Intrapulmonary administration of insulin to healthy volunteers

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Abstract
Objectives. To study the biological effects of nebulized insulin, administered intrapulmonary, to healthy volunteers. Design. A double-blind, randomized, controlled intervention study. Setting. The department of Internal Medicine, University Hospital, Linköping, Sweden. Subjects. Eight healthy, non-smoking volunteers, with a mean age of 28 (range 22 to 56) years. Interventions. Regular human insulin 100 U mL-1 (Actrapid®) or 0.9% saline was given randomly as an oral inhalation. Insulin was given in three different doses (40, 80 and 160 U). Aerosol was generated by a new jet nebulizer. Main outcome measures. Blood glucose, serum insulin, and serum C-peptide. Results. After the 160 U insulin dose the blood glucose concentration (mean±SE) fell from 4.3±0.2 to 2.8±0.2 mmol L-1 (P -1 (P -1 (P <0.001). All changes were dose dependent. No adverse reactions were noted and no significant changes in lung function tests. Conclusions. Intrapulmonary insulin administration to healthy subjects can induce a significant hypoglycaemia and cause a clinically relevant increase in serum insulin concentrations. If similar results can be obtained when administering insulin to diabetic subjects, this insulin administration route can be a future complement to certain groups of patients.

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