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| Topic: |
Diabetes (DM) |
| Title: |
Inhaled Insulin Improves Glycemic Control When Substituted for or Added to Oral Combination Therapy in Type 2 Diabetes: A Randomized, Controlled Trial. |
| Author: |
Rosenstock, J., et al. |
| Source: |
Annals of Internal Medicine. 143(8): 549-558. October 2005. |
| Abstract: |
Patients with type 2 diabetes who do not achieve glycemic control with oral drug therapy eventually require insulin. This article reports on a study undertaken to determine the effect on glycemic control of inhaled insulin alone or added to dual oral therapy (insulin secretagogue and sensitizer) after failure of dual oral therapy. The open-label, randomized, controlled trial set in 48 outpatient centers in the United States and Canada included 309 patients with type 2 diabetes, no clinically significant respiratory disease, and HbA1c (glycosylated hemoglobin, a measure of blood glucose over time) level of 8 percent to 11 percent who were receiving dual oral therapy. The patients were given inhaled insulin (Exubera), titrated to blood glucose, administered alone (n = 104) or added to dual oral agents (n = 103) versus oral therapy alone (n = 99). Results showed that reductions in HbA1c level were greater with inhaled insulin. HbA1c level less than 7 percent was achieved by 32 percent of the patients using inhaled insulin plus oral agents and by 1 percent of patients on oral agent therapy. Hypoglycemia, mild weight gain, mild cough, and insulin antibodies were more frequent with inhaled insulin than with oral agent therapy alone. Pulmonary function was similar in all groups. The authors conclude that inhaled insulin improved overall glycemic control and HbA1c level when added to or substituted for dual oral agent therapy with an insulin secretagogue and sensitizer. Similar to other insulin therapies, hypoglycemia and mild weight gain occurred. 4 figures. 3 tables. 42 references. |
| Format: |
Journal Article |
| Language: |
English. |
| Major Keywords: |
Diabetes Mellitus. Type 2 Diabetes. Inhaled Insulin. Drug Therapy. Oral Hypoglycemic Agents. Blood Glucose. |
| Minor Keywords: |
Administration and Dosage. Drug Effects. Glycosylated Hemoglobin. Respiratory System. |
| Publication Number: |
DMJA12349. |
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