Inhaled insulin reduces HbA1c, body weight in 24-week trial
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Among adults with type 2 diabetes, inhaled insulin was associated with HbA1c reductions similar to those with insulin aspart, fewer hypoglycemic episodes and lower body weight, according to a study published in Endocrine Practice.

This study aimed to compare glycemic efficacy of Technosphere insulin (TI) versus that of insulin aspart (IA), each added to basal insulin, in type 2 diabetes.

This randomized, 24-week trial included subjects aged from 18 to 80 years who were treated with subcutaneous insulin for 3 months and had glycated hemoglobin (HbA1C) levels of 7.0% to 11.5%. After receiving stabilized insulin glargine doses during a 4-week lead in, the subjects were randomized to TI or IA. The primary end point was an HbA1C change from baseline, with the differences analyzed by equivalence analyses.

Results:
-- In the overall cohort (N = 309; males, 23.3%), mean age was 58.5 years, body mass index was 30.8 kg/m2, weight was 82.2 kg, and duration of diabetes was 12.2 years.

-- An intention-to-treat cohort had 150 subjects randomized to TI (mean HbA1C: 8.9%) and 154 randomized to IA (mean HbA1C: 9.0%).

-- At 24 weeks, mean HbA1C value declined to 7.9% and 7.7% in the TI and IA cohorts, respectively.

-- A treatment difference of 0.26% was not statistically significant, but the predefined equivalency margin was not met.

-- Subjects receiving TI lost 0.78 kg compared to baseline; subjects receiving IA gained 0.23 kg.

-- The incidence of mild/moderate hypoglycemia was lower for the TI cohort, though not statistically significant.

Conclusively, both TI and IA resulted in significant and clinically meaningful HbA1C reductions. TI also resulted in significant and clinically meaningful weight reductions. These data support the use of inhaled insulin as a treatment option for individuals with type 2 diabetes.

Source: https://www.endocrinepractice.org/article/S1530-891X(20)48316-8/fulltext
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