Setji Tracy L, Hong Beatrice D, Feinglos Mark N
a Department of Medicine, Division of Endocrinology , Duke University Medical Center , Durham , NC , USA.
Expert Opin Biol Ther. 2016;16(1):111-7. doi: 10.1517/14712598.2016.1121230. Epub 2015 Dec 11.
Insulin therapy is a mainstay for treatment of diabetes mellitus; however, many barriers to insulin exist. Insulin human inhalation powder (technosphere insulin) is a new FDA-approved alternative to subcutaneous bolus insulin.
This is an overview of technosphere insulin (TI). Pharmacokinetics, clinical efficacy, safety and tolerability are discussed.
TI is more quickly absorbed than subcutaneous insulin therapies and has a shorter duration of action. It appears to be noninferior compared with subcutaneous insulin regimens, and is associated with less hypoglycemia. Thus, it may serve as an alternative insulin agent in patients reluctant to administer multiple subcutaneous injections of insulin daily or in patients who experience late postprandial hypoglycemia with subcutaneous insulin. Cough is the most common side effect, but tends to be mild and transient. A small decrease in the forced expiratory volume has been demonstrated, but does not appear to progress and is reversible. Patients should have periodic pulmonary function tests. TI is contraindicated in patients with chronic lung disease. The long-term risk of lung cancer is being monitored but at this point does not appear to be higher than the expected incidence of lung cancer in this population.
胰岛素治疗是糖尿病治疗的主要手段；然而，胰岛素存在诸多障碍。人胰岛素吸入粉（技术型胰岛素）是美国食品药品监督管理局（FDA）批准的皮下推注胰岛素的一种新型替代药物。
本文是技术型胰岛素（TI）的概述。讨论了其药代动力学、临床疗效、安全性和耐受性。
TI的吸收比皮下胰岛素治疗更快，作用持续时间更短。与皮下胰岛素治疗方案相比，它似乎并不逊色，且低血糖发生率更低。因此，对于不愿每日多次皮下注射胰岛素的患者或皮下胰岛素治疗后出现餐后晚期低血糖的患者，它可作为一种替代胰岛素药物。咳嗽是最常见的副作用，但往往较轻且为一过性。已证实用力呼气量有小幅下降，但似乎不会进展且是可逆的。患者应定期进行肺功能检查。TI在慢性肺病患者中禁用。肺癌的长期风险正在监测中，但目前看来并不高于该人群肺癌预期发病率。
