Trial Outcomes & Findings for This Study Is To Determine If Inhaled Insulin Is Effective In Treating Type 2 Diabetes Mellitus (NCT NCT00418522)

NCT ID: NCT00418522

Last Updated: 2018-09-28

Results Overview

HbA1c lab value: Change = value at Week 26 minus value at Baseline.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

413 participants

Primary outcome timeframe

Baseline, Week 26

Results posted on

2018-09-28

Participant Flow

Participant milestones

Participant milestones
Measure
Inhaled Human Insulin
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Overall Study
STARTED
219
194
Overall Study
Received Treatment
212
190
Overall Study
COMPLETED
136
152
Overall Study
NOT COMPLETED
83
42

Reasons for withdrawal

Reasons for withdrawal
Measure
Inhaled Human Insulin
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Overall Study
Adverse Event
7
1
Overall Study
Lack of Efficacy
1
3
Overall Study
Lost to Follow-up
10
4
Overall Study
Withdrawal by Subject
31
7
Overall Study
Other
27
23
Overall Study
Randomized but did not receive treatment
7
4

Baseline Characteristics

This Study Is To Determine If Inhaled Insulin Is Effective In Treating Type 2 Diabetes Mellitus

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Inhaled Human Insulin
n=212 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=190 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Total
n=402 Participants
Total of all reporting groups
Age, Customized
18 to 44 years
27 participants
n=5 Participants
26 participants
n=7 Participants
53 participants
n=5 Participants
Age, Customized
45 to 65 years
151 participants
n=5 Participants
125 participants
n=7 Participants
276 participants
n=5 Participants
Age, Customized
>=65 years
34 participants
n=5 Participants
39 participants
n=7 Participants
73 participants
n=5 Participants
Sex: Female, Male
Female
92 Participants
n=5 Participants
84 Participants
n=7 Participants
176 Participants
n=5 Participants
Sex: Female, Male
Male
120 Participants
n=5 Participants
106 Participants
n=7 Participants
226 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline, Week 26

Population: Per protocol (PP)=Full Analysis Set (FAS) subjects (i.e., had \>=1 study drug dose and \>=1 post-baseline measurement) with \>=12 weeks treatment and no major protocol violation. LOCF imputed missing data with any post-baseline visit. Number of subjects with HbA1c values at Baseline and Week 26: inhaled human insulin n=154, insulin glargine n=157.

HbA1c lab value: Change = value at Week 26 minus value at Baseline.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=154 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=157 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Change From Baseline in Glycosylated Hemoglobin A1c (HbA1c) at Week 26 for the Per Protocol (PP) Population
-2.01 percent
Standard Deviation 1.39
-1.75 percent
Standard Deviation 1.40

SECONDARY outcome

Timeframe: Week 26

Population: FAS=all subjects who took at least 1 dose of study drug and had at least 1 post-baseline measurement. LOCF imputed missing data with any post-baseline visit. Number of subjects with HbA1c \< 6.5% at Week 26: inhaled human insulin n=72, insulin glargine n=42.

Percentage of subjects with glycosylated hemoglobin A1c lab value less than 6.5%.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=203 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=189 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Percentage of Subjects Achieving Glycemic Control (HbA1c < 6.5%) at Week 26
35.5 percentage of participants
22.2 percentage of participants

SECONDARY outcome

Timeframe: Week 26

Population: FAS=all subjects who took at least 1 dose of study drug and had at least 1 post-baseline measurement. LOCF imputed missing data with any post-baseline visit. Number of subjects with HbA1c \< 7.0% at Week 26: inhaled human insulin n=127, insulin glargine n=90.

Percentage of subjects with glycosylated hemoglobin A1c lab value less than 7.0%.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=203 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=189 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Percentage of Subjects Achieving Glycemic Control (HbA1c < 7.0%) at Week 26
62.6 percentage of participants
47.6 percentage of participants

SECONDARY outcome

Timeframe: Week 26

Population: FAS=all subjects who took at least 1 dose of study drug and had at least 1 post-baseline measurement. LOCF imputed missing data with any post-baseline visit. Number of subjects with HbA1c \< 8.0% at Week 26: inhaled human insulin n=162, insulin glargine n=158.

