Questioning Medicine

INHALE-3, a randomized trial, 123patients with type 1 dm that compared the efficacy of an inhaled insulin regimen (Afrezza) plus degludec insulin (Tresiba®) against usual care over 17 weeks The study's primary endpoint was a change in HbA1c levels, a critical marker of long-term blood glucose control.  More participants using the inhaled insulin regimen experienced significant improvements in HbA1c levels compared to those on usual care.21% of those on inhaled insulin had an HbA1c improvement of greater than 0.5%, while only 5% of those with standard care.  21 – 5 that is an absolute difference of 16% (NNT of 6.25) And they found a bunch of things when they went back like more people with a1c >7 reached their goal—which was not their end point they just found it and like to talk about   inhaled insulin and degludec was not for everyone: and everyone is missing this—we know how many people had an improvement in their a1c by 0.5% but how many had a worsening??? well 26% of the patients in the inhaled insulin