We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

Preliminary Study of the Efficacy of Insulin Aerosol Delivered by Oral Inhalation in Diabetic Patients

Beth L. Laube, PhD; Angeliki Georgopoulos, MD; G. K. Adams III, PhD
JAMA. 1993;269(16):2106-2109. doi:10.1001/jama.1993.03500160076035.
Text Size: A A A
Published online


Objective.  —To maximize deposition of an aerosolized dose of insulin (mean± SD=0.99±0.06 U/kg of body weight) in the lungs of subjects with non—insulin-dependent diabetes mellitus (NIDDM), and investigate its efficacy in normalizing plasma glucose levels during the fasting state.

Design.  —Nonrandomized, placebo-controlled trial.

Setting.  —A primary care facility.

Patients or Other Participants.  —Six nonobese, nonsmoking volunteers with NIDDM. No subjects withdrew from the study.

Intervention.  —Aerosolized insulin was administered by oral inhalation after a 12-hour period of fasting. Aerosol was generated by a raindrop nebulizer from regular 500 U/mL pork insulin. During inhalation, inspiratory flow was regulated at 17 L/min. Plasma samples were collected after inhalation and analyzed for insulin and glucose levels.

Main Outcome Measures.  —Plasma insulin and glucose levels.

Results.  —Deposition of the aerosol was maximized within the lungs, with 79% ±17% of the inhaled dose depositing below the larynx. Geometric mean fasting plasma insulin level was 71 pmol/L (11.8 μU/mL), rising to 269 pmol/L (44.8 μU/mL) after insulin inhalation. Average time to peak insulin level was 40±34 minutes. The mean fasting plasma glucose level (12.63±2.59 mmol/L [225.5±46.3 mg/dL]) was reduced to within the normal range in five subjects and was almost normal in the sixth subject (5.52±0.89 mmol/L [98.6±15.9 mg/dL]). Average maximum decrease in plasma glucose from baseline was 55%±10% (n=6) vs 13%±9% after placebo aerosol inhalation (n=3). No side effects were reported following insulin or placebo aerosol inhalation.

Conclusions.  —These preliminary results indicate that a dose of approximately 1.0 U of aerosolized insulin per kilogram of body weight, delivered by oral inhalation and deposited predominantly within the lungs, is well tolerated and can effectively normalize plasma glucose levels in patients with NIDDM.(JAMA. 1993;269:2106-2109)


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?




Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...