Number of subjects with glycosylated hemoglobin A1c lab value less than 8.0%.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=203 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=189 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Percentage of Subjects Achieving Glycemic Control (HbA1c < 8.0%) at Week 26
79.8 percentage of participants
83.6 percentage of participants

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS=all subjects who took at least 1 dose of study drug and had at least 1 post-baseline measurement. LOCF imputed missing data with any post-baseline visit. Number of subjects with fasting plasma glucose at Baseline and Week 26: inhaled human insulin n=202, insulin glargine n=189.

Fasting plasma glucose lab value: Change = value at Week 26 minus value at Baseline.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=203 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=189 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Change From Baseline in Fasting Plasma Glucose at Week 26
-52.77 mg/dL
Standard Deviation 69.48
-53.50 mg/dL
Standard Deviation 62.92

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS=all subjects who took at least 1 dose of study drug and had at least 1 post-baseline measurement. LOCF imputed missing data with any post-baseline visit. Number of subjects with fasting and postprandial blood glucose measurements determined by standardized meal tolerance tests at Baseline and Week 26: n=inhaled human insulin, insulin glargine.

Postprandial blood glucose lab value (Time 0 min \[fasting\], Time 30 min, Time 60 min, Time 90 min, Time 120 min, Time 180 min): Change = value at Week 26 minus value at Baseline.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=203 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=189 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Change From Baseline in Fasting and Postprandial Blood Glucose as Determined by Standardized Meal Tolerance Tests at Week 26
Time 0 at Week 26 (n=105, 119)
-35.22 mg/dL
Standard Deviation 51.12
-61.16 mg/dL
Standard Deviation 54.68
Change From Baseline in Fasting and Postprandial Blood Glucose as Determined by Standardized Meal Tolerance Tests at Week 26
Time 30 at Week 26 (n=95, 107)
-49.91 mg/dL
Standard Deviation 62.41
-66.02 mg/dL
Standard Deviation 62.32
Change From Baseline in Fasting and Postprandial Blood Glucose as Determined by Standardized Meal Tolerance Tests at Week 26
Time 60 at Week 26 (n=110, 118)
-56.83 mg/dL
Standard Deviation 69.81
-64.77 mg/dL
Standard Deviation 64.47
Change From Baseline in Fasting and Postprandial Blood Glucose as Determined by Standardized Meal Tolerance Tests at Week 26
Time 90 at Week 26 (n=114, 120)
-64.94 mg/dL
Standard Deviation 75.67
-58.85 mg/dL
Standard Deviation 64.58
Change From Baseline in Fasting and Postprandial Blood Glucose as Determined by Standardized Meal Tolerance Tests at Week 26
Time 120 at Week 26 (n=113, 124)
-66.59 mg/dL
Standard Deviation 74.69
-54.89 mg/dL
Standard Deviation 63.02
Change From Baseline in Fasting and Postprandial Blood Glucose as Determined by Standardized Meal Tolerance Tests at Week 26
Time 180 at Week 26 (n=114, 122)
-66.99 mg/dL
Standard Deviation 74.19
-51.27 mg/dL
Standard Deviation 59.92

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS = all subjects who took at least 1 dose of study drug and had at least 1 post-baseline measurement. LOCF imputed missing data with any post-baseline visit. Number of subjects with postprandial blood glucose measurements as measured by 8-point profiles at Baseline and Week 26: n=inhaled human insulin, insulin glargine.

Post-prandial=after a meal. 8-point scale: (1 = before breakfast, 2 = 2 hours post breakfast, 3 = before lunch, 4 = 2 hours post lunch, 5 = before dinner, 6 = 2 hours post dinner, 7 = at bedtime, 8 = overnight \[between 2 and 4 am\]). Postprandial blood glucose lab value: Change = value at Week 26 minus value at Baseline.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=203 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=189 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Change From Baseline in Postprandial Blood Glucose as Measured by 8-Point Profiles at Week 26
Post-Breakfast, Week 26 (n=185,171)
-86.61 mg/dL
Standard Deviation 85.98
-75.36 mg/dL
Standard Deviation 79.04
Change From Baseline in Postprandial Blood Glucose as Measured by 8-Point Profiles at Week 26
Post-Lunch, Week 26 (n=184, 172)
-86.66 mg/dL
Standard Deviation 77.49
-58.51 mg/dL
Standard Deviation 86.93
Change From Baseline in Postprandial Blood Glucose as Measured by 8-Point Profiles at Week 26
Post-Dinner, Week 26 (n=187,166)
-81.86 mg/dL
Standard Deviation 75.94
-59.20 mg/dL
Standard Deviation 86.21

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS=all subjects who took at least 1 dose of study drug and had at least 1 post-baseline measurement. LOCF imputed missing data with any post-baseline visit. Number of subjects with lipids data at Baseline and Week 26: n=inhaled human insulin, insulin glargine.

