Inhaled Insulin
It’s been a long awaited, much talked-about treatment: The first inhaled insulin—Exubera-- is now given the green light to hit the market in the United States.
Exubera is designed to keep blood sugars under control around mealtime: it’s taken ten minutes before eating. When inhaled, it passes quickly into the blood stream.
The big payoff: it’s a relief for those who fear the needle.
Dr. Holly Schachner, Medical Director of Exubera for Pfizer, says, “It was an incredible innovation in order to take the insulin molecule, and actually the insulin that you take from Exubera is exactly the molecule that your body makes and what we needed to do was get it into a dry form so that it’s stable at room temperature, it does not need to be refrigerated and we needed to get it into a device that we knew would work reliably and effectively.”
Exubera is for both types of diabetes—type one—when the patient is dependent upon insulin—here, it would be used along with long acting injected insulin.
And type two diabetes—here it can be used along with insulin pills that are more long acting, meaning, the patient can avoid insulin shots altogether.
“Patients actually preferred inhaling Exubera instead of taking their insulin injections and in fact for those patients who were actually taking diabetes pills to manage their Type 2 diabetes, they actually preferred inhaling Exubera as opposed to their current treatment with pills,” says Dr. Schachner.
Jeanine Albu is an endocrinologist at the St. Luke’s Hospital Obesity Research Center who, too, has studied Exubera. She says, “It is cumbersome for patients to take 4-5 injections a day having the inhaled form would be an incentive for patients to accept such a regimen and for doctors to prescribe it.”
It’s been a long time since the first commercial insulin hit the market back in the 1920’s. In fact, Exubera acts more quickly than some other insulins, reaching peak levels in 49 minutes compared to 105 minutes on average with regular injected insulin.
Dr. Albu states, “It’s very exciting. It’s a novel route of delivery, and I really think it’s going to increase compliance with insulin treatment and we hope to get their glucose better controlled and their complications down.”
And, with no pain.
The safety was proven in studies on more than 2500 adults with type 1 and 2 diabetes, and it was shown to be as effective as injected insulin.
Now patients should not take Exubera if they smoke or have smoked in the past six months. It’s also not for people with chronic lung diseases.
A common side effect is a cough that may very well go away with continued use.
It’s going to be available sometime in the middle of the year. The pricing for this has not been made available. But it’s expected to be more expensive, and that raises concern about whether Medicare, Medicaid, and insurance policies will cover it.
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