Alain Ulrich Kalala Kabongo
University of South Wales, UK
Diabetes mellitus is a major cause of death and disability. Individuals have to deal with painful injections; inhaled insulin may be beneficial for glycaemic control. The primary objective of this study was to assess the benefits of inhaled insulin for glycaemic control in insulin-dependent and insulin-resistant patients older than 12 years. ADA website, Cochrane databases, and Medline were searched for randomised clinic trials published in English between 2000 and 2003. Relevant studies were identified and selected for our review and meta-analysis. Data extractions were assessed by two reviewers. Seven randomised control trials were included, involving 1689 participants in total. Four studies included patients with type 1 diabetes and three those with type 2 diabetes. All were open label, comparing inhaled insulin to subcutaneous insulin for the duration of â?¥12 weeks. There was no difference in the proportion of participants achieving HbA1C â?¥7%. The estimated average relative risk was equal to 0.1420 (95% CI: -0.0313 to +0.3154). The results suggest that the benefits in the treatment group is on average 14.2% less than the risk that in the control group. The null hypothesis shows that the average true effect is equal to zero and only marginally rejected (z=1.606, p=0.108), i.e., at about 10% significance level. Statistically, the differences in results were not quite significant. Therefore, we concluded that inhaled insulin may offer similar benefits for glycaemic control compared to subcutaneous insulin for patientâ??s â?¥12 years. Further studies are suggested regarding its benefits in diabetes-related acute and chronic events and its effectiveness alone.
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