Lipid (total cholesterol, high density lipoprotein cholesterol \[HDL-c\], low density lipoprotein cholesterol \[LDL-c\], triglycerides) lab value: Change = value at Week 26 minus value at Baseline.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=203 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=189 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Change From Baseline in Lipids at Week 26
Total cholesterol, Week 26 (n=197, 186)
-2.80 mg/dL
Standard Deviation 31.97
-6.19 mg/dL
Standard Deviation 29.95
Change From Baseline in Lipids at Week 26
HDL-c, Week 26 (n=197, 186)
2.97 mg/dL
Standard Deviation 6.99
0.69 mg/dL
Standard Deviation 6.07
Change From Baseline in Lipids at Week 26
LDL-c, Week 26 (n=197, 186)
-2.09 mg/dL
Standard Deviation 25.74
-3.71 mg/dL
Standard Deviation 23.63
Change From Baseline in Lipids at Week 26
Triglycerides, Week 26 (n=197, 187)
-42.65 mg/dL
Standard Deviation 87.70
-46.23 mg/dL
Standard Deviation 147.8

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS=all subjects who took at least 1 dose of study drug and had at least 1 post-baseline measurement. LOCF imputed missing data with any post-baseline visit. Number of subjects with CV biomarker data (hs-CRP, leptin, and spot urine microalbumin) at Baseline and Week 26: n=inhaled human insulin, insulin glargine.

CV biomarker (hs-CRP, Leptin, and Spot Urine Microalbumin) lab value: Change = value at Week 26 minus value at Baseline.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=203 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=189 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Change From Baseline in Cardiovascular (CV) Biomarkers High Sensitivity C-reactive Protein (Hs-CRP), Leptin, and Spot Urine Microalbumin at Week 26
hs-CRP, Week 26 (n=198, 187)
0.61 mg/L
Standard Deviation 4.56
0.32 mg/L
Standard Deviation 3.69
Change From Baseline in Cardiovascular (CV) Biomarkers High Sensitivity C-reactive Protein (Hs-CRP), Leptin, and Spot Urine Microalbumin at Week 26
Leptin, Week 26 (n=193, 186)
3.68 mg/L
Standard Deviation 13.50
4.41 mg/L
Standard Deviation 10.50
Change From Baseline in Cardiovascular (CV) Biomarkers High Sensitivity C-reactive Protein (Hs-CRP), Leptin, and Spot Urine Microalbumin at Week 26
Spot Urine Microalbumin, Week 26 (n=183, 169)
3.47 mg/L
Standard Deviation 96.48
3.70 mg/L
Standard Deviation 54.53

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS=all subjects who took at least 1 dose of study drug and had at least 1 post-baseline measurement. LOCF imputed missing data with any post-baseline visit. Number of subjects with CV biomarker data (adiponectin and ApoB) at Baseline and Week 26: n=inhaled human insulin, insulin glargine.

CV biomarker (adiponectin and ApoB) lab value: Change = value at Week 26 minus value at Baseline.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=203 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=189 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Change From Baseline in CV Biomarkers Adiponectin and Apolipoprotein B (ApoB) at Week 26
Adiponectin, Week 26 (n=195, 184)
0.23 mg/mL
Standard Deviation 5.58
-0.32 mg/mL
Standard Deviation 5.15
Change From Baseline in CV Biomarkers Adiponectin and Apolipoprotein B (ApoB) at Week 26
ApoB, Week 26 (n=198, 187)
-0.06 mg/mL
Standard Deviation 0.19
-0.06 mg/mL
Standard Deviation 0.17

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS-CGMS=all subjects with at least 1 study drug dose, at least 1 post-baseline measurement, and who participated in a 24-hour CGMS substudy. LOCF imputed missing data with any post-baseline visit. Number of subjects who participated in the substudy with 24-hour CGMS values at Baseline and Week 26: inhaled human insulin n=2, insulin glargine n=8.

