was considered unsuccessful, and the product was discontinued by the manufacturer the following year. A new inhaled insulin, Technosphere? insulin, was approved for use in type 1 and type 2 diabetes in 2014. This product was shown superior to placebo and non-inferior to a premixed bi-phasic subcutaneous insulin in patients with type 2 diabetes, and may offer an alternative to patients who are averse to giving subcutaneous injections.
Highlights
Diabetes and its complications continue to pose a major burden to the United States (US) and the world
Type 2 diabetes (T2D) accounts for over 90% of the total prevalence of the disease, and is characterized by increased insulin resistance by skeletal muscle, adipose and liver cells, and decreased insulin secretion by the pancreatic beta cells, both of which lead to elevated blood glucose levels, or hyperglycemia [3]
Technosphere® insulin (TI) is not recommended in patients who smoke or have smoked in the previous six months
Summary
Diabetes and its complications continue to pose a major burden to the United States (US) and the world. Type 2 diabetes (T2D) accounts for over 90% of the total prevalence of the disease, and is characterized by increased insulin resistance by skeletal muscle, adipose and liver cells, and decreased insulin secretion by the pancreatic beta cells, both of which lead to elevated blood glucose levels, or hyperglycemia [3]. This disease can be managed with lifestyle modifications (healthy diet, moderate exercise, and weight loss) together with one or more oral antihyperglycemic agents (OAAs), but due to its chronic, progressive nature, additional therapies are often required. This article reviews the evidence for pulmonary insulin delivery, with a focus on Technosphere® insulin, approved as an inhaled insulin in the US in 2014
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