The annals of Internal Medicine report that treatment of diabetes with inhaled insulin or exenatide, an injectable drug, can improve blood sugar control in patients with type 2 diabetes who don’t have a good enough response with pills.
In one study, Dr. Julio Rosenstock, from the Dallas Diabetes and Endocrine Center in Texas, and colleagues assessed the effect of inhaled insulin on sugar control in 309 patients when substituted for or added to standard oral medications. The subjects were followed for 12 weeks.
Compared with continued oral therapy alone, a significant improvement in sugar control was achieved by substituting or adding inhaled insulin therapy, the investigators report.
Inhaled insulin therapy was more likely than oral therapy alone to produce excessivelyClevels. Treatment was also associated with mild weight gain and mild cough.
“The results of the studies in these two papers suggest a real advance in managing the later stages of diabetes: achieving glucose control without concomitant weight gain (exenatide) and a real choice for patients who dislike the prospect of injections (inhaled vs. injected insulin),” Dr. Richard J. Comi, from Dartmouth Hitchcock Medical Center in Lebano, New Hampshire, writes in a related editorial.

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