24-Hour CGMS glucose lab value was obtained using the Medtronic MiniMed CGMS. Not all subjects were offered the opportunity to participate in this assessment. Change = value at Week 26 minus value at Baseline.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=203 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=189 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Change From Baseline in 24-Hour Continuous Glucose Monitoring System (CGMS) Glucose Values at Week 26
-36.53 mg/dL
Standard Deviation 33.96
-35.63 mg/dL
Standard Deviation 58.19

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS-CGMS=all subjects with at least 1 study drug dose, at least 1 post-baseline measurement, and who participated in a 24-hour CGMS substudy. LOCF imputed missing data with any post-baseline visit. Number of subjects who participated in the substudy with 24-hour CGMS values at Baseline and Week 26: inhaled human insulin n=2, insulin glargine n=8.

SD of 24-Hour CGMS glucose lab value obtained using the Medtronic MiniMed CGMS. Not all subjects were offered the opportunity to participate in this assessment. Change = value at Week 26 minus value at Baseline.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=203 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=189 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Change From Baseline in Mean Standard Deviation (SD) of 24-Hour Glucose Values Measured by CGMS at Week 26
-12.50 mg/dL
Standard Deviation 2.55
4.46 mg/dL
Standard Deviation 11.51

SECONDARY outcome

Timeframe: Months 1 to 7

Population: Safety population=all subjects who took at least 1 dose of study drug. Number of subjects with at least 1 hypoglycemic event during the course of the study that were evaluable at the specified month: n=inhaled human insulin, insulin glargine.

A hypoglycemic event was identified by characteristic symptoms or blood glucose levels. An event was severe if the subject was unable to treat him/herself; had at least 1 neurological symptom; or blood glucose of \< = 49 mg/dL. Events not meeting all 3 criteria were considered mild-moderate. Overall=mild, moderate, and severe.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=212 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=190 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Number of Subjects With Hypoglycemic Events
Mild/Moderate at Month 5 (n=117, 79)
55 participants
30 participants
Number of Subjects With Hypoglycemic Events
Severe at Month 5 (n=117, 79)
0 participants
0 participants
Number of Subjects With Hypoglycemic Events
Overall at Month 1 (n=147, 83)
70 participants
24 participants
Number of Subjects With Hypoglycemic Events
Mild/Moderate at Month 1 (n=147, 83)
69 participants
24 participants
Number of Subjects With Hypoglycemic Events
Severe at Month 1 (n=147, 83)
0 participants
0 participants
Number of Subjects With Hypoglycemic Events
Overall at Month 2 (n=141, 81)
98 participants
38 participants
Number of Subjects With Hypoglycemic Events
Mild/Moderate at Month 2 (n=141, 81)
98 participants
38 participants
Number of Subjects With Hypoglycemic Events
Severe at Month 2 (n=141, 81)
1 participants
0 participants
Number of Subjects With Hypoglycemic Events
Overall at Month 3 (n=135, 81)
84 participants
35 participants
Number of Subjects With Hypoglycemic Events
Mild/Moderate at Month 3 (n=135, 81)
83 participants
35 participants
Number of Subjects With Hypoglycemic Events
Severe at Month 3 (n=135, 81)
3 participants
0 participants
Number of Subjects With Hypoglycemic Events
Overall at Month 4 (n=120, 80)
61 participants
25 participants
Number of Subjects With Hypoglycemic Events
Mild/Moderate at Month 4 (n=120, 80)
61 participants
25 participants
Number of Subjects With Hypoglycemic Events
Severe at Month 4 (n=120, 80)
0 participants
0 participants
Number of Subjects With Hypoglycemic Events
Overall at Month 5 (n=117, 79)
55 participants
30 participants
Number of Subjects With Hypoglycemic Events
Overall at Month 6 (n=109, 77)
42 participants
31 participants
Number of Subjects With Hypoglycemic Events
Mild/Moderate at Month 6 (n=109, 77)
42 participants
31 participants
Number of Subjects With Hypoglycemic Events
Severe at Month 6 (n=109, 77)
0 participants
0 participants
Number of Subjects With Hypoglycemic Events
Overall at Month 7 (n=77, 60)
8 participants
4 participants
Number of Subjects With Hypoglycemic Events
Mild/Moderate at Month 7 (n=77, 60)
8 participants
4 participants
Number of Subjects With Hypoglycemic Events
Severe at Month 7 (n=77, 60)
0 participants
0 participants

