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Inhaled insulin refers to rapid-acting formulations of human insulin delivered to the lungs via a dry powder inhaler for the management of glycemic control in adults with diabetes mellitus. The pulmonary route allows for rapid absorption into the bloodstream, mimicking the natural prandial insulin spike. The first approved product was **Exubera**, developed by Pfizer and Nektar Therapeutics, which received FDA approval in 2006 but was discontinued in 2007 due to poor commercial performance and concerns regarding pulmonary safety. A second-generation product, **Afrezza**, developed by MannKind Corporation using its proprietary Technosphere delivery technology, received FDA approval in 2014 and remains available. Inhaled insulin is indicated for both type 1 and type 2 diabetes, though it is not a substitute for long-acting insulin in type 1 patients. It acts as an agonist at the insulin receptor, promoting glucose uptake in peripheral tissues and inhibiting hepatic glucose production.
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