Radermecker R P, Sélam J L
Service de Diabétologie, Nutrition et Maladies métaboliques, CHU Sart Tilman, 4000 Liège, Belgique.
Rev Med Liege. 2005 May-Jun;60(5-6):355-60.
Since the discovery of insulin and its use in diabetes care, patients, physicians and nurses dream of another way of insulin administration than the subcutaneous injections actually used. Different types of insulin administration have been evaluated and, particularly, that using the pulmonary route. The use of this alternative method to deliver insulin may result in improved patient compliance, facilitate intensified therapies and avoid the delay of initiating insulin administration because patient's reluctance. The different insulin pulmonary delivering devices actually studied will be presented. Preliminary data comparing this way of administration and the subcutaneous injection of human regular insulin are good, but sufficient data comparing inhaled insulin with the new short-acting insulin analogues are not yet available. Among various difficulties of the pulmonary insulin delivery, the finding of an effective promoter, capable of increasing the bioavailability of insulin, is a crucial issue. The cost of such insulin administration might also be a problem. Finally, careful studies concerning the safety of this kind of administration, particularly potential long-term pulmonary toxicity, are mandatory. Nevertheless, inhaled insulin is an attractive topic in which most important pharmaceutical companies are currently involved.
自胰岛素被发现并用于糖尿病治疗以来，患者、医生和护士一直梦想着能有除实际使用的皮下注射之外的其他胰岛素给药方式。人们已经对不同类型的胰岛素给药方式进行了评估，尤其是采用肺部给药途径的方式。使用这种替代方法来输送胰岛素可能会提高患者的依从性，便于强化治疗，并避免因患者不情愿而延迟开始胰岛素给药。本文将介绍目前实际研究的不同胰岛素肺部给药装置。比较这种给药方式与皮下注射人常规胰岛素的初步数据是良好的，但尚无足够数据来比较吸入胰岛素与新型短效胰岛素类似物。在肺部胰岛素给药的各种困难中，找到一种能够提高胰岛素生物利用度的有效促进剂是一个关键问题。这种胰岛素给药方式的成本也可能是一个问题。最后，关于这种给药方式安全性的仔细研究，特别是潜在的长期肺部毒性，是必不可少的。尽管如此，吸入胰岛素仍是一个备受关注的话题，目前大多数重要的制药公司都在参与其中。
