Inhaled Insulin As a Novel Administration Form For Insulin

Alveolar absorptive surface measures about 100 m2. The Inhaled Therapeutic System uses a fine powdered formulation or liquid insulin (Pulmosol powder technology or AERX device respectively). Minimum dose of insulin that can be delivered by inhalation is 3 units (1mg), but efforts are under way to further reduce the minimum possible dose. A newer technology, called AIR uses dry particle aerosol to prolong pulmonary insulin action. Aerosol insulin is absorbed and cleared faster than cutanous forms; also time to maximum glucose concentration and maximum glucose infusion is shorter. Newer devices guarantee the stability of inhaled insulin dose even better than cutanous forms. In fact, the most important advantage of this new mode of therapy is the enhanced therapeutic comfort and flexibility of mealtime, because it should be taken just before meal. The most important disadvantages include mild to moderate cough (without impairing pulmonary function tests), lower bioefficacy (about 10%) that results in more doses needed and higher cost (because of devices and higher insulin needed).