Randomized trial compares inhaled to subcutaneous insulin in diabetes management, suggesting its potential benefits.
Introduction and Objective: Inhaled insulin offers a non-invasive, patient-friendly alternative to SQ insulin. This meta-analysis was carried out to determine the efficacy, side effects, and clinical applicability of inhaled insulin in both Type 1 and Type 2 DM. Methods: RCTs were obtained from PubMed, Cochrane, Embase, and WOS databases comparing inhaled insulin with SQ insulin in Type 1 and/or Type 2 DM patients. Trials involving animals, crossover designs, comparisons of inhaled insulin with oral anti-diabetic drugs, and those lasting less than 12 weeks were excluded. Data on HbA1c, fasting blood glucose, body weight, and pulmonary function were analyzed using RevMan 5.4 with p < 0.05 considered statistically significant and a 95% confidence interval [95% CI]. Results: Analysis of 19 RCTs revealed that patients using inhaled insulin experienced a significant reduction in fasting blood glucose (Mean difference (MD): -22.12 [-29.29, -14.95]) and non-significant number of patients achieving HbA1c <7%. Inhaled insulin was associated with significant weight reduction but a significant decrease in DLCO (MD: -0.44 [-0.78, -0.11]) and FEV1 (MD: -0.03 [-0.04, -0.01]). Conclusion: Inhaled insulin offers a promising alternative to SQ insulin, with comparable glycemic control, improved fasting glucose and weight management. However, further studies are needed to assess its impact on pulmonary function and enhance its safety profile. Disclosure A. Khan: None. A. Awan: None. H. Saleem: None. A. Ahmad: None. M. Daniyal: None. W. Sultan: None. S. Ali: None.
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