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ADA: Another Inhaled Insulin Treatment for Type 1 and 2 Diabetes May Be Coming Soon

The technosphere insulin inhalation powder (TI) is a non-invasive insulin inhalant that is used to help decrease blood glucose following meals in both type 1 and 2 diabetes patients….

It has been shown to reduce patient’s HbA1c levels similarly to subcutaneous rapid acting analog (RAA) insulin.

A trial was conducted for 24 weeks in the US, Brazil, and Ukraine where TI Gen2 inhaler (n=174) was compared to RAA (n=171). These were used with the addition of basal insulin in type 1 diabetic patients whose HbA1c level was between 7.5-10%. The treatment with TI did not differ significantly with RAA in reducing HbA1c (-0.21% vs. -0.4%; 95% CI -0.02-0.36). Patients have improved fasting plasma glucose when using TI compared with RAA (95% CI -56.2 to -14.5). Hypoglycemia events were lower with TI than RAA at all HbA1c levels (p<0.0001).

A 24 week, double blind study was also performed to compare the effects of TI (n=177) vs placebo (n=176) on type 2 diabetic patients whose HbA1c levels were between 7.5-10%. These were used with the addition of metformin or more than two oral anti-diabetic drugs. More patients achieve better HbA1c reduction of less than 7% with TI when compared to placebo group (p<0.0021). The total number of severe hypoglycemia was not statistically significant when TI was compared with placebo. Fasting plasma glucose decrease from baseline were 11mg/dL with TI and 4mg/dL with placebo.

Innovations like the technosphere inhalant have provided effective glycemic control to patients with non-invasive means of treatment. Both studies have shown the effectiveness of the inhalant on the HbA1c levels, fasting plasma glucose, as well as decreased risk of hypoglycemia.

A government advisory committee last month recommended approval of this form of insulin that is inhaled rather than injected. The endorsement could lead to a new option for millions of Americans with diabetes and vindication for the persistent billionaire who spent a large amount of his fortune to develop the product. Members of the committee, which advises the FDA, suggested that the inhaled insulin — called Afrezza and developed by the MannKind Corporation — would be useful for some patients, even if it might not be quite as effective as injected insulin.

Practice Pearls:
  • The technosphere insulin inhalation powder (TI) is a non-invasive insulin inhalant that is used to help decrease blood glucose following meals in both type 1 and 2 diabetes patients.
  • TI is comparable to rapid acting analogs (RAA) insulin with similar reduction in HbA1c levels.
  • It is effective in reducing HbA1c levels and fasting plasma glucose with less severity in hypoglycemic risk.

Presented at the American Diabetes Association 2014 Scientific Sessions; June 17, 2014