The Pharmaceutical Journal
Vol 278 No 7435 p66
20 January 2007

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Benefits of inhaled insulin not sufficient to outweigh disadvantages

There are few situations where the potential benefit of inhaled insulin (Exubera) outweighs its associated safety concerns and expense, the authors of a Drug and Therapeutics Bulletin review conclude (2007;45:5).

The reviewers acknowledge that the need to inject insulin may make its use unacceptable to some patients and that alternative administration methods might address some of the problems associated with subcutaneous insulin. However they point out that, because Exubera is short-acting, it does not remove the need for patients with type 1 diabetes to inject basal insulin.

The reviewers are also not convinced by the promotional claim that Exubera maintains “long-term glycaemic control”, since experience of its use in routine long-term management of diabetes is limited. They also warn that the longer-term effects of continual exposure to insulin powder on the lungs are not known.

The January DTB also discusses the treatment of impetigo (ibid, p2).