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Caution over inhaled insulin

Diabetes patients should only be offered inhaled insulin if they are so opposed to the idea of injections that they will otherwise delay treatment, researchers have concluded.

Their meta-analysis found inhaled insulin was slightly less effective than the injectable form at achieving glycaemic control, although it did increase patient acceptability.

Patients with type 1 or type 2 diabetes using inhaled insulin had levels of HbA1c an average of 0.08 points higher than those on subcutaneous insulin.

Study leader Dr Lisa Ceglia, a researcher in the division of endocrinology, diabetes and metabolism at Tufts-New England Medical Center in Boston, said: 'Until long-term safety data is available, inhaled insulin should be reserved for non-pregnant adults with diabetes who are opposed to injections and who would otherwise delay appropriate and timely therapy.'

The conclusions are more cautious than the NICE provisional appraisal on inhaled insulin, which proposes merely restricting its use to patients with needle-phobia.

Dr Martin Hadley Brown, chair of the Primary Care

Diabetes Society and a GP in Norfolk, said: 'We have a responsibility to use the drug budget effectively, and I don't think

inhaled insulin stacks up.'

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