Article date: February 2008
By: Astrid H. Petersen, Gerd Köhler, Stefan Korsatko, Andrea Wutte, Manfred Wonisch, Agnes Mautner, Birgitte B. Rønn, Per Clauson, Torben Laursen, Per Wollmer, Thomas R. Pieber, in Volume 65, Issue 2, pages 165-171
What is already known about this subject
Aims
To investigate the effect of moderate exercise on the absorption of inhaled insulin.
Methods
A single‐centre, randomized, open‐label, three‐period cross‐over trial was carried out in 12 nonsmoking healthy subjects. A dose of 3.5 mg inhaled human insulin was administered via a nebulizer and followed in random order by either 1) no exercise (NOEX), 2) 30 min exercise starting immediately after dosing (EX0), or 3) 30 min exercise starting 30 min after dosing (EX30). The study was carried out as a 10 h euglycaemic glucose clamp (90 mg dl−1 (5.0 mmol l−1)).
Results
The absorption of insulin over the first 2 h after start of exercise was 16% increased for EX0 (ratio (95%CI) 1.16 (1.04, 1.30), P = 0.01) and 20% increased for EX30 (1.20 (1.05, 1.36), P < 0.01), both compared with NOEX; the overall insulin absorption during 6 h and 10 h after dosing was not influenced by exercise. The maximum insulin concentration (Cmax) increased by 32% for EX0 and 35% for EX30 (both P < 0.01) compared with NOEX, while the time to Cmax was 31 min faster for EX0 (P < 0.01), but not significantly different after EX30, compared with NOEX.
Conclusions
A significant and clinically relevant increase of insulin absorption over the first 2 h after the beginning of exercise was observed. Until data from studies using the specific insulin inhalers exists, patients using inhaled insulin should be made aware of a potential increased absorption and higher concentration of insulin in connection with exercise.
DOI: 10.1111/j.1365-2125.2007.03000.x
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