Efficacy and Safety of Inhaled Insulin ( Exubera ) Compared With Subcutaneous Insulin Therapy in Patients With Type 2 Diabetes

RESULTS — HbA1c decreased similarly in the inhaled ( 0.7%) and subcutaneous ( 0.6%) insulin groups (adjusted treatment group difference: 0.07%, 95% CI 0.32 to 0.17). HbA1c 7.0% was achieved in more patients receiving inhaled (46.9%) than subcutaneous (31.7%) insulin (odds ratio 2.27, 95% CI 1.24–4.14). Overall hypoglycemia (events per subject-month) was slightly lower in the inhaled (1.4 events) than in the subcutaneous (1.6 events) insulin group (risk ratio 0.89, 95% CI 0.82–0.97), with no difference in severe events. Other adverse events, with the exception of increased cough in the inhaled insulin group, were similar. No difference in pulmonary function testing was seen. Further studies are underway to assess tolerability in the longer term. Insulin antibody binding increased more in the inhaled insulin group. Treatment satisfaction was greater in the inhaled insulin group.

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