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The Diabetes Educator, Vol. 33, No. 2, 215-253 (2007)
DOI: 10.1177/0145721707299264
© 2007 American Association of Diabetes Educators; Published by SAGE Publications

PHARMACY UPDATE

Update in the Pharmacologic Treatment of Diabetes

Focus on Insulin Detemir, Insulin Glulisine, and Inhaled Dry Powdered Insulin

Jason L. Iltz, PharmD, CDM, Peggy Soule Odegard, PharmD, BCPS, CDE, Stephen M. Setter, PharmD, CDE and R. Keith Campbell, RPh, MBA, CDE

From the Department of Pharmacotherapy, College of Pharmacy, Washington State University, and Integrated Health Professionals, Spokane, Washington (Dr Iltz); Plein Geriatrics Certificate Program, School of Pharmacy, University of Washington, Seattle, and Evergreen Senior Health Specialists, Kirkland, Washington (Dr Odegard); Department of Pharmacotherapy, College of Pharmacy, Washington State University, and Elder Services/Visiting Nurse Association, Spokane, Washington (Dr Setter); and the Department of Pharmacotherapy, College of Pharmacy, Washington State University, Pullman (Dr Campbell).

Correspondence to Jason L. Iltz, PharmD, CDM, Department of Pharmacotherapy, College of Pharmacy, Washington State University, PO Box 1495, Spokane, WA 99210-1495 (iltzj{at}wsu.edu).

The prevalence of diabetes mellitus has increased to more than 20 million people in the United States, and current estimates indicate that one third of all Americans born in the year 2000 will develop diabetes mellitus in their lifetime. The need for diabetes therapies offering improved glucose control by mimicking normal physiological properties of glucose metabolism and improving on logistics such as ease of use, self-management, monitoring, and delivery is clear. This article, part 2 of a 3-part series, reviews newer injectable insulin preparations and examines the first-to-market orally inhaled dry powdered insulin (IDPI). The information provided is tailored to diabetes educators and includes mechanism of action, pharmacokinetics, drug interactions, clinical trials, dosage and administration guidelines, side effects, and educational pearls for each insulin discussed. A detailed patient case designed to acquaint the reader with these newer insulin products and provide an understanding of clinical issues to consider when providing diabetes education to patients is included.


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