More About Inhaled Insulin

I was interested to read an article in yesterday’s (Friday, November 16, 2007) Business section of the New York Times about a new inhaled insulin preparation which is being tested. The article was written by Andrew Pollack. You may recall that Pfizer recently announced that it was dumping its inhaled insulin, Exubera, apparently because of poor sales. Alfred E. Mann, the founder of MannKind Corporation is betting his personal fortune that his new inhaled insulin will be a big hit.

Is Mr. Mann’s inhaled insulin going to be a success?

If I were an investor, I probably wouldn’t rush out and buy lots of stock in MannKind Corporation (I don’t even know if it is publically traded) but I’m glad we may have an inhaled insulin available; it’s just another treatment tool that may be useful for some patients. As I discussed in an earlier entry, I was not very impressed with Exubera when our group studied its use in teenagers with diabetes; the patients learned that just taking the shots (or using an insulin pump) was quite a bit easier (for teens, “easier” means quicker) than messing with the inhaled stuff. Unfortunately, unless one takes an inhalation every 2-3 hours around-the-clock, it is still necessary to take at least one daily injection with a long-acting insulin. The article says that Mr. Mann feels that “his” inhaled insulin will be a success because it acts quicker than any of the current fast-acting insulins, including Exubera, and that the delivery device is much smaller than the Exubera device. Well, we’ll see. I am not “sold” on the idea that quicker action (both on and off) is necessarily a big benefit since it may make it trickier to deal with the long-acting insulin needs. Also, the theory that post-meal high blood sugars are bad for a person even if overall blood sugar control is good, has never been proven despite the many drugs on the market that give their raison d’etre that the drugs are an aid (generally a very very expensive aid) in controlling post-meal highs. I’m not sold on that idea, but who knows?
Given how long it took Pfizer to clear the FDA safetly hurdles with Exubera, it may be quite a while before Mr. Mann’s insulin hits the streets. As I mentioned, the more treatment options the better. I would like to see some companies make decisions about patient care products not only on the “bottom line.”

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