SECONDARY outcome

Timeframe: Months 1 to 7

Population: Safety population=all subjects who took at least 1 dose of study drug. Number of subjects with at least 1 hypoglycemic event during the course of the study that were evaluable at the specified month: n=inhaled human insulin, insulin glargine.

A hypoglycemic event was identified by characteristic symptoms or blood glucose levels. Severe=the subject was unable to treat him/herself; had at least 1 neurological symptom; or blood glucose of \< = 49 mg/dL. Events not meeting all 3 criteria were considered mild-moderate. Overall=mild, moderate, and severe. Total=events during the study.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=212 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=190 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Number of Total Hypoglycemic Events
Overall at Month 1 (n=147, 83)
195 events
41 events
Number of Total Hypoglycemic Events
Mild/Moderate at Month 1 (n=147, 83)
194 events
41 events
Number of Total Hypoglycemic Events
Severe at Month 1 (n=147, 83)
0 events
0 events
Number of Total Hypoglycemic Events
Overall at Month 2 (n=141, 81)
365 events
66 events
Number of Total Hypoglycemic Events
Mild/Moderate at Month 2 (n=141, 81)
364 events
66 events
Number of Total Hypoglycemic Events
Severe at Month 2 (n=141, 81)
1 events
0 events
Number of Total Hypoglycemic Events
Overall at Month 3 (n=135, 81)
292 events
84 events
Number of Total Hypoglycemic Events
Mild/Moderate at Month 3 (n=135, 81)
289 events
84 events
Number of Total Hypoglycemic Events
Severe at Month 3 (n=135, 81)
3 events
0 events
Number of Total Hypoglycemic Events
Overall at Month 4 (n=120, 80)
166 events
51 events
Number of Total Hypoglycemic Events
Mild/Moderate at Month 4 (n=120, 80)
166 events
51 events
Number of Total Hypoglycemic Events
Severe at Month 4 (n=120, 80)
0 events
0 events
Number of Total Hypoglycemic Events
Overall at Month 5 (n=117, 79)
157 events
64 events
Number of Total Hypoglycemic Events
Mild/Moderate at Month 5 (n=117, 79)
157 events
64 events
Number of Total Hypoglycemic Events
Severe at Month 5 (n=117, 79)
0 events
0 events
Number of Total Hypoglycemic Events
Overall at Month 6 (n=109, 77)
119 events
63 events
Number of Total Hypoglycemic Events
Mild/Moderate at Month 6 (n=109, 77)
119 events
63 events
Number of Total Hypoglycemic Events
Severe at Month 6 (n=109, 77)
0 events
0 events
Number of Total Hypoglycemic Events
Overall at Month 7 (n=77, 60)
12 events
5 events
Number of Total Hypoglycemic Events
Mild/Moderate at Month 7 (n=77, 60)
12 events
5 events
Number of Total Hypoglycemic Events
Severe at Month 7 (n=77, 60)
0 events
0 events

SECONDARY outcome

Timeframe: Months 1 to 7

Population: Safety population=all subjects who took at least 1 dose of study drug. Number of subjects with at least 1 hypoglycemic event during the course of the study that were evaluable at the specified month: n=inhaled human insulin, insulin glargine.

