NDLI: Efficacy, safety, and patient acceptability of Technosphere inhaled insulin for people with diabetes: a systematic review and meta-analysis.

Please wait, while we are loading the content...

The need for annual echocardiography to detect cabergoline-associated valvulopathy in patients with prolactinoma: a systematic review and additional clinical data.

Challenges and controversies in management of pancreatic neuroendocrine tumours in patients with MEN1.

Primary hyperparathyroidism presenting as a brown cell tumour of the hallux.

Inhaled insulin: weighing the pros and cons.

Efficacy, safety, and patient acceptability of Technosphere inhaled insulin for people with diabetes: a systematic review and meta-analysis.

Prevention of diabetes: more answers, more questions.

Long-term effects of lifestyle intervention or metformin on diabetes development and microvascular complications over 15-year follow-up: the Diabetes Prevention Program Outcomes Study.

Health-care costs over 15 years after bariatric surgery for patients with different baseline glucose status: results from the Swedish Obese Subjects study.

Bariatric surgery: time to move beyond clinical outcomes.

Heart failure: fatal, forgotten, and frequent in type 1 diabetes too.

Long-term excess risk of heart failure in people with type 1 diabetes: a prospective case-control study.

Sebastien Sasseville: dreaming with type 1 diabetes.

Robots and type 1 diabetes.

Cardiovascular disease and mortality in patients with type 2 diabetes after bariatric surgery in Sweden: a nationwide, matched, observational cohort study.

Weight loss surgery and cardiovascular risk and mortality in patients with type 2 diabetes.

Join us at The Lancet Clinic.

Evolution of insulin patents and market exclusivities in the USA.

Reducing socioeconomic inequalities in obesity: the role of population prevention.

Getting to the heart of the matter in type 2 diabetes.

Diabetes prevention and continuing health-care reform in China.

