Inhaled insulin: Concerns remain

doi:10.1136/bmj.332.7552.1273-e

BMJ 2006;332:1273-1274 (27 May), doi:10.1136/bmj.332.7552.1273-e

Letter

Inhaled insulin

Concerns remain

The first 150 words of the full text of this article appear below.

EDITOR—Morton-Eggleston and Barrett conclude that theadverse effects of inhaled insulin are not clinically worrisome.¹Insulin is a potent mitogen and growth factor in the lung, leadingto concerns that repeated inhaled delivery of insulin resultsin supraphysiological alveolar insulin deposition which mayresult in adverse local effects.²

Several studies of the efficacy of the inhaled insulin (Exubera)in patients with type 1 and type 2 diabetes have shown a reductionin lung diffusing capacity (DLCO).^{3 4} Since lung function hasnot been altered in other studies of inhaled insulin, the manufacturersof Exubera have concluded that inhaled insulin is not associatedwith pulmonary dysfunction.⁵ Only one of these studies was ofgreater than two years' duration, whereas the remainder werelimited to three months.

The chronicity of diabetes means that patients will requiretreatment with inhaled insulin for much longer than two years.Although inhaled insulin is currently . . . [Full text of this article]

Niamh M Martin, specialist registrar

n.martin@imperial.ac.uk, Metabolic Medicine Unit, Hammersmith Hospital, London W12 0HS

Karim Meeran, consultant

Metabolic Medicine Unit, Hammersmith Hospital, London W12 0HS