Inhaled Insulin: A Clinical and Historical ReviewChan, Jason PharmD; Cheng-Lai, Angela PharmD, BCPSCardiology in Review: May/June 2017 - Volume 25 - Issue 3 - p 140–146 doi: 10.1097/CRD.0000000000000143 New Therapy Updates Abstract Author Information Insulin is the most effective blood glucose lowering agent and remains one of the cornerstones of diabetes management. However, many individuals with diabetes are either reluctant to initiate or are nonadherent to their insulin therapy for various reasons, including fear of frequent injections. Technosphere Insulin (TI) is a novel inhaled insulin powder that is approved by the United States Food and Drug Administration for the management of diabetes. The results from 2 phase III clinical trials have shown that TI was noninferior to subcutaneous insulin aspart and superior to inhaled placebo in lowering HbA1c in patients with diabetes mellitus types 1 and 2, respectively. Across both studies, TI appears to be generally well tolerated, with the most common adverse events being hypoglycemia and cough. However, long-term pulmonary safety concerns have not been addressed and additional studies are needed. Overall, TI appears to be a promising noninvasive prandial insulin alternative for individuals with diabetes who are at risk for medication nonadherence due to aversion to frequent injections. This article provides a review of the historical development of TI, its safety and efficacy data, and its advantages and disadvantages over traditional injectable insulins. From the Department of Pharmacy, Montefiore Medical Center, Bronx, NY. Disclosure: The authors have no conflicts of interest to report. Correspondence: Jason Chan, PharmD, Department of Pharmacy, Montefiore Medical Center, 1825 Eastchester Road, Bronx, NY 10461. E-mail: Jachan@montefiore.org. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.