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Antes Revista del Instituto Nacional de Enfermedades Respiratorias

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2006, Número 2

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Neumol Cir Torax 2006; 65 (2)


Insulina inhalada: Eficacia y seguridad pulmonar

Campos CR, Reza AAA, Morales BJE

Idioma: Español
Referencias bibliográficas: 58
Paginas: 74-87
Archivo PDF: 177.50 Kb.


RESUMEN

En el mundo, cerca de 177 millones de personas padecen diabetes mellitus. Hasta el momento, es una de las primeras 5 causas de muerte en los países desarrollados. La diabetes sin control se asocia con mayor morbilidad y mortalidad. La diabetes tipo 1 afecta aproximadamente a más de 18 millones de americanos, el mayor porcentaje son niños, adolescentes y adultos jóvenes. Los individuos con diabetes tipo I representan el 10% del total, con frecuencia algunos son renuentes a la utilización de insulina exógena para el control de su enfermedad. En la diabetes tipo 2 el porcentaje de presentación ha incrementado en las últimas décadas debido al aumento en el promedio de vida, mayor incidencia de obesidad disminución de la actividad física y cambios en el estilo de vida. En los Estados Unidos, el 19% de la población mayor de 65 años tiene diabetes y cuenta con una incidencia de 8,000 casos nuevos por año de diabéticos tipo 2. Se han reportado beneficios tanto en pacientes con diabetes tipo 1 y tipo 2, con el control estricto de la glucosa mostrado por una mayor sobrevida y menor número de complicaciones (neuropatía periférica, retinopatía, enfermedades cardiovasculares y renales). Para alcanzar dicho objetivo, son importantes las estrategias de tratamiento, pero durante varios años, se ha observado la dificultad en el apego al mismo. En aquellos pacientes que requieren terapia con insulina, ya sea monoterapia o en combinación con hipoglucemiantes orales, la no aceptación por parte del personal de salud, del paciente y de los familiares, dificultan llegar al control adecuado de los niveles de glucosa. La insulina inhalada, es una nueva opción terapéutica eficaz y segura en el control estricto y regulado de los niveles de glucosa en la diabetes mellitus. Este método de administración proporciona un efecto farmacológico comparable al de la insulina endógena, con posología similar al esquema habitual de insulina inyectable y/o de hipoglucemiantes orales. Con la insulina inhalada se tiene una mayor aceptación del paciente al tratamiento, es fácil su empleo, de aplicación no invasiva, con efectos colaterales leves, comparados con la insulina inyectable. Los resultados son satisfactorios en pacientes con diabéticos tipo 1 o tipo 2, en sus diferentes formas de administración: monoterapia, terapia combinada con hipoglucemiantes orales, o como terapia de rescate en pacientes con diabetes de difícil control. En pacientes sin enfermedad pulmonar, estudios a corto y largo plazo han confirmado su perfil de seguridad en el control de la glucosa, sin mostrar alteraciones de la función pulmonar. La experiencia clínica indica que la insulina inhalada es una opción terapéutica segura y eficaz en pacientes con diabetes mellitus tipo 1 y 2.


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