BILLINGS (LEE) -- For 80 years, diabetics in need of insulin have had little choice but to give themselves regular injections of the blood-sugar-regulating protein.

Now, a handheld inhaler that delivers insulin orally is allowing some people with the disease to reduce the number of injections they need or to skip them altogether.

The device, marketed under the brand name Exubera, was approved earlier this year for diabetics 18 and older who don't smoke.

It could help the United States get control of a diabetes epidemic, said Janie Fitch Meszaros, a certified diabetes educator at the St. Vincent Healthcare Broadwater Clinic.

Twenty million Americans have diabetes.

"Our average control of diabetes in America is not as good as it should be," Fitch Meszaros said. "People who have needle fears and needle phobias, sometimes they won't even try it (insulin)."

Inhalable insulin could convince some who have neglected their diabetes to begin addressing it, she said.

It could also open the door for other drugs to be delivered via inhalation, said Dr. Howard Knapp, executive director of the Billings Clinic Research Center.

"There are a lot of things that might be used this way," Knapp said. "As a drug guy, it's interesting to see how this will expand into other areas of pharmacology."

The insulin inhaler delivers doses of insulin in powder form. The powder is inhaled through the mouth and absorbed into the bloodstream via the lungs.

"You can't even taste it," said Vernetta Corbett, a Broadwater Clinic patient who uses an insulin inhaler three times a day. "Sometimes I wonder if I got the dose."

Corbett was diagnosed with Type 2 diabetes eight years ago. Until this year, she managed the disease with medication and by watching her diet. She never injected insulin.

"This is really good for me because I hate shots," she said.

Dr. Richard Anderson suggested Corbett try the inhalable insulin after drugs couldn't regulate her diabetes.

"Oral medications weren't working too well. The best option was to add insulin," Anderson said. "Most people aren't too enthusiastic about injections."

People with Type 1 or Type 2 diabetes can use inhalable insulin, but the doses on the market now won't work for everyone who has the disease, Fitch Meszaros said. Diabetics should ask their doctors if the device could help them, she said.

The device will likely change as more drug companies develop and market their own versions, she said.

At Billings Clinic, researchers are examining inhaled insulin in five studies sponsored by a pharmaceutical company that hopes to market its own version of Exubera, Knapp said.

The studies are looking at how inhaling insulin affects smokers, asthmatics, people with Type 1 diabetes and people with Type 2 diabetes. Another study is focused on the product's safety.

Inhalable insulin probably won't completely replace the substance's injectable form, and it's not a fix-all for diabetics. Like insulin injections, the inhaler should be used in conjunction with regular medical visits and careful regulation of diet.

"This does not take care of diabetes by itself," Fitch Meszaros said.

Still, it is an exciting option for people with diabetes, she said.

"We are absolutely just giddy about these new things," Fitch Meszaros said.

Contact Diane Cochran at dcochran@billingsgazette.com or 657-1287.