Inhaled Insulin

Written by Alyson Powell Key
Medically Reviewed by Michael Dansinger, MD on April 16, 2025
5 min read

Inhaled insulin is a drug you breathe into your lungs to help control your blood sugar and diabetes. It comes in the form of an inhaler.

"Inhaled insulin comes as a powder and has a component that helps it absorb into the lungs," explains Thomas Blevins, MD, a board-certified endocrinologist at Texas Diabetes and Endocrinology. "The lungs have a large absorptive capacity, so insulin gets across readily. And with the inhaled version, it gets into the bloodstream very quickly."

The idea of inhaling insulin has been around for decades. It wasn't until the 1990s that researchers made it possible.

With an inhaler similar to those for asthma, you breathe a fine insulin powder into your lungs. There, it enters your blood through tiny blood vessels. It works to boost your insulin levels while lowering your blood sugar.

How to use inhaled insulin

Your doctor will show you how to use inhaled insulin and tell you the correct dose. You'll inhale it into your mouth before meals and will need to adjust the dose based on your activity level and illness.

You'll get an inhaler device, plus cartridges containing dry powder insulin. Before using the inhaler, breathe out to remove as much air from your lungs as you can. Then, you'll breathe in deeply through the inhaler, holding your breath for as long as possible.

Be sure to use inhaled insulin exactly as prescribed. Talk to your doctor or pharmacist if you have any questions.

Where to keep inhaled insulin

Store your inhaler and unopened cartridges in the refrigerator or at room temperature. Once you've opened an inhaler, throw it away after 15 days. Use or toss out cartridges kept at room temperature within 10 days. If you store them in the fridge, you can use them until the expiration date.

There are many benefits of inhaled insulin, including the following:

  • It doesn't involve needles
  • It works quicker than an injection.
  • You can take it before meals.
  • It lowers your chance of low blood sugar.
  • It may help you maintain your weight.
  • The inhaler is small and discreet and doesn't require as much prep as an injection.

Blevins says another benefit of inhaled insulin is that, compared to the injected version, it more closely mimics how your body naturally processes insulin. "The injectable type of insulin typically peaks in its effect in about 90-120 minutes. Inhaled insulin peaks in about 45 minutes. Ideally, when a person takes insulin, you want the effect to be as close to the effect in people who don't have diabetes, and their peak is also about 45 minutes."

This type of insulin can cause both common and serious side effects. Here's what to look out for:

Common side effects of inhaled insulin

Common side effects may include:

  • Anxiety
  • Vision changes
  • Chills
  • Cough
  • Depression
  • Headache
  • Feeling hungrier than usual
  • Feeling sick to your stomach (nausea)
  • Nightmares
  • Shakiness
  • Feeling tired or weak

Severe side effects of inhaled insulin

More serious side effects of this drug include:

  • Rash or itching
  • Hives
  • Rapid heartbeat
  • sweating
  • Trouble breathing or swallowing
  • Shortness of breath
  • Swelling of the arm, hand, foot, ankle, or lower leg
  • Quickly gaining weight
  • Feeling very tired
  • Confusion
  • Dizziness

Inhaled insulin interactions

Some prescription and over-the-counter medicines, supplements, and herbal products may cause a reaction with inhaled insulin. Talk to your doctor or pharmacist about what you're taking. They may change your dose or closely watch you for side effects.

Who shouldn't use inhaled insulin?

People with asthma or chronic obstructive pulmonary disease (COPD) should avoid inhaled insulin. It can raise your chances of tightening of the muscles that line the airways connecting your windpipe to your lungs, a condition called bronchospasm.

The FDA approved the first inhaled insulin, Exubera, in September 2006. People who had type 1 or type 2 diabetes could use it.

But the drugmaker took it off the market in October 2007 because it didn't seem to catch on with patients. People thought the inhaler was too big and clunky. Later, the FDA was concerned that Exubera might cause lung problems, including cancer.

In June 2014, the FDA approved Afrezza; it's currently the only FDA-approved insulin inhaler. The Afrezza inhaler is much smaller than Exubera, with premeasured, rapid-acting insulin you use before meals. The makers of Afrezza say the drug enters your bloodstream in less than a minute and begins to lower blood sugar levels in about 12 minutes.

It's not for diabetes emergencies such as diabetic ketoacidosis (DKA). 

If you have type 1 diabetes, you'll still need to take long-acting insulin, too, to help control your blood sugar.

This depends on whether you have insurance and the type of plan you have. With health insurance and a prescription savings card, you could pay as little as $35 a month.

Is inhaled insulin covered by insurance?

Most self-paid health insurance plans or plans through an employer cover inhaled insulin. Many people on Medicare also have access to this drug.

Inhaled insulin is a needle-free way to manage diabetes by breathing in insulin powder through a small inhaler. It works quickly by entering the bloodstream through the lungs and helps lower blood sugar levels. While it can be easier to use, people with asthma or COPD should avoid inhaled insulin. Side effects can range from mild (like cough or nausea) to serious (like breathing problems or swelling).

Why was inhaled insulin discontinued?

The first FDA-approved inhaled insulin, Exubera, was removed from the market because people weren't buying it. The inhaler was large, and the FDA was concerned about it causing possible health problems, including cancer.

What happens if you miss a dose?

Talk to your doctor about what to do if you miss a dose, but don't take double the prescribed amount.

Can inhaled insulin replace basal insulin?

No. You'll still need injections or a pump for basal insulin.

Does Afrezza need to be refrigerated?

You can refrigerate the inhaler and cartridges or keep them at room temperature.