Place of technosphere inhaled insulin in treatment of diabetes

Table 4 Advantages and limitations of technosphere insulin

Advantages

Relatively easy and non-painful administration

Flexible timing of administration either inhaled directly before meals or within 20 min after finishing a meal[10]

Hypoglycemia is less frequent than subcutaneous insulin, particularly late postprandial hypoglycemia

Weight gain is slightly less pronounced than subcutaneous insulin

Limitations

Frequent cough (24%-33% of patients)

Available only as prandial short-acting insulin. Hence, long-acting basal subcutaneous insulin should be added in patients with type 1 diabetes

Slightly less effective than subcutaneous insulin

Need for baseline and then serial pulmonary function testing

Safer to switch to subcutaneous insulin in case of upper or lower respiratory infections to avoid exacerbation of the disease and possible unreliable pulmonary absorption

No data available for pediatric and pregnant populations

Limited strength options and difficult fine titration of doses

Lack of long-term safety data

High cost, e.g., average price of ninety 4-unit cartridges and 2 inhalers is $271[21]