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Review: inhaled insulin provided better glycaemic control than oral hypoglycaemic agents but not subcutaneous insulin

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 Q In patients with diabetes, what is the relative efficacy, safety, and acceptability of inhaled insulin compared with subcutaneous (SC) insulin and oral hypoglycaemic agents?

Clinical impact ratings GP/FP/Primary care ★★★★★★★ IM/Ambulatory care ★★★★★★☆ Endocrine ★★★★★☆☆


Embedded ImageData sources:

Medline (to June 2006), Cochrane Controlled Clinical Trials Register (issue 2, 2006), reference lists, and the US Food and Drug Administration website.

Embedded ImageStudy selection and assessment:

randomised controlled trials (RCTs) of ⩾12 weeks’ duration that compared inhaled insulin with SC insulin or oral hypoglycaemic agents in non-pregnant adult patients with type 1 or type 2 diabetes. 16 RCTs (n = 4023, mean age range 29–60 y, 58% men) met the selection criteria. Methodological quality was assessed based on randomisation method, intention to treat analysis, dropout rate, and primary outcome (efficacy or safety).

Embedded ImageOutcomes:

change in haemoglobin …

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  • For correspondence: Dr A G Pittas, Tufts-New England Medical Center, Boston, MA, USA. apittas{at}

  • National Institutes of Health and Friedman New York Foundation for Medical Research.