Waiting to Inhale. Part 2

Good News for Type 2 Diabetics, Too
Analgesics aren’t the only medications expected to be available soon for administration via inhalation.

William Cefalu, M.D., an endocrinologist at the University of Vermont College of Medicine and Fletcher Allen Health Care in Burlington, has recently moved into the third phase of trials testing inhaled insulin as an alternative insulin injections.

According to Cefalu, results of the study’s second phase — which examined safety and tolerance issues in the study’s 26 adults with Type 2 diabetes receiving their insulin as a dry powder delivered by an aerosol inhaler — were promising. When delivered by inhaler, the insulin powder is absorbed directly into the lungs, where it quickly enters the bloodstream.

“In this phase, we determined that the inhaled insulin appears comparable to the injected insulin in controlling blood glucose,” said Cefalu. “The risk for low blood sugar appears to be no greater than from the injected insulin. Furthermore, so far, no adverse effect on the lungs have been observed. If these results are confirmed in our next study phase, inhaled insulin will offer the first real alternative to injecting insulin for many diabetics.”

Asthmatics Led the Way
Inhaled medications have been used in the treatment of asthma for some time. According to Divyana Trivedi, M.D., a Norwalk, Calif.-based physician who treats many asthmatics, there are three basic devices used — the metered-dose inhaler (MDI), the nebulizer, and the rotary or dry powder inhaler.

Many other medications use similar devices, often referred to by their users as “puffers.”

Trivedi explains the MDI uses a chemical to propel medication out of the inhaler and into an asthmatic’s respiratory system. A nebulizer, in contrast, uses air or oxygen under pressure to deliver a fine liquid mist of medication through a mask that fits over a patient’s nose and mouth.пїЅNebulizers are commonly used for individuals who can’t use an inhaler, including infants, young children and the acutely ill.

The rotary inhaler is the newest of the three delivery systems. It was developed fairly recently in response to environmental concerns about the propellants used in MDIs, many of which contain ozone-damaging chemicals. Trivedi believes rotary devices are likely to become increasingly popular as protecting the ozone receives greater emphasis.

Every person need learn basic first aid techniques. You never know at what time you may need it – your loved one, you might be on holiday, at work.

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