March 5, 2001
Inhaled Insulin, Insulin Pumps
Question from New Berlin, Wisconsin, USA:
I am a 23 year old busy college student with type 1 diabetes, so I can’t always eat at exact meal times, and I enjoy hiking on longer excursions. I was considering going on the insulin pump, but am now waiting to use the new insulin for the long acting and then Humalog at meals. Do you know when the new insulin (24 hour) will be on the market? Can you now purchase the inhalers used for insulin?
The new insulin to which you refer is Lantus (insulin glargine). It can be given once a day and is roughly equivalent to two doses of NPH, but it does have to be given as a separate shot and cannot be mixed with other insulins. You still, of course, need short acting insulin and common practise is to use Humalog at meal times in a dose that varies with the carbohydrate content of your meal. Glargine is expected to reach the market later this year.
The insulin inhaler is a rather cumbersome device although it works well [it is still in clinical trials]. The Generex Oral Insulin Spray is a much more convenient unit. It is about the size of an asthma inhaler, and the insulin is absorbed through the mucosa of the mouth, so that there is less chance of respiratory infections. It is unlikely to be on the market for a year at the least as it is still in clinical trials.
I would certainly endorse using one of the new insulin pumps which are very versatile, but you need experienced support in the early stages.