I heard that a mouth spray form of insulin is in trials in England. Is this true and are there any clinical trials being run on this in the USA? How are subjects chosen for these trials? My daughter is 12 and she was diagnosed when she was 10. The hardest part for her are the shots. She has looked at some pump info but is not interested in it at this time.

I suspect you are talking about an inhaled insulin study that we and many others in the United States are doing at present. It is sponsored by Pfizer with insulin manufactured by Hoechst and using an Inhaled Therapeutics System device. The study is about 6 months already [as of Spring, 2000] but results will take about 2 years to be fully completed. The initial studies with adults have gone quite well and now there are studies in adolescents as well as middle-school-aged children with diabetes in progress.

There are also several other companies investigated inhaled insulins. It works much like Humalog (lispro) and aspart insulin from Lilly and Novo Nordisk but gets absorbed through the lungs. Does not seem to cause asthma or bronchitis, so far.

You should be sure to subscribe to magazines like Diabetes Forecast and Diabetes in the News since they will keep you updated on these experiments.

Another product, Oralgen, is under clinical investigation by Generex but we will need to await scientific presentation of their data at the upcoming American Diabetes Association meetings in San Antonio in June 2000 as well as at the IDF triennial meetings in Mexico City in November 2000. Initial reports look promising but there have not yet been published results. It’s likely that such an oral medication might provide background insulin effect but also likely that there are several more years of clinical safety and efficacy trials before this is ready for patient use here or elsewhere. The good news, of course, is that trials are ongoing and the early data looks reasonable.

SB