Insulin that can be inhaled into the lungs is becoming available for use in diabetics. It is more expensive but may show greater acceptance in selected patients.
Intended use: A patient whose glycated hemoglobin remains elevated after the fasting glucose has been controlled with basal insulin
Ideal candidate for the use of inhaled insulin - one or both of the following:
(1) true needle phobia
(2) extensive cutaneous lipodystrophy at injection sites
People who should not be treated with inhaled insulin:
(1) children or adolescents (not approved)
(2) pregnant women (not approved)
(3) smokers (increased absorption)
(4) chronic lung disease (COPD, asthma), or when the FEV1 is less than 70% of predicted
(5) a person using inhaled insulin who have experienced a decline of 20% in the FEV1 or an absolute decline of 500 mL from baseline
Need for caution:
(1) someone who works in a smoky environment (decreased absorption)
(2) someone who has experienced repeated episodes of hypoglcyemia while using inhaled insulin
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Specialty: Endocrinology, Clinical Laboratory