World Journal of
Pharmaceutical and Life Sciences

A COMPREHENSIVE REVIEW OF INHALATION INSULIN: EVALUATING ITS EFFICACY, SAFETY PROFILE, MECHANISTIC INSIGHTS, CLINICAL APPLICATIONS, AND POTENTIAL TO TRANSFORM DIABETES MANAGEMENT AND PATIENT ADHERENCE IN THE CONTEXT OF EVOLVING THERAPEUTIC STRATEGIES

Agilandeswari Devarajan, Sagar, Pinnu Sathish Kumar, Kanika, Anil Kumar, Arpan Dutta, Manoj Kumar Katual , Yash Srivastav and Uriti Sri Venkatesh*

ABSTRACT

Diabetes mellitus (DM) is a chronic metabolic disorder affecting millions worldwide, requiring effective glycemic control to prevent complications. Insulin therapy is the cornerstone of diabetes management, yet traditional subcutaneous injections pose challenges related to patient adherence, injection discomfort, and delayed pharmacokinetics. Inhaled insulin emerges as a promising alternative, offering a non-invasive, rapid-acting approach that mimics endogenous insulin secretion more closely than subcutaneous administration. Despite its potential, early formulations like Exubera faced market failure due to bulky device design and safety concerns. However, newer advancements, particularly Afrezza, have demonstrated improved bioavailability, better patient adherence, and faster onset of action. This review explores the mechanism of action, pharmacokinetics, clinical efficacy, safety profile, delivery technologies, regulatory challenges, and economic considerations of inhaled insulin. Furthermore, it discusses patient adherence trends, emerging AI-driven insulin monitoring systems, and future perspectives in diabetes management. Although inhaled insulin shows promise in improving patient compliance and glycemic control, challenges such as cost-effectiveness, long-term pulmonary safety, and insurance coverage remain critical barriers. Advancements in nanoparticle-based insulin formulations, smart inhalers, and personalized medicine approaches may further enhance the feasibility and adoption of inhaled insulin in clinical practice.

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