Literature DB >> 14693983

Intensive therapy with inhaled insulin via the AERx insulin diabetes management system: a 12-week proof-of-concept trial in patients with type 2 diabetes.

Kjeld Hermansen1, Tapani Rönnemaa, Astrid Heide Petersen, Shannon Bellaire, Ulf Adamson.   

Abstract

OBJECTIVE: To compare the glycemic control of inhaled insulin via the AERx insulin diabetes management system (iDMS) with that of subcutaneous (SC) insulin, both combined with NPH insulin at bedtime, in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: The AERx iDMS uses a liquid insulin formulation to achieve flexible precise mealtime dosing (with increments corresponding to 1 IU administered subcutaneously) and ensures insulin delivery only when the breathing technique is optimal. This trial in patients with type 2 diabetes compared the glycemic control (HbA(1c)) achieved by inhaled insulin administered via AERx iDMS with that using SC insulin. This was a randomized, 12-week, open-label, parallel, multicenter, multinational trial in 107 nonsmoking patients with type 2 diabetes (mean age 59 years, mean duration of diabetes 11.9 years). Patients were randomized to receive either inhaled fast-acting human insulin via AERx iDMS immediately before meals or SC fast-acting human insulin administered 30 min before meals, both in combination with evening NPH insulin.
RESULTS: Baseline and demographic characteristics were similar between the two groups. There was no statistically significant difference in HbA(1c) between the AERx and SC groups after 12 weeks of treatment (7.84 +/- 0.77 vs. 7.76 +/- 0.77%, P = 0.60). Fasting serum glucose was significantly lower in the AERx group compared with the SC group by the end of the trial (8.9 +/- 3.8 vs. 10.8 +/- 3.7 mmol/l, P = 0.01) with a similar NPH dose in the two groups (0.23 vs. 0.23 IU/kg, P = 0.93). There were no statistically significant differences between the two groups in the intra-subject variability of fasting or prandial blood glucose increment. Adverse events were similar in the two groups. No major safety concerns were raised during the trial.
CONCLUSIONS: In patients with type 2 diabetes, preprandial inhaled insulin via AERx iDMS is as effective as preprandial SC insulin injection in achieving glycemic control with similar tolerability.

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Year:  2004        PMID: 14693983     DOI: 10.2337/diacare.27.1.162

Source DB:  PubMed          Journal:  Diabetes Care        ISSN: 0149-5992            Impact factor:   19.112


  12 in total

Review 1.  Waiting to inhale: noninjectable insulin, are we there yet?

Authors:  Kjeld Hermansen
Journal:  Curr Diab Rep       Date:  2004-10       Impact factor: 4.810

2.  Mealtime inhaled insulin lowers fasting glucose: a look at possible explanations.

Authors:  J H Devries
Journal:  Diabetologia       Date:  2005-11-05       Impact factor: 10.122

3.  Efficacy and safety of preprandial human insulin inhalation powder versus injectable insulin in patients with type 1 diabetes.

Authors:  S Garg; J Rosenstock; B L Silverman; B Sun; C S Konkoy; A de la Peña; D B Muchmore
Journal:  Diabetologia       Date:  2006-02-28       Impact factor: 10.122

Review 4.  Evolution of a pulmonary insulin delivery system (Exubera) for patients with diabetes.

Authors:  Priscilla A Hollander
Journal:  MedGenMed       Date:  2007-03-05

Review 5.  Inhaled insulin: overview of a novel route of insulin administration.

Authors:  Lucy D Mastrandrea
Journal:  Vasc Health Risk Manag       Date:  2010-03-03

Review 6.  New insulin analogues and routes of delivery: pharmacodynamic and clinical considerations.

Authors:  Paris Roach
Journal:  Clin Pharmacokinet       Date:  2008       Impact factor: 6.447

7.  Inhaled insulin is associated with prolonged enhancement of glucose disposal in muscle and liver in the canine.

Authors:  Dale S Edgerton; Alan D Cherrington; Doss W Neal; Melanie Scott; Margaret Lautz; Nancy Brown; Jeff Petro; Charles H Hobbs; Chet Leach; Angelo Del Parigi; Thomas R Strack
Journal:  J Pharmacol Exp Ther       Date:  2008-12-19       Impact factor: 4.030

Review 8.  Immunogenicity of Biotherapeutics: Causes and Association with Posttranslational Modifications.

Authors:  Anshu Kuriakose; Narendra Chirmule; Pradip Nair
Journal:  J Immunol Res       Date:  2016-06-29       Impact factor: 4.818

9.  Recent challenges in insulin delivery systems: a review.

Authors:  M M Al-Tabakha; A I Arida
Journal:  Indian J Pharm Sci       Date:  2008 May-Jun       Impact factor: 0.975

Review 10.  Inhaled insulin for controlling blood glucose in patients with diabetes.

Authors:  Bernard L Silverman; Christopher J Barnes; Barbara N Campaigne; Douglas B Muchmore
Journal:  Vasc Health Risk Manag       Date:  2007
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