Does Availability of AIR Insulin Increase Insulin Use and Improve Glycemic Control in Patients with Type 2 Diabetes?

Abstract

The opportunity to choose AIR insulin did not affect overall use of insulin at end point or A1C outcomes. Regardless of group assignment, utilizing a shared decision-making approach to treatment choices (concordance model), resulted in improved treatment satisfaction and A1C values at end point. Therefore, increasing patient involvement in treatment decisions may improve outcomes.

Patient-Reported Outcomes in Adults with Type 2 Diabetes Using Mealtime Inhaled Technosphere Insulin and Basal Insulin Versus Premixed Insulin

“…19 The statistically significant advantages for the Technosphere Insulin System during this study in terms of weight and hypoglycemia were not reflected in patients' HRQoL or treatment satisfaction. It has been suggested that the availability of inhaled insulin may increase patients' willingness to initiate insulin therapy, but the evidence is equivocal, 19,20 and there is little compelling evidence to suggest that the availability of inhaled insulin will lead to increased insulin initiation. Although this study was not designed as a PRO non-inferiority trial, the results do suggest that it is possible to initiate basal-bolus therapy using the Technosphere Insulin System without decrement in patients' HRQoL or treatment satisfaction compared with a regimen of twicedaily injections.…”

“…Although this study was not designed as a PRO non-inferiority trial, the results do suggest that it is possible to initiate basal-bolus therapy using the Technosphere Insulin System without decrement in patients' HRQoL or treatment satisfaction compared with a regimen of twicedaily injections. An earlier study of the effect of the availability of inhaled insulin found that multiple daily injection regimens were more common when inhaled insulin was available, 19 so availability of the Technosphere Insulin System might enhance willingness to implement a true basalbolus insulin regimen.…”

Inhaled insulin: overview of a novel route of insulin administration

“…The study determined that the availability of inhaled insulin did not increase the likelihood that individuals would add insulin to their treatment regimen. In addition, both groups had a comparable improvement in HbA 1c regardless of whether they added inhaled or subcutaneous insulin 70. Finally, patients with T1DM who received Exubera ® reported higher overall satisfaction scores and quality of life scores compared to those receiving subcutaneous therapy 35.…”

“…Freemantle et al demonstrated that the availability of inhaled insulin as a hypothetical treatment option increases the likelihood that patients with poorly controlled T2DM will accept the addition of insulin to their therapeutic regimen 69. Alternatively, Bergenstal et al addressed the question of whether having the opportunity to choose AIR ® insulin increased the likelihood that individuals with poorly controlled T2DM would choose any insulin therapy 70. In this study, subjects were randomized to receive counseling on therapeutic options to intensify diabetes management that either excluded or included inhaled insulin.…”