Ultra Rapid-Acting Inhaled Insulin Improves Glucose Control in Patients With Type 2 Diabetes Mellitus

Abstract

Objective: To determine whether the use of an inhaled insulin would improve HbA1c. Methods: This study was performed in 20 type 2 diabetes mellitus (T2DM) participants with HbA1c values !7.5 (58) to 11.5% (102 mmol/mol) on a variety of glucose-lowering regimens. Prandial Technosphere insulin (TI) was rapidly titrated based on a treatment algorithm using postprandial blood glucose to calculate premeal doses. A 2-week baseline period was followed by 12 weeks of active treatment with TI. The primary outcome was change in HbA1c. Secondary outcomes included glucose time in range (time in range: 70-180 mg/dL) obtained by a blinded continuous glucose monitoring during the baseline period and at the end of 12 weeks. Goals were to assess how to rapidly and safely initiate TI intensification, determine dosing requirements, and establish an effective dose range in uncontrolled T2DM. Results: Mean HbA1c decreased by À1.6% (À17 mmol/mol) from 9.0% (75 mmol/mol) at baseline to 7.4% (57 mmol/mol) at 12 weeks (P < .0001). Mean time in range increased from 42.2% to 65.7% (P < .0002). Mean prandial doses of TI were 18 or 19 units for all meals. Time below range was 1.1% baseline and 2.6% post treatment (P ¼ .01). Conclusion: Treatment with inhaled TI dosed using a simple algorithm improved glycemic control measured by both HbA1c and time in range, with low rates of hypoglycemia. These data add significantly to understanding TI in the management of T2DM patients for whom prandial insulin is a consideration.

The potential health benefits of aloin from genus Aloe

“…Diabetes mellitus is a metabolic disease caused by defective secretion and utilization of insulin and characterized by hyperglycemia resulting from multiple causes. α‐amylase in human pancreatic cells helps control the breakdown of starch in the body, thus preventing postprandial hyperglycemia (Levin et al, 2021). Early studies have revealed that Aloe vera can lower the levels of blood sugar and blood lipids in mouse models of non‐insulin‐dependent diabetes (Kim et al, 2009).…”

Role of serum β2-microglobulin, glycosylated hemoglobin, and vascular endothelial growth factor levels in diabetic nephropathy

“…HbA1c has been a common indicator used to evaluate patients’ blood glucose control in recent months. The more obvious the increase in HbA1c level, the worse the blood glucose control[ 13 , 14 ]. However, excessive blood glucose levels can damage vascular endothelial cells in patients with DN and easily induce spasms of renal afferent arterioles, thus causing damage to the renal units due to ischemia and hypoxia[ 15 , 16 ].…”

Type Ii Diabetes Mellitus and Management of Isolated Hyperglycemia: A Review

“…where, t is the total dose administered to the patient [49]. Fluid replacement is performed in patients with blood glucose greater than 400 mg/dl, dehydration, and ketosis.…”