Inhaled insulin may be a better option than injections or pumps for some patients with type 1 diabetes, a new clinical trial shows.
Patients who used inhaled insulin (Afrezza) plus long-acting insulin degludec injections had better control over their blood sugar than those assigned to receive usual care, the researchers report.
About 21 percent of those who received inhaled insulin had an improvement in hemoglobin A1C of more than 0.5 percent during the study, compared with 5 percent of those who received standard care, the results show.
The results of the clinical trial “will have an impact on diabetes management by providing healthcare providers and patients with an alternative method of insulin delivery,” said lead researcher Dr. Irl Hirsch, professor of diabetes treatment and teaching at Washington University in St. Louis.
Inhaled insulin comes in powder form and is administered orally with a special inhaler, the National Institutes of Health (NIH ) explained. It is usually used at the beginning of each meal.
For the study, 123 adults with type 1 diabetes were randomly assigned to take inhaled insulin plus insulin degludec, or simply continue with their usual multiple daily insulin injections or an automated insulin pump.
The trial lasted more than 16 weeks in 19 hospitals in the United States. People with diabetes have an A1C level of 6.5% or higher, according to the NIH.
Among participants who had an A1C level of 7 percent or higher, about 21 percent of those taking inhaled insulin fell below 7 percent during the study. None of the participants who received standard care achieved this goal.
Additionally, 19 percent of participants who switched from using an automated delivery system to inhaled insulin had an A1C improvement of more than 0.5 percent, the results show.
It also proved to be a popular choice. More than half of the study participants wanted to continue using inhaled insulin after the trial concluded, the researchers said.
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However, inhaled insulin was not for everyone. About 26 percent of patients in the inhaled insulin group experienced a worsening of their A1C levels, compared with 3 percent of those who stuck to their standard of care.
The trial results were reported at the American Diabetes Association annual meeting in Orlando, Florida. Findings presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.
More information: The Cleveland Clinic has more information about inhaled insulin.
SOURCE: American Diabetes Association, press release, June 22, 2024