Keywords
use
properties
inhaled insulin
students
How to Cite
Abstract
Introduction: Diabetes is a class of diseases characterized by high blood sugar levels due to insufficient insulin production or insulin action. Inhaled insulin is fast-acting and is designed to be used in conjunction with carbohydrate intake, aimed at controlling prandial glucose excursions.
Objective: To determine the level of knowledge about the uses and properties of inhaled insulin in clinical students and interns recently graduated from Medicine and Surgery-UNA.
Methodology: Non-probabilistic convenience sampling descriptive cross- sectional observational study. It covered from May 1 to August 1, 2017. It was held at the facilities of the National University of Asunción of the Republic of Paraguay. The sample consisted of 221 cases, corresponding to students and interns recently graduated from Medicine and Surgery. For the processing, a database was created in the Microsoft Office Excel 2013 software, from which it was analyzed in the PSPP software. For the determination of the correlation between the nominal and quantitative variables and for the correlation of the quantitative variables, the Spearman correlation coefficient. To analyze the dependency relationship between nominal and continuous variables, a one-factor ANOVA table was performed, considering p<0.05 as significant.
Results: 55.9% (128) of the participants were female. The age range was between 21 and 29 years old (23.96±1.57). The subjects surveyed stated that the World Health Organization values range between 60-110mg/dl in 64.6% (148). 82.1% (188) of the respondents stated that the current classification of the American Diabetes Association (ADA) regarding Diabetes Mellitus is DM 1, DM 2, gestational DM and other specific types. 64.6% (148) of the subjects claimed not to know about inhaled insulin. Acute kidney disease is the pathology mentioned by the participants that would not have any contraindication in 64.1% (52). 58% (47) state that there is no significant difference in the decrease in HbAc1 between the use of injectable and inhalable insulin. 72.4% (166) of the participants have a lack of knowledge of the subject or do not answer the necessary answers to obtain a level of knowledge of 60%.
Conclusion: The level of knowledge on the part of medical students and interns of the FCM-UNA towards the use and properties of inhaled insulin continues to be a little studied subject and represents a significant issue for the field of therapeutics in Medicine.
References
(1) OMS. Informe mundial sobre la diabetes. 2016 http://apps.who.int/iris/bitstream/10665/204877/1/ WHO_NMH_NVI_16.3_spa.pdf?ua=1
(2) Hawra Ali Aleirani, Rasha Shaker Alkhonizi, Rawan Abdulkarim Agala, Rawan Zuhair Alqurashi, Mai Khalid Alshaikh. Inhaled Insulin Therapy in Diabetes Mellitus. International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Vol. 4, Issue 2, pp: (1504-1528), Month: October 2016 - March 2017 http://mnkd.proboards.com/thread/7335/journal- paper?page=1
(3) López de Briñas Ortega,O. LA ANHELADA INSULINA INHALADA. 2016 http://www.asvidia.org/ la-anhelada-insulina-inhalada/
(4) American Diabetes Association. ¿No más agujas? Todo lo que necesita saber sobre la insulina inhalada. 2015. http://www.nomasdiabetes.org/2015/03/04/ no-mas-agujas-todo-lo-que-necesita-saber-sobre-la- insulina-inhalada/
(5) John S. Patton Julie G. Bukar Michael A. Eldon. Clinical Pharmacokinetics and Pharmacodynamics of Inhaled Insulin. 2012. Volume 43, Issue 12, pp 781–801. https://link.springer.com/ article/10.2165/00003088-200443120-00002
(6) Patton JS, Bukar JG, Eldon MA. Clinical pharmacokinetics and pharmacodynamics of inhaled insulin. Clin Pharmacokinet. 2004;43(12):781-801. https://www.ncbi.nlm.nih.gov/pubmed/15355125
(7) REINHARD H.A. BECKER, MD, PHD1 SUE SHA, MD, PHD2 ANNKE D. FRICK, PHD1 ROBERT J. FOUNTAINE, PHARMD2. The Effect of Smoking Cessation and Subsequent Resumption on Absorption of Inhaled Insulin. DIABETES CARE, VOLUME 29, NUMBER 2, FEBRUARY 2006. http:// care.diabetesjournals.org/content/diacare/29/2/277. full.pdf
(8) Diario Medico. La insulina inhalada, no apta para fumadores y asmático. Pg 13. 2006 http://www.fundaciondiabetes.org/general/ noticia/5612/la-insulina-inhalada-no-apta-para- fumadores-y-asmaticos
(9) González Sarmiento E. Insulina inhalada y sus efectos sobre el pulmón. Archivos de Bronconeumología. diciembre de 2007;43(12):643-5. http://www.archbronconeumol.org/es/insulina- inhalada-sus-efectos-sobre/articulo/13112960/
(10) American Diabetes Association. Diabetes Myths [base de datos en Internet]. United Kingdom. [fecha de acceso 14 de septiembre de 2017]. Disponible en: https://www.diabetes.org.uk/guide-to-diabetes/ enjoy-food/eating-with-diabetes/diabetes-food- myths/myth-sugar-causes-diabetes
(11) K Nguyen, S Lin and P Heidenreich. A systematic comparison of sugar content in low-fat vs regular versions of food. Nature [revista en Internet]. Agosto 2015. [acceso 14 de septiembre de 2017]. Disponible en: http://www.nature.com/nutd/journal/v6/n1/full/ nutd201543a.html?foxtrotcallback=true
(12) AMERICAN DIABETES ASSOCIATION. Standards of medical care in Diabetes 2006. Diabetes Care 2006; 29 (13.1): S4-S42.