Number of total subject months of treatment. Subject months = number of days from start of treatment to the last day of active treatment + 1 day lag, including off-drug time)/30.44. Severe=the subject was unable to treat him/herself; had at least 1 neurological symptom; or blood glucose of \< = 49 mg/dL. Events not meeting all 3 criteria were considered mild-moderate. Overall=mild, moderate, and severe.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=212 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=190 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Number of Total Subject Months of Treatment
Overall at Month 1 (n=147, 83)
145.8 subject months
82.4 subject months
Number of Total Subject Months of Treatment
Mild/Moderate at Month 1 (n=147, 83)
145.8 subject months
82.4 subject months
Number of Total Subject Months of Treatment
Severe at Month 1 (n=147, 83)
145.8 subject months
82.4 subject months
Number of Total Subject Months of Treatment
Overall at Month 2 (n=141, 81)
138.3 subject months
81.0 subject months
Number of Total Subject Months of Treatment
Mild/Moderate at Month 2 (n=141, 81)
138.3 subject months
81.0 subject months
Number of Total Subject Months of Treatment
Severe at Month 2 (n=141, 81)
138.3 subject months
81.0 subject months
Number of Total Subject Months of Treatment
Overall at Month 3 (n=135, 81)
128.8 subject months
80.4 subject months
Number of Total Subject Months of Treatment
Mild/Moderate at Month 3 (n=135, 81)
128.8 subject months
80.4 subject months
Number of Total Subject Months of Treatment
Severe at Month 3 (n=135, 81)
128.8 subject months
80.4 subject months
Number of Total Subject Months of Treatment
Overall at Month 4 (n=120, 80)
117.7 subject months
79.7 subject months
Number of Total Subject Months of Treatment
Mild/Moderate at Month 4 (n=120, 80)
117.7 subject months
79.7 subject months
Number of Total Subject Months of Treatment
Severe at Month 4 (n=120, 80)
117.7 subject months
79.7 subject months
Number of Total Subject Months of Treatment
Overall at Month 5 (n=117, 79)
112.2 subject months
77.9 subject months
Number of Total Subject Months of Treatment
Mild/Moderate at Month 5 (n=117, 79)
112.2 subject months
77.9 subject months
Number of Total Subject Months of Treatment
Severe at Month 5 (n=117, 79)
112.2 subject months
77.9 subject months
Number of Total Subject Months of Treatment
Overall at Month 6 (n=109, 77)
103.5 subject months
75.7 subject months
Number of Total Subject Months of Treatment
Mild/Moderate at Month 6 (n=109, 77)
103.5 subject months
75.7 subject months
Number of Total Subject Months of Treatment
Severe at Month 6 (n=109, 77)
103.5 subject months
75.7 subject months
Number of Total Subject Months of Treatment
Overall at Month 7 (n=77, 60)
12.8 subject months
6.6 subject months
Number of Total Subject Months of Treatment
Mild/Moderate at Month 7 (n=77, 60)
12.8 subject months
6.6 subject months
Number of Total Subject Months of Treatment
Severe at Month 7 (n=77, 60)
12.8 subject months
6.6 subject months

SECONDARY outcome

Timeframe: Months 1 to 7

Population: Safety population=all subjects who took at least 1 dose of study drug. Number of subjects with at least 1 hypoglycemic event during the course of the study that were evaluable at the specified month: n=inhaled human insulin, insulin glargine.

