Treating diabetes with aerosolized insulin

Because of the pain, inconvenience, and disruption of lifestyle associated with the injection of insulin, many patients with diabetes are noncompliant in terms of treatment regimens that require daily multiple injections. To eliminate the pain and to improve treatment outcome, there has been increas ing interest in the development of aerosolized insulin to replace subcutane ously (SC) delivered formulations. Recent studies in human volunteers have shown that when aerosolized insulin is effectively delivered to the alveola r region of the lung, absorption rates and decreases in glucose levels are similar to those achieved with SC-delivered insulin during the fasting stat e. Other human trials have shown that inhaled insulin also effectively cont rols postprandial glucose levels. Aerosolized insulin is well-tolerated, an d there is no evidence of irritation, hypoglycemia, or changes in pulmonary function when administered over short periods. At present, limitations in the delivery device result in less efficient administration of insulin aero sol compared to SC dosing. However, new devices and different formulations of insulin, which are currently, under development, should improve the effi ciency. It is likely that the treatment of diabetes with aerosolized insuli n will provide an effective alternative means for controlling plasma glucos e levels in diabetic individuals. Aerosolized insulin also will serve as a developmental model for this route of administration for a number of other therapeutic peptides that are currently administered by injection only.