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Uncontrolled Type 2 Diabetes Patients More Likely to Start Insulin When Inhaled Insulin Is an Option

Posted: Wednesday, April 25, 2007

The availability of inhaled insulin may increase the number of patients with uncontrolled type 2 diabetes who are willing to start or intensify insulin therapy. 
"We believe many more people with type 2 diabetes should be on insulin therapy just to get to goal [blood glucose levels]," said Richard M. Bergenstal, MD, executive director, International Diabetes Center, Minneapolis, Minnesota, United States.

Dr. Bergenstal and colleagues conducted a study to study if the availability of inhaled insulin would affect treatment choice in patients with uncontrolled type 2 diabetes (defined as hemoglobin A1c 7% or higher).

The trial was a randomized, parallel-group, multicenter questionnaire-based study. Prior to randomization, subjects were stratified into 2 groups: subjects who were on 2 or more oral agents (n = 393), and subjects on 1 or more oral agents plus insulin glargine (n = 216).

Subjects were assigned to receive educational material about standard therapies or to receive educational materials about standard therapies plus about inhaled insulin.

The study found that, when inhaled insulin was an option, the joint decisions made between physicians and their subjects were significantly more likely to include insulin in their future treatment regimen or chose a more intensive treatment in both the group on 2 or more oral agents (47.1% vs. 27.5%, P = .0002) and in the group on 1 or more oral agents plus insulin glargine (66.0% vs. 40.0%, P= .0005).

Nearly all subjects who chose insulin selected inhaled insulin when it was presented to them as an option. The decision by subjects to start therapy or intensify the regimen occurred more frequently when inhaled insulin was presented as a choice.

The researchers concluded that patients with type 2 diabetes, if provided with educational materials on the availability of insulin therapy, are more likely to use insulin, whether it's injected or inhaled, explained Dr. Bergenstal. "But when inhaled [insulin] was available, 2 to 3 times as many [patients] were willing [to use it]," he added.

This study was supported by Pfizer, Inc.

Source: Diabetes In Control: Presented at the American Association of Clinical Endocrinologists 16th Annual Meeting and Clinical Congress (AACE). [Presentation title: Impact of Inhaled Insulin on Treatment Choices in Uncontrolled Type 2 Diabetes Mellitus. Abstract 239]

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