crude event rate=(events)/(subject-months). Severe=the subject was unable to treat him/herself; had at least 1 neurological symptom; or blood glucose of \< = 49 mg/dL. Events not meeting all 3 criteria were considered mild-moderate. Overall=mild, moderate, and severe.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=212 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=190 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Crude Hypoglycemic Event Rate
Overall at Month 1 (n=147, 83)
1.3 events / subject-months
0.5 events / subject-months
Crude Hypoglycemic Event Rate
Mild/Moderate at Month 1 (n=147, 83)
1.3 events / subject-months
0.5 events / subject-months
Crude Hypoglycemic Event Rate
Severe at Month 1 (n=147, 83)
0 events / subject-months
0 events / subject-months
Crude Hypoglycemic Event Rate
Overall at Month 2 (n=141, 81)
2.6 events / subject-months
0.8 events / subject-months
Crude Hypoglycemic Event Rate
Mild/Moderate at Month 2 (n=141, 81)
2.6 events / subject-months
0.8 events / subject-months
Crude Hypoglycemic Event Rate
Severe at Month 2 (n=141, 81)
0.7 events / subject-months
0 events / subject-months
Crude Hypoglycemic Event Rate
Overall at Month 3 (n=135, 81)
2.3 events / subject-months
1.0 events / subject-months
Crude Hypoglycemic Event Rate
Mild/Moderate at Month 3 (n=135, 81)
2.2 events / subject-months
1.0 events / subject-months
Crude Hypoglycemic Event Rate
Severe at Month 3 (n=135, 81)
2.3 events / subject-months
0 events / subject-months
Crude Hypoglycemic Event Rate
Overall at Month 4 (n=120, 80)
1.4 events / subject-months
0.6 events / subject-months
Crude Hypoglycemic Event Rate
Mild/Moderate at Month 4 (n=120, 80)
1.4 events / subject-months
0.6 events / subject-months
Crude Hypoglycemic Event Rate
Severe at Month 4 (n=120, 80)
0 events / subject-months
0 events / subject-months
Crude Hypoglycemic Event Rate
Overall at Month 5 (n=117, 79)
1.4 events / subject-months
0.8 events / subject-months
Crude Hypoglycemic Event Rate
Mild/Moderate at Month 5 (n=117, 79)
1.4 events / subject-months
0.8 events / subject-months
Crude Hypoglycemic Event Rate
Severe at Month 5 (n=117, 79)
0 events / subject-months
0 events / subject-months
Crude Hypoglycemic Event Rate
Overall at Month 6 (n=109, 77)
1.2 events / subject-months
0.8 events / subject-months
Crude Hypoglycemic Event Rate
Mild/Moderate at Month 6 (n=109, 77)
1.2 events / subject-months
0.8 events / subject-months
Crude Hypoglycemic Event Rate
Severe at Month 6 (n=109, 77)
0 events / subject-months
0 events / subject-months
Crude Hypoglycemic Event Rate
Overall at Month 7 (n=77, 60)
0.9 events / subject-months
0.8 events / subject-months
Crude Hypoglycemic Event Rate
Mild/Moderate at Month 7 (n=77, 60)
0.9 events / subject-months
0.8 events / subject-months
Crude Hypoglycemic Event Rate
Severe at Month 7 (n=77, 60)
0 events / subject-months
0 events / subject-months

SECONDARY outcome

Timeframe: Months 1 to 7

Population: Safety population=all subjects who took at least 1 dose of study drug.

A hypoglycemic event was identified by characteristic symptoms or blood glucose levels. Severe=the subject was unable to treat him/herself; had at least 1 neurological symptom; or blood glucose of \< = 49 mg/dL. Events not meeting all 3 criteria were considered mild-moderate. Nocturnal hypoglycemia=event occuring from midnight to 5:59 am.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=212 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=190 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Number of Nocturnal Hypoglycemic Events
187 events
114 events

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS=all subjects who took at least 1 dose of study drug and had at least 1 post-baseline measurement. LOCF imputed missing data with any post-baseline visit. Number of subjects with body weight measurements at Baseline and Week 26: inhaled human insulin n=192, insulin glargine n=183.

Body weight value: Change = value at Week 26 minus value at Baseline.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=203 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=189 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Change From Baseline in Body Weight at Week 26
3.55 kg
Standard Deviation 4.74
2.33 kg
Standard Deviation 3.80

SECONDARY outcome

Timeframe: Baseline, Week 26

Population: FAS=all subjects who took at least 1 dose of study drug and had at least 1 post-baseline measurement. LOCF imputed missing data with any post-baseline visit. Number of subjects with BMI measurements at Baseline and Week 26: inhaled human insulin n=192, insulin glargine n=183.

BMI value (kg/m2): Change = value at Week 26 minus value at Baseline.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=203 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=189 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Change From Baseline in Body Mass Index (BMI) at Week 26
1.22 kg/m2
Standard Deviation 1.66
0.80 kg/m2
Standard Deviation 1.30

SECONDARY outcome

Timeframe: Baseline, Week 26

Due to cancellation of the EXUBERA program, the collected Patient Reported Outcome (PRO) data, including the Diabetes Treatment Satisfaction Questionnaire-Status, Diabetes Treatment Satisfaction Questionnaire-Change, Diabetes-39, Mental Health Inventory-17, and SF-36 vitality domain questionnaire were not summarized, and no statistical analyses were performed.

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Baseline, Week 26

Population: FAS=all subjects who took at least 1 dose of study drug and had at least 1 post-baseline measurement. LOCF imputed missing data with any post-baseline visit. Using the FAS yielded supplemental analyses for the primary efficacy endpoint.

