Intrapulmonary insulin reduces blood glucose in type 1 diabetic patients

ABSTRACT

Administration of biosynthetic insulin is the mainstay of treatment of type 1 diabetes. Because of the inconvenience of multiple daily injections, alternative methods are actively sought. Intrapulmonary insulin delivery is a new and promising method. The aim of the present work has been to assess its efficacy and safety. We conducted our study on 11 patients with type1 diabetes mellitus. The patients received in the fasting state 3 units / kg BW of unmodified insulin by inhalation using an air compression nebulizer. Pulmonary function tests [FEV1, FVC and PEF] were measured to rule out immediate side effects on the airways, and blood glucose and insulin were measured before and after insulin inhalation. No significant changes were observed in pulmonary functions. Blood glucose decreased from 289 +/- 107 mg/dl to 218 +/- 106 mg/dl after 120 minutes [P<0.01]. The percent change [d%] reached a maximum of -26 +/- 14.8% [min. 2.9 and max. 52%]. Meanwhile, serum insulin reached a peak of 144 +/- 162 micro lU/ml 10 minutes after the inhalation. The maximum% change in insulin level was observed at 40 minutes [714%]. However, great variability was observed between patients. One can conclude that insulin is absorbed effectively from the pulmonary bed and this route carries a good potential for insulin delivery. However, the great inter- individual variability will be a problem in dose prescription. Further studies are needed to assess the efficiency of intrapulmonary insulin delivery in controlling mealtime glucose peaks.