Diabetes Care
New, FDA-Approved Inhaled Insulin Underwent Testing for Effectiveness by Memorial Physicians
Take Control of Your Diabetes
Diabetics are more susceptible to illness, so proper medical care is essential. Insulin treatment, combined with exercise, a well-balanced diet and stress management, can help ensure a longer, healthier life.
Memorial Healthcare System’s inpatient and outpatient diabetes programs focus on self-care skills and improving quality of life for diabetic adults and children. Outreach services include community screenings and free support groups.
For more information, please call one of the Memorial Diabetes and Nutrition Centers:
Memorial Regional Hospital
(954) 265-5889
Joe DiMaggio Children’s Hospital
(954) 986-2234, Press 4
Memorial Hospital West
(954) 844-6801
Memorial Hospital Miramar
(954) 538-4517
Memorial Hospital Pembroke
(954) 963-8013
April 2006 — For insulin-dependent diabetics, administering injections is part of their daily routine. Taking insulin is essential to their health, even their survival.
Now another insulin-delivery method — inhaled insulin — promises to make living with diabetes easier and more manageable. An inhaler device recently received FDA approval after extensive clinical trials in Europe and the United States, including South Florida, where Memorial Healthcare System physicians helped to prove its effectiveness.
Fast-Acting Relief
Sam Lerman, MD, FACE, endocrinologist on the medical staff at Memorial Regional Hospital, was one of the doctors who had been involved in the evaluation of the innovative therapy. During the five-year study, Dr. Lerman saw fast acceptance of inhaled insulin by the test subjects. “Patients take to it very quickly,” he says. “They definitely like the idea of inhaling insulin, rather than using needles.”
In healthy people, the pancreas produces insulin, a hormone that regulates how the body uses sugar, the fuel that feeds the body’s cells. Diabetics can’t make enough insulin to keep their blood sugar under control, and therefore need insulin therapy.
While long-acting forms of insulin help control blood sugar throughout the day, many diabetics also need to take insulin with meals to offset the sudden increase in blood sugar from food. Yet, they need this insulin to wear off quickly so they don’t experience a “blood-sugar crash” from the insulin taken before the meal.
Until now, the only way to deliver rapid-onset, short-acting insulin was through injections. But the new inhaled insulin offers the same benefits for adults with type 1 or type 2 diabetes — without shots.
About the size of a flashlight when folded, the inhaler uses dry powder insulin (supplied in convenient, dosage-controlled blister packs) and an aerosol delivery system. A cloud of rapid-acting insulin is inhaled through the mouth and into the lungs, where it enters the bloodstream. The insulin doesn’t need to be refrigerated, which is an additional benefit for travelers or those living in areas like South Florida, which are prone to hurricane-related electrical outages.
Dr. Lerman explains that many diabetics may still need to supplement their inhaled insulin treatments with injections of longer-acting insulin in the morning or at night. Type 2 diabetics often can use oral medications to supplement the inhaled insulin.
In addition, the FDA says the new inhaled insulin is not recommended for smokers or those who have quit smoking within the previous six months, or people with asthma, bronchitis or emphysema. It also has not been approved for use by children younger than 18. Dr. Lerman and other Memorial physicians are currently participating in national studies of the safety of inhaled insulin in patients with asthma and chronic bronchitis.
A Look to the Future
Inhaled insulin should become widely available by the middle of this year. Dr. Lerman sees additional improvements to the inhaler device, as well: “I foresee insulin inhalers becoming more miniaturized and convenient to use, much like cell phones and other electronics,” he says. “Managing diabetes will be even easier. More patients may be willing to take insulin, and control of blood sugars will be improved overall.”
Although many years from being introduced to the public, other needle-free insulin methods are undergoing research, including:
- Insulin Pill
A pill coated with a special polymer would allow insulin to reach the bloodstream without being destroyed by the digestive system. - Implantable Insulin Pump
External insulin pumps worn outside the body are already available. However, researchers are looking into a surgically implanted insulin pump. It would mimic the body’s natural insulin production, monitoring blood sugar levels and delivering precise amounts of insulin as needed. - Implantable Capsule
Special microchip technology would allow a capsule to be implanted under the skin, where it wouldn’t be affected by the body’s immune system. The capsule would contain insulin-secreting cells that would draw nutrients from the body to continuously produce insulin and release it to the bloodstream. - Insulin Patch
With this treatment, a patch placed on the skin would deliver a continuous, low dose of insulin. Insulin could be released before meals by pulling off a tab on the patch.
If you are concerned about diabetes and would like a referral to a physician, please call Memorial Physician Referral Service toll-free at (800) 944-DOCS. We’re available 24 hours a day, 7 days a week.