Overcoming Therapeutic Inertia with Inhaled Insulin Therapy

Despite the known acute and chronic complications associated with suboptimal glycemic control, only approximately 25% of people with type 1 diabetes and type 2 diabetes who are treated with prandial insulin are achieving the American Diabetes Association-recommended glycated hemoglobin target of <7%. A significant driver of poor diabetes management is therapeutic inertia, which is the failure to intensify therapy when glycemic goals are not achieved. suboptimal adherence to insulin therapy. While patient reluctance to initiate or intensify insulin therapy can be attributed to many factors, the most common reasons for nonadherence include fear of hypoglycemia, aversion to needles, and concerns about weight gain. Whereas clinicians often delay therapy intensification due to lack education/training in insulin therapy, concerns about hypoglycemia, and restrictions on time and resources. Inhaled insulin therapy with Technosphere® insulin has the potential to overcome these obstacles. This article reviews the impact of therapeutic inertia in individuals with diabetes who are treated with insulin or require insulin therapy and discusses how the use of inhaled insulin may overcome many of the barriers to insulin treatment intensification.