Insulin, inhaled Smoking

Becker RHA, Sha S, Frick AD, Fountaine RJ (2006) The effect of smoking cessation and subsequent resumption on absorption of inhaled insulin. Diabetes Care 29 277-282. 

Wise S, Chien J, Yeo K, Richardson C (2006) Smoking enhances absorption of insulin but reduces glucodynamic effects in individuals using the Lilly-Dura inhaled insulin system. Diabet Med 23 510-515. 

The dose of inhaled insulin is about 10 times higher than the subcutaneous dose that produces the same hypoglycemic effect. In an open, randomized, crossover study subcutaneous insulin was compared with a 10 times higher dose of inhaled insulin in 15 non-smoking patients with type 2 diabetes (262). The peak action of inhaled insulin was earlier. Apart from that, the effects were similar. There were no differences in FEVi at baseline or at 4 or 8 hours after treatment. Absorption of inhaled insulin is significantly higher in smokers (263). In non-diabetics, absorption is reduced in asthma (264). Inhaled insulin may increase the titer of insulin antibodies (265). 

Himmelmann A, Jendle J, Mellen A, Petersen AH, Dahl UL, Wollmer P. The impact of smoking on inhaled insulin. Diabetes Care 2003 26(3) 677-82. 

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