Inhaled insulin for the treatment of diabetes mellitus.

(1) Insulin delivery via inhalation, as an alternative to administration by injection, is under development. (2) The available evidence comparing subcutaneous (sc) insulin with inhaled insulin for persons with type 1 and 2 diabetes, shows similar glycosylated hemoglobin (HgA1c) levels after three months of treatment. (3) Clinical trials suggest that insulin delivered by inhalation has a quicker onset of action relative to regular insulin. This means insulin can be taken just prior to a meal rather than the 30 minutes prior to eating required with sc injections of regular insulin. (4) No changes in pulmonary function were noted in the studies, however data is limited to use for three months. Pulmonary thrombosis has subsequently been reported in one patient out of 1000, using Exubera(R) and the Inhale Therapeutic Systems device.