Inhaled Insulin

[tutsiwarrior]

an article from today's Guardian may be of interest...

Health | The NHS plan

Inhaler could replace jabs to control diabetes

James Meikle, health correspondent

Wednesday April 20, 2005

The Guardian

Hundreds of thousands of people with diabetes may soon benefit from inhalers that could dramatically cut the number of injections needed to control the disease.

Researchers believe the first insulin inhaler will be licensed for general use in Europe within the year.

About 700,000 Britons are thought to need at least one jab a day, and maybe four or five. But the new, dry powder form of insulin, which is inhaled and which has been tried by more than 3,500 adults worldwide, some for more than seven years, offers promising prospects.

The scientists say it could lead to better management of the disease and so reduce the risk of amputation and complications like heart disease, stroke and kidney failure.

Possibly, regular mealtime puffs from an inhaler could take the place of inconvenient injections, even if a long-acting daily jab were used to ensure sufficient insulin levels.

The development is likely to benefit far more people over the next 10 years than the promising, but small-scale, transplants of pancreatic islet cells, which produce insulin.

Results of the trials into the safety and effectiveness of the inhaler are being presented today at a conference in Glasgow organised by the charity Diabetes UK.

Teams in Birmingham, London and Miami, are among those involved in the trials, which have involved patients with type 1 diabetes treated by insulin injections and diet, and patients with type 2 diabetes. Patients in the latter group, mainly older people but increasingly those who are younger and obese, are often treated through diet and tablets to control glucose levels but more of these patients are also needing injections.

Douglas Smallwood, chief executive of Diabetes UK, said: "Since insulin was discovered in the 1920s, injections have been the only option. That can be difficult for some people. Many attempts have been made to come up with new treatments and at last we appear to be close to success. While it will not be suitable for everyone, this could make a real difference to the lives of many people with diabetes."

Trials suggest that for those with type 2 diabetes already on tablets, inhaled insulin gives better blood glucose control than further doses of tablets. For those with type 1 disease, four years of inhaled insulin treatment plus a daily injection have proved effective without serious side-effects.

Anthony Barnett, professor of medicine at Birmingham University and lead investigator for two trials on inhalers and type 2 diabetes, said: "Good blood glucose control is essential to keeping people with diabetes healthy. It can sometimes be very difficult trying to maintain that on a daily basis. One of the difficulties can be having to inject insulin up to four times a day. Our hope is that inhaled insulin will provide more choice, making it easier for people with diabetes to stay healthy."

Prof Barnett, also a consultant for the Birmingham Heartlands and Solihull NHS trust, added: "The beauty of inhaled insulin is you have a massive surface area for absorption." Short-acting insulin goes into the furthest parts of the lungs before crossing over into the bloodstream, he said.

Pfizer and Sanofi-Aventis have filed with US and European regulatory bodies for licences to market the inhaler, known as Exubera.