Inhaled Technosphere Insulin Safe and Well-Tolerated in Youth With Type 1 Diabetes: Study
A Diabetes Care study has found that inhaled Technosphere insulin (TI) was safe over 26 weeks in children and adolescents, without affecting pulmonary function. While it did not achieve HbA1c noninferiority compared with rapid-acting insulin (RAA), TI was linked to greater treatment satisfaction and less weight gain, supporting its use as a treatment option for some pediatric patients.
A study was done to evaluate inhaled technosphere insulin (TI) in children with diabetes. 230 youth 4–17 years old with type 1 (98%) or type 2 (2%) diabetes treated with multiple daily injections of insulin were randomly assigned 1:1 to TI or rapid-acting analog (RAA) insulin plus continuation of long-acting basal insulin and continuous glucose monitoring (CGM) for 26 weeks. The primary outcome was change in HbA1c, tested for noninferiority with margin of 0.4%.
Results: In intent-to-treat analysis, mean HbA1c (% ± SD) was 8.22 ± 0.87 at baseline and 8.41 ± 1.38 at 26 weeks with TI and 8.21 ± 0.96 and 8.21 ± 1.10, respectively, with RAA (adjusted difference = 0.18; 95% CI −0.07, 0.43; noninferiority P = 0.091). CGM-measured time in range 70–180 mg/dL was not significantly different between groups (adjusted difference −2.2%; 95% CI −7.0, 2.7; P = 0.38). Two severe hypoglycemic events occurred in the TI group and one in the RAA group. Change in forced expiration volume in 1 s from baseline to 26 weeks did not differ comparing TI and RAA (P = 0.53). The TI group reported greater treatment satisfaction (P = 0.004) and had less gain in weight and BMI percentile (P = 0.009) than did the RAA group.
The primary analysis did not meet the prespecified criteria for HbA1c noninferiority. However, TI use was safe over 26 weeks without affecting pulmonary function and was associated with greater treatment satisfaction and less weight gain compared with RAA, supporting TI as a treatment option for some pediatric patients with type 1 diabetes.
Reference:
Michael J. Haller, Lauren Kanapka, Roshanak Monzavi, Thomas J. Mouse, Gnanagurudasan Prakasam, Asheesh K. Dewan, Linda A. DiMeglio, Lori M. Laffel, Steven M. Willi, Michael J. Tansey, Bryce A. Nelson, Himala Kashmiri, Jamie R. Wood, Kashif Latif, Perrin White, Mark Kipnes, Henry Rodriguez, Joshua Smith, David P. Sparling, Faisal S. Malik, Anna Cymbaluk, Anuj Bhargava, Laya Ekhlaspour, Shannon Beasley, Kristina Cossen, Kupper A. Wintergerst, Rosanna Fiallo-Scharer, David M. Maahs, Kathleen E. Bethin, Michael A. Wood, Patrick C. Hanley, Surya N. Mulukutla, Michelle Van Name, Scott M. Blackman, Mary Pat Gallagher, Mark A. Clements, Nicole Sheanon, Konda Reddy, Barry J. Reiner, Robin Gal, Roy W. Beck, INHALE-1 Study Group; INHALE-1: A Multicenter Randomized Trial of Inhaled Technosphere Insulin in Children With Type 1 Diabetes. Diabetes Care 2025; dc251994. https://doi.org/10.2337/dc25-1994
