Diabetes Mellitus

Medical Problem

Diabetes mellitus is a group of metabolic diseases characterized by high blood sugar (glucose) levels, which result from defects in insulin secretion, or action, or both. There are two major types of diabetes, called type 1 and type 2. Most people with type 2 diabetes are failing to achieve optimal blood glucose control, leading to disease progression and the onset of debilitating and expensive complications, including heart disease, amputations, blindness and kidney failure. To achieve adequate blood glucose control, all patients with type 1 diabetes need exogenous insulin, and most with type 2 diabetes will also eventually require insulin replacement therapy. Fear of needles and the burden associated with multiple daily injections remain among the most significant barriers to initiating and maintaining insulin therapy.

New Discovery

EXUBERA (insulin human [rDNA origin]) Inhalation Powder is a prescription medication that contains rapid-acting, dry powder human insulin that is inhaled normally through the mouth into the lungs, using the handheld Exubera Inhaler. EXUBERA helps control high blood sugar.

Hypothesis

In patients with type 1 diabetes, glycemic control can be achieved as effectively with an inhaled insulin regimen, comprising preprandial inhaled intrapulmonary insulin plus a bedtime ultralente injection, as with a conventional subcutaneous insulin regimen involving two to three injections per day. My objective was to compare patient satisfaction between inhaled insulin and subcutaneous insulin.