Inhaled Insulin for Prandial Glucose Control in Type 1 and Type 2 Diabetes: Scoping Review with ☸️SAIMSARA

Name: SAIMSARA Evidence Object visceral::INHALED_INSULIN_SS
Creator: SAIMSARA
License: https://saimsara.com/license/

SAIMSARA

doi:10.62487/saimsara989b2320

SAIMSARA Journal

Machine-Readable Science • ISSN 3054-3991

Inhaled Insulin for Prandial Glucose Control in Type 1 and Type 2 Diabetes: Scoping Review with ☸️SAIMSARA

Gastrointestinal & Metabolic Health

Issue 9, Volume 1, 2026

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DOI: 10.62487/saimsara989b2320

Editorial note

• Last update: 2026-06-08 21:46:41

What is this paper about

Inhaled insulin is emerging as a genuinely faster prandial option that can reduce early glucose excursions, limit weight gain, improve treatment satisfaction, and complement automated insulin delivery. This review maps the full evidence across type 1 and type 2 diabetes while confronting the unresolved pulmonary safety questions that will determine where inhaled insulin truly belongs in clinical practice.

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Video summary generated from this ☸️SAIMSARA evidence map. Full reference-linked paper and evidence JSON are available after purchase.

Abstract: To comprehensively map the existing evidence on inhaled insulin, synthesizing findings on its glycemic efficacy, safety, pharmacokinetic/pharmacodynamic properties, patient acceptability, and role in special populations, in order to delineate its current clinical utility and identify critical knowledge gaps. The review uses 73 references and builds its evidence map from 159 original studies with 1087552 total participants/sample observations (topic-deduplicated ΣN). Overall, the evidence indicates that inhaled technosphere insulin offers a clinically viable, ultra-rapid prandial option that is noninferior to subcutaneous rapid-acting analogs for HbA1c control in adults with type 1 diabetes while better blunting early postprandial excursions and improving treatment satisfaction. This signal is reinforced by favorable weight outcomes in type 2 diabetes, including a −0.78 kg change versus +0.23 kg with insulin aspart, and by emerging utility as an adjunct within automated insulin delivery systems. However, a retrospective cohort reporting a threefold higher COPD incidence tempers enthusiasm and highlights that pulmonary safety remains the central unresolved question. Future work should prioritize long-term prospective pulmonary registries and dedicated trials in pediatric, pregnant, and AID-integrated populations to clarify where inhaled insulin delivers the greatest net clinical benefit.
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Keywords: Technosphere insulin; inhaled insulin pharmacokinetics; postprandial glucose control; type 1 diabetes; automated insulin delivery; HbA1c noninferiority; pulmonary safety; insulin degludec combination; pediatric diabetes; patient satisfaction

Review Stats

Final search date and database lock: 2026-05-31 10:57:42 CEST
Plan: Pro (expanded craft tokens; source: Semantic Scholar)
Source: Semantic Scholar
Total Abstracts/Papers: 976075
Downloaded Abstracts/Papers: 1000
Included original and non-original Abstracts/Papers (all): 366
Included original Abstracts/Papers (Vote counting by direction of effect): 159
Reference Index (links used in paper): 73
Total participants/sample observations (topic deduplicated ΣN): 1087552

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Reference Index (73)

[1] Inhaled insulin in pregnancy: A case series supporting feasibility and clinical potential for pregnant people with diabetes — https://doi.org/10.1002/pmf2.70065
[2] Replacing or Supplementing Automated Insulin Delivery With Inhaled Insulin: A 90-Day Randomized Controlled Trial. — https://doi.org/10.1177/19322968251388128
[3] A Randomized Comparison of Postprandial Glucose Excursion Using Inhaled Insulin Versus Rapid-Acting Analog Insulin in Adults With Type 1 Diabetes Using Multiple Daily Injections of Insulin or Automated Insulin Delivery — https://doi.org/10.2337/dc24-0838
[4] Inhaled Insulin: A Much-Needed Needleless Paradigm Shift in Diabetes Management — https://doi.org/10.29011/2574-7568.010140
[5] Is There a Place for Inhaled Insulin in the Era of Automated Insulin Delivery? — https://doi.org/10.2337/dci24-0093
[6] A Randomized Trial Comparing Inhaled Insulin Plus Basal Insulin Versus Usual Care in Adults With Type 1 Diabetes — https://doi.org/10.2337/dc24-1832
[7] An in-silico modeling approach to separate exogenous and endogenous plasma insulin appearance, with application to inhaled insulin — https://doi.org/10.1038/s41598-024-61293-y
[8] A 13-Week Single-Arm Evaluation of Inhaled Technosphere Insulin Plus Insulin Degludec for Adults with Type 1 Diabetes — https://doi.org/10.1089/dia.2024.0581

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