Clinicians should consider adding prandial inhaled insulin to oral antidiabetic medication in those whose type 2 diabetes is not well controlled, according to a randomized trial of 353 patients.

Study participants had type 2 diabetes and HbA1c levels between 7.5% and 10.0%. They were taking metformin alone or two or more oral antidiabetic medications. One hundred and seventy seven were given the add-on medication, whereas 176 were administered placebo. HbA1c levels were measured at 24 weeks.

The inhaled add-on significantly reduced HbA1c by 0.8%, vs 0.4% for the placebo group. More patients in the treatment group lowered their levels to less than 7%. Prandial inhaled insulin also controlled postprandial hyperglycemia.

Both groups experienced similar rates of mild, transient dry cough: 23.7% in the treatment group; 19.9% in the group taking placebo.

Citation: Rosenstock J, Franco D, Korpachev V, et al. Inhaled Technosphere Insulin Versus Inhaled Technosphere Placebo in Insulin-Naïve Subjects With Type 2 Diabetes Inadequately Controlled on Oral Antidiabetes Agents. Diabetes Care. 2015; August 7,2015. doi:10.2337/dc15-0629.