Inhaled insulin therapy was recently approval by the FDA for clinical use in patients with type 1 and type 2 diabetes. Dry powder or liquid insulin formulations are aerosolized within an inhaler and delivered into the distal airways for alveolar absorption. Insulin is typically inhaled immediately before a meal because the peak glucose-lowering effect occurs 30-60 min post-inhalation. Studies in type 2 diabetics demonstrate postprandial BG control similar to rapid-acting insulin injected into the sc tissue (42).
Routine use of inhaled insulin appears to be safe and effective when used by patients who do not smoke cigarettes or have chronic obstructive pulmonary disease. The long-term
FIGURE 6 Enzyme-based electrochemical/oxygen blood glucose sensor with flexible catheter designed to float freely long-term in the superior vena cava (www.MedtronicDiabetes.com).
health effects of delivering large doses of insulin deep in the lung, however, are unknown. Only 20% to 30% of the inhaled dose is absorbed into the pulmonary bloodstream, whereas 70% to 80% is metabolized within the alveoli and bronchi. Clinical trials have revealed a mild decrease in lung function (forced expiratory volume and lung volume), increase in insulin antibodies and increase in the incidence of pulmonary thromboses (43).
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All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.