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Review: inhaled insulin provides better glycaemic control than oral hypoglycaemic agents but not better than subcutaneous insulin

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 Q In patients with diabetes, what is the relative efficacy, safety, and acceptability of inhaled insulin compared with subcutaneous (SC) insulin and oral hypoglycaemic agents?

METHODS

Embedded ImageData sources:

Medline (June 2006), Cochrane Controlled Clinical Trials Register (Issue 2, 2006), reference lists, and the US Food and Drug Administration web site.

Embedded ImageStudy selection and assessment:

English language randomised controlled trials (RCTs) that compared inhaled insulin with SC insulin or oral hypoglycaemic agents in non-pregnant adults with type 1 or type 2 diabetes and had a duration ⩾12 weeks. 16 RCTs (n = 4023, mean age range 29–60 y, 58% men) met the selection criteria. Methodological quality was assessed based on randomisation method, intention to treat analysis, dropout rate, and primary outcome (efficacy or safety).

Embedded ImageOutcomes:

change in haemoglobin A1c (HbA1c …

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