Cystic fibrosis insulin

Insulin lispro and repaglinide were given to seven patients with diabetes related to cystic fibrosis (26). They had normal fasting blood glucose and insulin concentrations, but postprandial glucose concentrations were substantially raised. Insulin lispro had a larger and more... 

Moran A, Phillips J, Milla C. Insulin and glucose excursion following premeal insulin lispro or repaglinide in cystic fibrosis-related diabetes. Diabetes Care 2001 24(10) 1706-1710. 

The effect of nebulized salbutamol 2.5 mg on blood glucose concentration has been assessed in a doubleblind, placebo-controlled study in 19 patients with insulin-dependent diabetes (9 of whom had cystic fibrosis-related diabetes) (1053). There were no significant... 

Although routine oral delivery of proteins has not been realized, some protein formulations have been developed for pulmonary delivery. Pulmonary delivery can result in either parenteral or local administration of the drug and, like oral delivery, is considered non-invasive. As with other routes of delivery, the size of the protein may limit its ability to be delivered systemi-cally via the pulmonary route of administration. Pulmozyme , a DNase-based formulation approved for the treatment of cystic fibrosis (CF), is delivered to the lungs by a nebulizer to clear blockage of the airways in the CF patient.Formulations for insulin to be administered by inhalation for systemic delivery of... 

Part Three is the most extensively modified in the second edition. In the early 1990s asthma was the only disease that was being treated systematically with aerosols. Throughout the decade the concept of treating diabetes with insulin aerosols, cystic fibrosis by gene transfection, and infectious diseases with antimicrobials gained ground. Many of these approaches have yet to be commercial or therapeutic success stories, but by the time this book is in print they may be available to the clinician. Consequently, sections on these topics have been added. 

Cystic Fibrosis. Glycosylated hemoglobin in 34 cystic fibrosis patients (age I5-2O years) was significantly higher (7.97 1.16%) compared with 150 normal children (6.8 0.8%). This correlated with their decreased insulin response and impaired glucose tolerance (B16), although diabetes mellitus is reported to be rare in cystic fibrotics (B16). 

The first report of insulin iontophoresis was not related to diabetes management. It was an attempt to see if insulin could affect the saline content of sweat in cystic fibrosis patients (Shapiro et al, 1975). A decrease in sweat chloride was observed after insulin iontophoresis however, the role of the insulin, and whether insulin reached the circulatory system for systemic effect, was not clear. 

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