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Inhaled insulin added onto or replacing 2 oral agents reduced haemoglobin A1c concentrations in type 2 diabetes

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 Q In patients with type 2 diabetes mellitus, does inhaled insulin added onto or replacing a failing regimen with 2 oral agents reduce haemoglobin A1c (HbA1c) concentrations?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ Internal medicine ★★★★★★★ Endocrine ★★★★★☆☆

METHODS

Embedded ImageDesign:

randomised controlled trial.

Embedded ImageAllocation:

concealed.*

Embedded ImageBlinding:

unblinded.*

Embedded ImageFollow up period:

12 weeks.

Embedded ImageSetting:

48 outpatient centres in the US and Canada.

Embedded ImagePatients:

309 patients 35–80 years of age (mean age 57 y, 65% men) with ⩾1 year history of type 2 diabetes treated with a stable oral agent regimen (1 insulin secretagogue and 1 insulin sensitiser) and HbA1c of 8–11%. Exclusion criteria included predisposition to severe hypoglycaemia; hospital admission or emergency department visit for poor diabetic control in previous 6 months; …

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