(13) World Health Organization: Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications: Report of a WHO Consultation. Part 1: Diagnosis and Classification of Diabetes Mellitus. Geneva, 1999. World Health Org.
(14) Malpartida C, Angel M. Nivel de conocimiento en el manejo del paciente con diabetes mellitus tipo 1 y 2 en alumnos de 5to año e internos de la facultad de odontología de la Universidad Nacional Mayor de San Marcos. Repos Tesis - UNMSM [Internet]. 2016 [citado 14 de septiembre de 2017]; Disponible en: http://cybertesis.unmsm.edu.pe/ handle/cybertesis/4964
(15) Vargas C, Alex G. Grado de conocimiento de la Diabetes Mellitus en la población de barrio «Quijarro» en la provincia Cercado del Departamento de Cochabamba. Rev Científica Cienc Médica. 2011;14(1):17-20.
(16) Quattrin T, Belanger A, Bohannon NJV, Schwartz SL. Efficacy and safety of inhaled insulin compared with subcutaneous insulin therapy in patients with type 1 diabetes. Diabetes Care 2004; 27: 2622-27.
(17) Skyler JS, Weinstock RS, Raskin P, et al. Use of inhaled insulin in a basal/bolus insulin regimen in type 1 diabetic subjects. Diabetes Care 2005; 28: 1630-35.
(18) DeFronzo RA, Bergenstal RM, Cefalu WT, et al. Efficacy of inhaled insulin in patients with type 2 diabetes not controled with diet and exercise. Diabetes Care 2005; 28: 1922-28.
(19) Barnett AH. Efficacy and one-year pulmonary safety of inhaled insulin as adjunctive therapy with metformin or glybenclamide in type 2 diabetes patients poorly controlled on oral agent monotherapy. Diabetes 2004; 53: A107.
(20) Rosenstock J, Zinman B, Murphy LJ, et al. Inhaled insulin improves glycemic control when substituted for or added to oral combination therapy in type 2 diabetes. Ann Int Med 2005; 143: 549-58.
(21) Hollander PA, Blonde L, Rowe R, Metha AE, Milburn JL. Efficacy and safety of inhaled insulin compared with subcutaneous insulin therapy in patients with type 2 diabetes. Diabetes Care 2004; 27: 2356-62.
(22) Rave K, Bott S, Heinemann L, et al. Time- action profile of inhaled insulin in comparison with subcutaneously injected insulin lispro and regular human insulin. Diabetes Care 2005; 28: 10782-2005.
(23) Edgerton DS, Neat DW, Scott M, Bowen LE. Inhalation of insulin augments the efficiency of muscle glucose uptake in vivo. 40th Annual Meeting of the European Association for the Study of Diabetes, September 5-9, 2004. Munich, Germany.
(24) Edgerton DS, Cherrington AD, Neal DW, Scott M, Glass D. Effect of inhaled insulin versus matched intravenous infusion on hepatic glucose balance following intraportal glucose infusion in dogs. 40th Annual Meeting of the European Association for the Study of Diabetes, September 5-9, 2004. Munich, Germany.
(25) Ampudia-Blasco, F. J. Tratamiento con insulina: alternativas terapéuticas y su optimización. Unidad de Referencia de Diabetes. Servicio de Endocrinología y Nutrición. Hospital Clínico Universitario. Valencia. España. 2007. Disponible en: www.elsevier. es/es-revista-endocrinologia-nutricion-12-pdf- 13112122-S300
(26) Asociación Americana de Diabetes. Diagnóstico y Clasificación de la Diabetes Mellitus. DIABETES CARE. 2011 [citado en sep 2017] 34(1):S62-S69. Disponible en: https://apps.webofknowledge. com/full_record.do?product=WOS&search_
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2022 Mónica Amarilla, Nicolás Ayala Servín, Claudia Bogarin, Amyas Bottrell, Angélica Caballero, Karina Cacace, Alejandro Céspedes, Claudia Duarte Fariña, Marcia Duré Martínez, Marcelo Martínez, César Oviedo, Elena Raquel Torres, Miguel Zacarías