Inhaled Technosphere insulin lowers HbA1c in Indian patients with T2D

Inhaled Technosphere insulin significantly reduced HbA_1c levels in Indian individuals with type 2 diabetes (T2D) compared with placebo, according to a study presented at ATTD-ASIA 2025.

“There is a huge burden of uncontrolled diabetes, with only approximately 36 percent of Indian patients achieving HbA_1C targets of <7 percent, and this would vary depending on different epidemiological data,” said Dr Manoj Chawla from Lina Diabetes Care Mumbai Diabetes Research Centre in Mumbai, India.

Chawla and his team conducted a phase III, multicentre, double-blind, placebo-controlled trial involving 216 adults (mean age 49.9 years) with T2D (baseline HbA_1c 8.66 percent) inadequately controlled on oral antihyperglycaemic drugs (OADs) across 23 centres in India. Participants were randomized in a 2:1 ratio to receive either Technosphere insulin (n=133) or inhaled placebo (n=83).

In the modified intention-to-treat analysis, patients treated with Technosphere insulin achieved a significantly greater reduction in HbA_1c level at week 12 than those receiving placebo (least squares [LS] mean change from baseline, -0.203 percent vs -0.620 percent), with a treatment difference of 0.417 percent (p=0.0124). [Chawla M, et al, ATTD-ASIA 2025]

“Technosphere insulin met the primary efficacy endpoint of the study,” Chawla stated.

For safety, the most common treatment-emergent adverse events (TEAEs) in the Technosphere insulin and placebo groups were hypoglycaemia (25.6 percent and 16.9 percent), cough (9 percent and 8.4 percent), and pyrexia (5.3 percent and 8.4 percent).

Chawla noted that none of the TEAEs led to treatment discontinuation in any of the treatment arms.

By week 28, lung function, as assessed by FEV₁ and FVC, was comparable between the Technosphere insulin and placebo groups (LS mean change from baseline, 2.83 vs 2.78 L [FEV₁] and 3.19 vs 3.14 L [FVC]). “[These findings indicate] that inhaled insulin was well tolerated without significant pulmonary compromise,” said Chawla.

The safety profile of Technosphere insulin was consistent with that of prior studies, he noted.

Post-prandial glucose control among Indians

Technosphere insulin is currently the only US FDA-approved inhaled insulin, delivered as a dry powder, to improve glycaemic control in adults with diabetes. Assessing the efficacy and safety of Technosphere insulin across different ethnicities is important as response can vary. [Diabetes 2025;74(Supplement_1):833-P]

“The relevance [of the current study] to the Indian population is [that] the ultra-rapid onset and short duration of Technosphere insulin may offer better post-prandial glucose control, which is especially relevant to Indian dietary patterns characterized by high carbohydrate content and high glycaemic load meals,” according to Chawla.

“Overall, Technosphere insulin demonstrated a greater reduction in HbA_1C compared with placebo at 12 weeks, supporting its efficacy as a rapid-acting prandial insulin option in patients inadequately controlled on OADs,” said Chawla.

He also added that “it may improve adherence and patient satisfaction in appropriate clinical settings, and may add value in terms of comfort, convenience, and lifestyle fit.”