Pfizer - Exubera; dont hold your breath

Inhaled Insulin (Exubera) is already receiving UK media attention despite the product not being launched yet.

It is likely that a great many patients will be disappointed when the product is launched because there are several contraindications and monitoring issues associated with this novel product.

Inhaled Insulin is a short acting insulin for the treatment of Type I and Type II diabetes however it is not recommended for use in the following patients:

Current smokers
Any who has smoked in the last 6 months
Patients with poorly controlled, unstable or severe asthma
Patients with severe COPD
Patients with Heart Failure and compromised lung function
Patients under the age of 18

Any patient who is initiated on inhaled insulin should also undergo a baseline assessment of lung function using spirometry to assess FEV1. This test should be repeated at 6 months in all patients and periodically thereafter depending upon the decline in lung function. Patients whose lung function is confirmed as having declined by 20% or more should have treatment stopped.

This insulin is also a short acting insulin and many patients will still need to inject an intermediate or long acting insulin. This removes the main advantage for needle phobic patients if injections will still be necessary.

The upshot of all of this is that Exubera will be suitable for a relatively small number of patients given the contraindications and also comes with some intensive monitoring requirements.

Source: Prescribing Advice for GPs