Exubera could mean the end of an insulin injection era for diabetics

Diabetes and cancer remain the most feared diseases all around the world. Researchers have now come up with an insulin inhaler, potentially offering adult diabetics an alternative to injections for controlling their blood sugar. The drug is yet to be approved by the FDA.

If approved, the drug, known as Exubera, would mean an end to the insulin injections taken by millions worldwide. The product works by releasing an insulin-powder cloud inhaled via a handheld plastic machine similar to the inhalers used for asthma and allergy. The drug has been in development for a decade and is now backed by a joint venture between Pfizer, Sanofi-Aventis and Nektar Therapeutics.

Pfizer presented several studies showing Exubera controlled blood sugar as well as insulin shots for up to two years in patients with both forms of diabetes. Questions remain about whether adult Type 1 diabetics can expect to achieve tight glycemic control with Exubera.

Up to two-thirds of all diabetics do not adequately control their blood sugar, according to the American Academy of Clinical Endocrinologists. Poor control over the long term can lead to blood vessel and organ damage, blindness, and kidney failure and foot ailments.

Despite approval, many would still have to use needles, because the drug is not a replacement for the currently available longer-acting insulin. In addition, patients who smoke will be excluded from taking the drug, because of evidence that damage from cigarettes boosts patients` exposure to insulin.

'To have people rush to the this product saying, `I can throw away my syringes` ... is simply an incorrect message and that needs to be emphasized more,' said Dr. Paul D. Woolf, chief of medicine at Crozer Chester Medical Center in Upland, Pa., and acting chair of the advisory panel. I think the use of insulin without a needle, the siren call of that is almost irresistible,' said Rebecca W. Killion, the panel`s patient representative -- herself a diabetic. 'The practicality issue, though ... is huge.' The companies did not seek approval for adolescents and children -- two groups that could benefit greatly from a needle-free product. It has been proposed to restart pediatric studies with special emphasis on breathing problems.