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This is a **combination therapy** consisting of **inhaled human insulin** (notably the product Exubera, a rapid-acting, recombinant human insulin powder for oral inhalation) and **insulin ultralente** (an extended-release recombinant human insulin designed for basal glycemic control). In this regimen, inhaled human insulin is used preprandially as a rapid-acting insulin to control postprandial blood glucose spikes, while insulin ultralente is administered by subcutaneous injection to provide basal insulin coverage throughout the day and night. Inhaled human insulin facilitates faster onset of action with a glucose-lowering effect within 10–20 minutes, peaking by approximately 2 hours; ultralente’s prolonged duration mimics the steady secretion of basal insulin. **Mechanism of action** for both components: they act as agonists at the insulin receptor, thereby facilitating glucose uptake into tissues and inhibiting hepatic glucose output. This combination is primarily used in adults with type 1 or type 2 diabetes mellitus, with clinical trials showing non-inferior HbA1c outcomes compared to conventional subcutaneous regimens. Development and commercial work for inhaled human insulin was originally led by Pfizer and Nektar for Exubera.
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