Year: 2015 Volume: 3 Issue: 10

Year: 2015 Volume: 3 Issue: 9

Year: 2015 Volume: 3 Issue: 8

Year: 2015 Volume: 3 Issue: 7

Year: 2015 Volume: 3 Issue: 6

Year: 2015 Volume: 3 Issue: 5

Year: 2015 Volume: 3 Issue: 4

Year: 2015 Volume: 3 Issue: 3

Year: 2015 Volume: 3 Issue: 2

Year: 2015 Volume: 3 Issue: 1

Year: 2014 Volume: 2

Year: 2013 Volume: 1

Efficacy, safety, and patient acceptability of Technosphere inhaled insulin for people with diabetes: a systematic review and meta-analysis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Pittas, Anastassios G. Westcott, Gregory P. Balk, Ethan M.
Description	Author Affiliation: Pittas AG ( Department of Medicine, Tufts Medical Center, Boston, MA, USA); Westcott GP ( Department of Medicine, Tufts Medical Center, Boston, MA, USA.); Balk EM ( Center for Evidence-Based Medicine, Brown University School of Public Health, Providence, RI, USA.)
Abstract	BACKGROUND: Technosphere inhaled insulin is a non-invasive alternative to subcutaneous injectable insulin for adults with type 1 or 2 diabetes. In this systematic review and meta-analysis of randomised controlled trials, we aimed to establish the efficacy, safety, and patient acceptability of Technosphere inhaled insulin in patients with diabetes. METHODS: We searched MEDLINE, the Cochrane Central Register of Controlled Clinical Trials, ClinicalTrials.gov, and relevant US regulatory documents for reports of randomised trials published in English up to May 30, 2015, that compared mealtime Technosphere inhaled insulin with placebo, subcutaneous insulin, or oral antidiabetic drugs in people with type 1 or type 2 diabetes. Two reviewers independently extracted data for outcomes of interest and risk of bias. Endpoints included changes in HbA1c concentration and bodyweight, and safety outcomes, including severe hypoglycaemia and pulmonary toxicity. When three or more studies provided relevant data, we did a meta-analysis for the outcome using a profile-likelihood random-effects model. FINDINGS: 13 trials met the inclusion criteria for qualitative systematic review; 12 met the inclusion criteria for quantitative meta-analysis (n=5273; age range 18-80). HbA1c decrease from baseline was greater with subcutaneous insulin than with Technosphere inhaled insulin (net difference 0·16%, 95% CI 0·06-0·25; eight trials). However, inhaled insulin was associated with less weight gain (net difference -1·1 kg, -2·1 to -1·6; three trials) and a smaller risk of severe hypoglycaemia (odds ratio 0·61, 95% CI 0·35-0·92; five trials). Incidence of mild transient cough was increased in people allocated to inhaled insulin (odds ratio 7·82, 6·14-10·15; seven trials) compared with those allocated to active comparator groups, as was the decrease in forced expiratory volume in 1 s (net difference -0·038 L, -0·049 to -0·026; five trials). Quality of life and overall patient satisfaction did not differ significantly between inhaled insulin groups and active comparator groups (no numerical estimate). INTERPRETATION: Glycaemic efficacy of Technosphere inhaled insulin is lower than that of subcutaneous insulin, but inhaled insulin has a lower risk of severe hypoglycaemia and weight gain. Long-term outcomes and safety with Technosphere insulin should be further investigated. Until further data for safety become available, Technosphere inhaled insulin should be reserved for healthy adults with diabetes who do not have pulmonary disease and who would otherwise delay initiating or intensifying insulin therapy because they are unwilling or unable to use injectable insulin. FUNDING: None.
File Format	HTM / HTML
ISSN	22138587
Issue Number	11
Volume Number	3
e-ISSN	22138595
Journal	The Lancet Diabetes & Endocrinology
Language	English
Publisher	Elsevier
Publisher Date	2015-11-01
Publisher Place	Great Britain (UK)
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Endocrinology Diabetes Mellitus, Type 1 Drug Therapy Diabetes Mellitus, Type 2 Hypoglycemic Agents Therapeutic Use Insulin Adolescent Adult Aged Aged, 80 And Over Dry Powder Inhalers Female Humans Administration & Dosage Adverse Effects Male Middle Aged Randomized Controlled Trials As Topic Registries Technology, Pharmaceutical Treatment Outcome Young Adult Journal Article Meta-analysis Review
Content Type	Text
Resource Type	Article
Subject	Endocrinology, Diabetes and Metabolism Internal Medicine Endocrinology

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

A review of inhaled technosphere insulin.

Impact of race/ethnicity on the efficacy and safety of commonly used insulin regimens: a post hoc analysis of clinical trials in type 2 diabetes mellitus.

Inhaled technosphere insulin: a novel delivery system and formulation for the treatment of types 1 and 2 diabetes mellitus.

Short-term intensive insulin therapy in type 2 diabetes mellitus: a systematic review and meta-analysis.

Systematic review and meta-analysis of the efficacy and hypoglycemic safety of gliclazide versus other insulinotropic agents.

Efficacy and Safety of Technosphere Inhaled Insulin Compared With Technosphere Powder Placebo in Insulin-Naive Type 2 Diabetes Suboptimally Controlled With Oral Agents

Vegetarian and Vegan Dietary Patterns to Treat Adult Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The effect of using the insulin pump bolus calculator compared to standard insulin dosage calculations in patients with type 1 diabetes mellitus - systematic review.

Efficacy of carbohydrate counting in type 1 diabetes: a systematic review and meta-analysis.

Efficacy, safety, and patient acceptability of Technosphere inhaled insulin for people with diabetes: a systematic review and meta-analysis.

Similar Documents

A review of inhaled technosphere insulin.

Impact of race/ethnicity on the efficacy and safety of commonly used insulin regimens: a post hoc analysis of clinical trials in type 2 diabetes mellitus.

Inhaled technosphere insulin: a novel delivery system and formulation for the treatment of types 1 and 2 diabetes mellitus.

Short-term intensive insulin therapy in type 2 diabetes mellitus: a systematic review and meta-analysis.

Systematic review and meta-analysis of the efficacy and hypoglycemic safety of gliclazide versus other insulinotropic agents.

Efficacy and Safety of Technosphere Inhaled Insulin Compared With Technosphere Powder Placebo in Insulin-Naive Type 2 Diabetes Suboptimally Controlled With Oral Agents

Vegetarian and Vegan Dietary Patterns to Treat Adult Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

The effect of using the insulin pump bolus calculator compared to standard insulin dosage calculations in patients with type 1 diabetes mellitus - systematic review.

Efficacy of carbohydrate counting in type 1 diabetes: a systematic review and meta-analysis.

Efficacy, safety, and patient acceptability of Technosphere inhaled insulin for people with diabetes: a systematic review and meta-analysis.