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New Methods May Mean Fewer Insulin Shots for Diabetics

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WebMD Health News

May 30, 2000 -- It may soon be possible for people with diabetes to breathe insulin into their lungs or spray it into their mouths instead of giving themselves several daily shots, researchers say.

Jay S. Skyler, MD, who has been testing an inhaled version of insulin for the past three years, says: "It's pretty simple. If you know how to breathe, which most people on this planet do, you can use it."

The inhalation device, which crushes a pellet of insulin into a fine cloud of powder that is then breathed deeply into the lungs, is one of several alternatives to insulin shots now being tested. These methods, which also include insulin pills and a spray inhaler, are not designed to replace the shots entirely, but to reduce the number of daily injections needed, researchers say.

Skyler, a diabetes expert from the University of Miami, says patients who have used the inhalation device tend to like it. After an earlier study of the device ended, 80% of the study participants with type 1 diabetes and 92% of those with type 2 diabetes continued to use it. Five longer-term studies, aimed at confirming its effectiveness and safety, are beginning. If approved by the FDA, the device could be available to patients as early as the end of next year.

The inhalation device consists of a flashlight-sized clear tube with a slot into which an insulin pellet is placed. Squeezing a trigger crushes the insulin. Placing your mouth over the chamber and taking one or two slow, deep breaths is enough to draw the powder into the lungs, where it is rapidly absorbed into the bloodstream.

Another approach now being tested involves a much smaller device that resembles an asthma inhaler. With this device, rather than going all the way to the lungs, the insulin spray coats the inside of the mouth and the back of the throat. Because it is easy for drugs to pass through the sensitive tissue there, the insulin can get into the bloodstream quickly.

The spray mimics the body's normal secretion of insulin and, like the inhaled insulin, appears to control blood sugar levels as well as frequent injections. Its manufacturer, Generex Biotechnology Corp., of Toronto, says the spray has essentially no side effects, and the only patient complaints have been about a slight medicinal taste immediately after using it.

Arthur Krosnick, MD, a researcher involved in early tests of the device, says patients tell him they like it because it's easy to use. "Time and again, they have said, 'If I had my druthers, I would rather have this device than a needle,'" he says.

Although it has only been tested in adults, Krosnick, a diabetologist and clinical associate professor at Robert Wood Johnson Medical School in Princeton, N.J., says the spray inhaler is simple enough that kids should be able to use it, if studies show it works as well for them.

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