Question:
From the Microsoft Network:
I am interested in the research on an insulin nasal spray. Could you please tell me why those who used it did not complete the study?
Answer:
When people with diabetes saw how easily asthmatics contained
attacks with nasal sprays, it was a great temptation to suppose that
insulin might be
administered in this way. And indeed there were a number of trials, the
best of which was probably conducted in New Zealand. From the beginning
however, the apparatus necessary to deliver a droplet that was
sufficiently small was cumbersome and expensive. In time that could have
been overcome and indeed a good deal of progress was made. More important
objections were that much larger amounts of insulin were required than
with the conventional subcutaneous route and this was true even when the
insulin was combined with inhibitors of proteolytic enzymes. Furthermore,
absorption was very variable depending on obvious factors such as
environmental humidity and the presence of any mucosal [skin] inflammation.
With much greater emphasis on the importance of control in recent years,
episodes of
ketoacidosis
have become much rarer and also with the advent of ultrafine
needles the tedium of injections has been reduced. In short, inhaled
insulin has rather faded from the scene and with the further advent of
very sophisticated pumps, it will probably not come back.
DO'B
Original posting 18 Apr 1998
Posted to Research: Other
and Insulin
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