[Inhaled human insulin (Exubera): a revolution?].

Type 2 diabetes is a step by step process which, at the end, leads to insulin injections. This last step is accomplished in many cases with great delay which increases the risk of micro- and macro-vascular complications. Patients are often reluctant to accept insulin injections and clinicians frequently postpone insulin prescription for many reasons. Any method which could favour more insulin initiation is welcome and this is the case with inhaled insulin. Efficacy has been demonstrated in type 2 and type 1 patients as well as safety if indications are strictly followed by patients and physicians. Long-term results (about 4 years) have been published, indicating efficacy and safety. At the present time, no cost/benefit study has been published and the extra cost of such a treatment will probably retard its clinical application.