Update in the Pharmacologic Treatment of Diabetes: Focus on Insulin Detemir, Insulin Glulisine, and Inhaled Dry Powdered Insulin

The prevalence of diabetes mellitus has increased to more than 20 millionpeople in the United States, and current estimates indicate that one third ofall Americans born in the year 2000 will develop diabetes mellitus in theirlifetime. The need for diabetes therapies offering improved glucose control bymimicking normal physiological properties of glucose metabolism and improvingon logistics such as ease of use, self-management, monitoring, and delivery isclear. This article, part 2 of a 3-part series, reviews newer injectableinsulin preparations and examines the first-to-market orally inhaled drypowdered insulin (IDPI). The information provided is tailored to diabeteseducators and includes mechanism of action, pharmacokinetics, druginteractions, clinical trials, dosage and administration guidelines, sideeffects, and educational pearls for each insulin discussed. A detailed patientcase designed to acquaint the reader with these newer insulin products andprovide an understanding of clinical issues to consider when providingdiabetes education to patients is included.