Patients with uncontrolled T2DM benefit from inhaled insulin

Patients with poorly controlled type 2 diabetes (T2DM) experienced a significant decline in their HbA1c levels when adding Technosphere inhaled insulin (Afrezza, MannKind Corp.) to their current treatment regimen, according to a new study.

Published online first August 17 in Diabetes Care, the study was authored by Julio Rosenstock, MD, with the Dallas Diabetes and Endocrine Center in Dallas, Texas. Researchers in Brazil, the Ukraine, Washington, New York, New Jersey, and Missouri also contributed to the study.

The pharmacist’s calling is to educate patients

In the double-blind, placebo-controlled study, researchers found that participants assigned to inhaled insulin realized decreases in postprandial blood glucose levels compared to patients receiving an inhaled placebo. “Prandial TI [Technosphere inhaled insulin] added to one or more OADs  [oral anti-diabetic medications] in inadequately controlled T2DM is an effective treatment option,” the researchers wrote.

When the FDA-approved inhaled insulin in June, 2014, the agency said the treatment is not a substitute for long-acting insulin.

“These results provide the basis for prandial [Technosphere insulin] as a viable option for those who require initiation of insulin but are reluctant to accept injectable therapy,” the researchers wrote. “It is conceivable that more rigorous titration regimens would have resulted in lower HbA1c reductions.”

Researchers followed 353 adults with T2DM with an HbA1c between 7.5 and 10 percent, who were prescribed metformin alone or two or more oral anti-diabetes medications. Researchers randomly assigned prandial Technosphere inhaled insulin or prandial Technosphere inhaled placebo as an addition to their oral anti-diabetes medications for 24 weeks.

A drop in HbA1c levels

Researchers found that inhaled insulin reduced HbA1c levels in diabetes patients by 0.8 percent from a baseline of 8.3 percent. The patients also achieved an HbA1c level of 7 percent less on average, compared to the placebo group. Participants in the inhaled insulin group experienced an average weight gain of 0.5 kg, while the placebo group lost an average of 1.1 kg.

The most common adverse event reported in both groups was a dry cough (23.7 percent for the inhaled insulin group versus 19.9 percent for the placebo group).