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New Diabetes Treatments Show Promise

Inhaled Insulin, Lizard-Saliva Drug Offer New Options

Weight Gain, Weight Loss continued...

But the exenatide group reported much higher rates of gastrointestinal side effects, with 57% reporting nausea, compared with 9% of the insulin patients, and 17% reported vomiting, compared with just fewer than 4% of those on insulin.

Overall, roughly 19% of the patients taking exenatide withdrew from the study because of side effects vs. just under 10% of those on insulin.

Patients receiving exenatide showed more improvement in blood glucose level after meals compared with the long-acting insulin (glargine), yet those taking long-acting insulin showed a greater reduction in fasting blood sugars compared with exenatide.

Both drugs similarly improved overall blood sugar control in people with type 2 diabetes with less than adequate control with a combination of oral diabetes medications, concludes the study.

The study was funded by exenatide manufacturer Eli Lilly and Co., a WebMD sponsor.

No More Needles

In a separate three-month trial involving 309 patients, the inhaled insulin Exubera was compared with treatment with two blood sugar-lowering drugs or in combination with the two treatments.

The groups receiving Exubera either alone or in combination with the two diabetes pills achieved better blood sugar levels than those taking oral medications use to enhance insulin secretion or increase insulin sensitivity.

But mild weight gain was seen in patients taking the inhaled insulin and was similar to that seen with injected insulin.

Exubera therapy resulted in more low-blood-sugar episodes (hypoglycemia) than those taking the combination oral drug alone. The study was paid for by Exubera manufacturers Pfizer Inc. and the French company Sanofi-Aventis. Both companies are WebMD sponsors.

An FDA advisory panel recently approved Exubera, and experts tell WebMD that they expect the treatment to be commercially available soon.

Patients would be expected to embrace an alternative to insulin shots, and studies have shown that, in theory, this is the case. But the experts say acceptance of inhaled insulin is far from certain.

That is because the insulin-delivery device is relatively large -- about the size of a standard flashlight -- and it must be used before every meal.

"Most people picture an asthma inhaler, but this is much bigger," diabetes treatment expert Richard Comi, MD, tells WebMD.

There is also some concern about the long-term toxicity of inhaled insulin, says Rizza. And Comi expressed concerns about whether smokers and patients with lung problems will be candidates for inhaled treatment.

The inhaled insulin comes in a dry powder delivery system similar to some asthma inhalers. When it hits the lungs, it's absorbed directly into the bloodstream, allowing it to take effect faster than injected insulin.

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