In a special edition of the Diabetes Dialogue podcast recorded at the 84th American Diabetes Association Scientific Sessions, Dr. Carol Levy, director of the Mount Sinai Diabetes Center and Type 1 Diabetes Clinical Research, delves into the findings of the INHALE-3 trial and explores how individual patient factors can guide the use of inhaled insulin (Afrezza) in managing type 1 diabetes.
Analyzing the INHALE-3 Trial
Dr. Levy joins hosts Diana Isaacs, an endocrine clinical pharmacist and director of Education and Training in Diabetes Technology at the Cleveland Clinic, and Natalie Bellini, program director of Diabetes Technology at University Hospitals Diabetes and Metabolic Care Center, for a comprehensive discussion on the INHALE-3 trial. This phase 4 study evaluated the safety and efficacy of inhaled insulin combined with degludec insulin compared to standard care in type 1 diabetes patients.
Key Findings from INHALE-3
Conducted across 19 centers in the US, the trial involved 123 adult patients randomized to receive either inhaled insulin with degludec insulin or standard care. The 17-week randomized period was followed by a 13-week extension. Notably, 48% of participants used automated insulin delivery (AID) systems, while 44% relied on multiple daily injections (MDI).
Results revealed that 30% of the inhaled insulin group achieved an HbA1c level below 7% at week 17, compared to 17% in the usual care group. For participants with a baseline HbA1c of 7% or higher, 21% of those using inhaled insulin reached the target HbA1c, while none in the usual care group met this goal.
Efficacy and Safety of Inhaled Insulin
The trial also highlighted that 24% of the inhaled insulin group attained a time in range (TIR) greater than 70%, compared to 13% in the usual care group. Importantly, there was no increase in hypoglycemia among those using inhaled insulin.
Isaacs and Bellini discuss the trial’s implications for safety and efficacy, particularly among patients using AID systems like Control-IQ, Omnipod 5, and MiniMed 780G. They also explore the potential benefits of inhaled insulin in managing type 1 diabetes during pregnancy, offering a new perspective on optimizing care for this subgroup.
Expert Perspectives and Disclosures
For a deeper understanding of the trial, listeners are encouraged to check out another episode featuring Dr. Grazia Aleppo, professor of Medicine and director of the Diabetes Center at Northwestern University.
Disclosures for the involved experts include affiliations with companies such as Sequel, Eli Lilly, Tandem Diabetes, Dexcom, Abbott Diabetes Care, MannKind, Provention Bio, Novo Nordisk, Sanofi, and Medtronic.
This podcast episode provides valuable insights into how inhaled insulin can be integrated into personalized diabetes management strategies, highlighting the potential for improved outcomes in type 1 diabetes care.
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