Abstract
Pulmonary delivery of insulin is more than a promise in the treatment of diabetes mellitus. Inhaled insulin seems at least as efficacious as the conventional regimen of subcutaneous insulin and/or oral glucose-lowering agents in both type 1 and type 2 diabetes mellitus. Improved metabolic control and the use of a non-invasive route of administration represent the main benefits of this new treatment. Several physico-chemical factors could reduce the bioavailability of inhaled insulin. Indeed, both deep-lung deposition and adsorption of insulin variously depend on the type of propellants used, speed of air flow, particle size and velocity, drug deposition into the throat and larger bronchial tree. These factors, in turn, depend on the pulmonary delivery systems used and on respiratory mechanics and flows. Furthermore, the pharmacokinetics of inhaled insulin is affected by smoke, which increases its absorption, and by lung diseases, which decrease the available alveolar-capillary surface. Selected abnormalities of respiratory function complicate both type 1 and type 2 diabetes mellitus and a mild depression of carbon monoxide lung transfer after a 6-month period of treatment with inhaled insulin has been reported. Finally, results from some longitudinal studies suggest that diabetes might speed up the age-related decline of lung volumes and probably alter the pharmacokinetics of inhaled insulin, particularly in the elderly. Clarifying these issues is mandatory in order to define the indications and safety of inhaled insulin.
Keywords: Diabetes mellitus, Pulmonary drug delivery, Inhaled insulin, Lung function, Insulin bioavailability, Insulin antibodies
Current Medicinal Chemistry
Title: Inhaled Insulin and the Lung
Volume: 14 Issue: 12
Author(s): Leonello Fuso, Dario Pitocco and Raffaele Antonelli Incalzi
Affiliation:
Keywords: Diabetes mellitus, Pulmonary drug delivery, Inhaled insulin, Lung function, Insulin bioavailability, Insulin antibodies
Abstract: Pulmonary delivery of insulin is more than a promise in the treatment of diabetes mellitus. Inhaled insulin seems at least as efficacious as the conventional regimen of subcutaneous insulin and/or oral glucose-lowering agents in both type 1 and type 2 diabetes mellitus. Improved metabolic control and the use of a non-invasive route of administration represent the main benefits of this new treatment. Several physico-chemical factors could reduce the bioavailability of inhaled insulin. Indeed, both deep-lung deposition and adsorption of insulin variously depend on the type of propellants used, speed of air flow, particle size and velocity, drug deposition into the throat and larger bronchial tree. These factors, in turn, depend on the pulmonary delivery systems used and on respiratory mechanics and flows. Furthermore, the pharmacokinetics of inhaled insulin is affected by smoke, which increases its absorption, and by lung diseases, which decrease the available alveolar-capillary surface. Selected abnormalities of respiratory function complicate both type 1 and type 2 diabetes mellitus and a mild depression of carbon monoxide lung transfer after a 6-month period of treatment with inhaled insulin has been reported. Finally, results from some longitudinal studies suggest that diabetes might speed up the age-related decline of lung volumes and probably alter the pharmacokinetics of inhaled insulin, particularly in the elderly. Clarifying these issues is mandatory in order to define the indications and safety of inhaled insulin.
Export Options
About this article
Cite this article as:
Fuso Leonello, Pitocco Dario and Antonelli Incalzi Raffaele, Inhaled Insulin and the Lung, Current Medicinal Chemistry 2007; 14 (12) . https://dx.doi.org/10.2174/092986707780597925
DOI https://dx.doi.org/10.2174/092986707780597925 |
Print ISSN 0929-8673 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-533X |
Call for Papers in Thematic Issues
Advances in Medicinal Chemistry: From Cancer to Chronic Diseases.
The broad spectrum of the issue will provide a comprehensive overview of emerging trends, novel therapeutic interventions, and translational insights that impact modern medicine. The primary focus will be diseases of global concern, including cancer, chronic pain, metabolic disorders, and autoimmune conditions, providing a broad overview of the advancements in ...read more
Approaches to the treatment of chronic inflammation
Chronic inflammation is a hallmark of numerous diseases, significantly impacting global health. Although chronic inflammation is a hot topic, not much has been written about approaches to its treatment. This thematic issue aims to showcase the latest advancements in chronic inflammation treatment and foster discussion on future directions in this ...read more
Cellular and Molecular Mechanisms of Non-Infectious Inflammatory Diseases: Focus on Clinical Implications
The Special Issue covers the results of the studies on cellular and molecular mechanisms of non-infectious inflammatory diseases, in particular, autoimmune rheumatic diseases, atherosclerotic cardiovascular disease and other age-related disorders such as type II diabetes, cancer, neurodegenerative disorders, etc. Review and research articles as well as methodology papers that summarize ...read more
Chalcogen-modified nucleic acid analogues
Chalcogen-modified nucleosides, nucleotides and oligonucleotides have been of great interest to scientific research for many years. The replacement of oxygen in the nucleobase, sugar or phosphate backbone by chalcogen atoms (sulfur, selenium, tellurium) gives these biomolecules unique properties resulting from their altered physical and chemical properties. The continuing interest in ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Negative Glucocorticoid Receptor Response Elements and their Role in Glucocorticoid Action
Current Pharmaceutical Design Arrhythmias and Left Ventricular Hypertrabeculation/Noncompaction
Current Pharmaceutical Design Stem Cell and Tissue Engineering Therapies for Ocular Regeneration
Current Stem Cell Research & Therapy Outcome of Heart Failure with Preserved Ejection Fraction: A Multicentre Spanish Registry
Current Cardiology Reviews Ghrelin in Obesity, Physiological and Pharmacological Considerations
Mini-Reviews in Medicinal Chemistry PPAR Agonists, Atherogenic Dyslipidemia and Cardiovascular Risk
Current Pharmaceutical Design Antioxidant Therapy for the Treatment of Oxidative Stress Associated to Cancer and Cancer- Related Anorexia/Cachexia
Current Nutrition & Food Science Green Synthesis of Silver Nanocomposites of Nigella sativa Seeds Extract for Hepatocellular Carcinoma
Current Nanomaterials Pain and Child: A Translational Hypothesis on the Pathophysiology of a Mild Type-2 Diabetes Model
Endocrine, Metabolic & Immune Disorders - Drug Targets Transition of Care for Patients with Diabetes
Current Diabetes Reviews Antioxidant Therapy and Drugs Interfering with Lipid Metabolism: Could They Be Effective in NAFLD Patients?
Current Pharmaceutical Design The Association of Transcription Factor 7 like 2 Gene Polymorphism with Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus
Current Diabetes Reviews Diabetes Mellitus and Osteoporosis Correlation: Challenges and Hopes
Current Diabetes Reviews Human Amniotic Membrane: Clinical Uses, Patents And Marketed Products
Recent Patents on Regenerative Medicine Measuring Glycaemic Variation
Current Diabetes Reviews Molecular Targets for Promoting Wound Healing in Diabetes
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery Protrhombotic Effects of Contraceptives
Current Pharmaceutical Design Clinical Consequences and Novel Therapy of Hyperphosphatemia: Lanthanum Carbonate for Dialysis Patients
Recent Patents on Cardiovascular Drug Discovery Targeting T-Cell Adhesion Molecules for Drug Design
Current Pharmaceutical Design Acute Toxicity Analysis and Antidiabetic Effect of the Moroccan Spider Flower (<i>Cleome Arabica</i> L.) in Normal and Sreptozotocin-Induced Diabetic Rats
Endocrine, Metabolic & Immune Disorders - Drug Targets