Exubera: Is inhaled insulin right for you?
Exubera: Is inhaled insulin right for you?
Inhaled insulin — What you need to know about Exubera, the new inhaled insulin therapy.
Maria Collazo-Clavell, M.D.
Inhaled insulin has been approved by the Food and Drug Administration (FDA) and is now available by prescription. Maria Collazo-Clavell, M.D., an endocrinologist specializing in diabetes at Mayo Clinic, Rochester, Minn., answers questions about this new form of insulin therapy.
What is inhaled insulin?
Inhaled insulin is a powdered form of insulin absorbed by the lungs through use of a hand-held inhaler. It was approved by the FDA in January 2006. Inhaled insulin is the first noninjectable option for insulin therapy in the United States since the discovery of insulin in the 1920s. Currently, it's marketed under the brand name Exubera.
Will inhaled insulin replace insulin injections?
The inhaled powdered insulin is rapid-acting insulin, usually taken before a meal. It replaces only short-acting forms of injectable insulin. Although people with type 1 diabetes and type 2 diabetes can use inhaled insulin, it won't replace the longer acting (basal) insulin that may be required as part of a diabetes treatment program. This is especially true for people with type 1 diabetes who need to take more comprehensive insulin therapy.
In patient trials, inhaled insulin was found to be just as effective as injected short-acting insulin and to significantly improve blood sugar control when added to pill (oral) diabetes medications in people with type 2 diabetes.
How does inhaled insulin work?
The inhaled insulin contains rapid-acting, dry, powdered human insulin that is inhaled into the lungs, using a hand-held inhaler device. Inhaling powdered insulin is a fast and efficient way to get insulin into the bloodstream, because the lungs have a very large and permeable surface area. When used as a meal-time insulin, it can be taken within 10 minutes of eating.
The hand-held inhaler device was designed for ease of use and doesn't need batteries or electricity. It consistently delivers the prescribed dose and doesn't require a special breathing technique.
The powdered insulin comes in 1-milligram and 3-milligram packets that require no special storage. You empty the prescribed number of insulin packets into the inhaler. Dosages are determined by your health care provider.
How large is the inhaler device?
The device used for inhaled insulin therapy is larger than those commonly used to deliver asthma medication. The inhaler, when closed, is about the size of an eyeglass case and weighs only 4 ounces. However, when fully extended, the inhaler is about 10 to 12 inches long. Its portable size may be especially convenient for active people.
Insulin inhaler compared to eyeglass case
An insulin inhaler, when closed, is slightly larger than an eyeglass case. The size of the device makes it easy to carry.
Are there side effects from using inhaled insulin?
Although no severe or permanent reactions have been noted, it's important to monitor your lung function throughout the first few months of inhaled insulin therapy. This can be done with a special calibration device as recommended by your health care provider.
Inhaled insulin has been used in clinical trials for two years. The reported side effects have included a slight cough, dry mouth and chest discomfort. Ongoing studies will continue to monitor the long-term use of inhaled insulin.
Can I use inhaled insulin?
Inhaled insulin may be an option if you want a more portable, less conspicuous method of taking your insulin. It's important to discuss any change in your insulin therapy regimen with your health care provider.
Inhaled insulin isn't recommended for those who smoke or recently quit smoking or those with asthma or any type of lung disease. Inhaled insulin hasn't been approved for children.
Inhaled insulin can be absorbed into breast milk. If you're breast-feeding, discuss the possible risks with your health care provider.
Your pharmacist can offer details on availability and pricing. Check with your insurance provider to verify coverage. Then, weigh all the pros and cons to decide if inhaled insulin is right for you.
Last Updated: 06/30/2006
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