HbA1c lab value: Change = value at Week 26 minus value at Baseline.

Outcome measures

Outcome measures
Measure
Inhaled Human Insulin
n=203 Participants
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
n=189 Participants
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Change From Baseline in Glycosylated Hemoglobin A1c (HbA1c) at Week 26 for the FAS
-1.91 percent
Standard Deviation 1.41
-1.67 percent
Standard Deviation 1.38

Adverse Events

Inhaled Human Insulin

Serious events: 9 serious events
Other events: 177 other events
Deaths: 0 deaths

Insulin Glargine

Serious events: 4 serious events
Other events: 142 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Inhaled Human Insulin
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Cardiac disorders
Angina pectoris
0.47%
1/212
0.53%
1/190
Cardiac disorders
Angina unstable
0.47%
1/212
0.00%
0/190
Cardiac disorders
Cardiovascular disorder
0.00%
0/212
0.53%
1/190
Cardiac disorders
Palpitations
0.47%
1/212
0.00%
0/190
Gastrointestinal disorders
Pancreatitis
0.94%
2/212
0.00%
0/190
General disorders
Chest pain
0.47%
1/212
0.00%
0/190
Infections and infestations
Hepatitis A
0.47%
1/212
0.00%
0/190
Infections and infestations
Sepsis
0.00%
0/212
0.53%
1/190
Injury, poisoning and procedural complications
Ankle fracture
0.47%
1/212
0.00%
0/190
Nervous system disorders
Transient ischaemic attack
0.47%
1/212
0.00%
0/190
Renal and urinary disorders
Nephrolithiasis
0.47%
1/212
0.00%
0/190
Reproductive system and breast disorders
Benign prostatic hyperplasia
0.00%
0/212
0.53%
1/190

Other adverse events

Other adverse events
Measure
Inhaled Human Insulin
Initiation dose of 1 milligram per meal, and individually adjusted doses, per subject's blood glucose, over the 6 month study, in addition to oral agents.
Insulin Glargine
Insulin glargine, label instruction initiation dose (10 units), and individually adjusted doses, per subject's blood glucose, over the six months study, in addition to oral agents.
Eye disorders
Vision blurred
6.6%
14/212
3.2%
6/190
Gastrointestinal disorders
Diarrhoea
5.7%
12/212
4.2%
8/190
Gastrointestinal disorders
Nausea
9.9%
21/212
7.9%
15/190
General disorders
Asthenia
13.2%
28/212
8.9%
17/190
General disorders
Fatigue
6.1%
13/212
5.8%
11/190
General disorders
Injection site haematoma
0.00%
0/212
6.8%
13/190
General disorders
Oedema peripheral
5.2%
11/212
4.7%
9/190
Infections and infestations
Influenza
4.2%
9/212
5.3%
10/190
Infections and infestations
Nasopharyngitis
5.7%
12/212
6.8%
13/190
Infections and infestations
Upper respiratory tract infection
10.8%
23/212
15.3%
29/190
Investigations
Weight increased
8.0%
17/212
4.7%
9/190
Metabolism and nutrition disorders
Hypoglycaemia
67.9%
144/212
43.7%
83/190
Nervous system disorders
Dizziness
18.9%
40/212
15.3%
29/190
Nervous system disorders
Headache
13.7%
29/212
8.9%
17/190
Nervous system disorders
Tremor
31.6%
67/212
22.6%
43/190
Respiratory, thoracic and mediastinal disorders
Cough
8.5%
18/212
3.2%
6/190
Skin and subcutaneous tissue disorders
Hyperhidrosis
16.5%
35/212
11.1%
21/190

Additional Information

Pfizer ClinicalTrials.gov Call Center

Pfizer, Inc.

Phone: 1-800-718-1021

Results disclosure agreements

  • Principal investigator is a sponsor employee Pfizer has the right to review disclosures, requesting a delay of \< 60 days. Investigator will postpone single center publications until after disclosure of pooled data (all sites), \< 12 months from study completion/termination at all participating sites. Investigator may not disclose previously undisclosed confidential information other than study results.
  • Publication restrictions are in place

Restriction type: OTHER