Exubera(®) (inhaled insulin): an evidence-based review of its effectiveness in the management of diabetes

INTRODUCTION: Inadequate glycemic control contributes to the development and progression of complications, which are associated with a significant economic burden on healthcare systems. However, optimal glycemic control is difficult to sustain with oral antidiabetic agents and adherence to intensive insulin regimens is compromised by patient compliance to multiple daily injections. Therefore, alternative delivery systems are required to improve the acceptability of insulin therapy. AIMS: This review assesses the evidence for the therapeutic value of inhaled insulin (Exubera(®)) in the management of type 1 and type 2 diabetes. EVIDENCE REVIEW: Evidence indicates that glycemic control, as measured by plasma HbA(1c) levels, with Exubera is as effective as subcutaneous insulin in patients with type 1 or type 2 diabetes. There is also good evidence that Exubera provides improved patient satisfaction and ease of use compared with subcutaneous insulin. However, the cost effectiveness of Exubera and its place in therapy compared with other inhaled insulin delivery systems currently in development remain to be determined. OUTCOMES SUMMARY: Exubera is an alternative treatment option for the management of diabetes which provides effective glycemic control with improved patient satisfaction.