Expanding Patient Choice in Diabetes Care: Reducing Access Barriers to Inhaled Insulin.

Inhaled insulin provides a unique prandial insulin option, offering an alternative, with a more rapid onset of effect, to subcutaneous rapid-acting analog insulin. Clinical studies with inhaled insulin have demonstrated its efficacy and safety, with glycemic outcomes comparable to or in some cases better than those of contemporary insulin delivery approaches. However, the use of inhaled insulin for diabetes therapy in daily life remains limited due to payer restrictions, prior authorization requirements, formulary exclusions, clinician knowledge gaps, clinician time constraints, persistent misconceptions regarding safety, and inadequate patient awareness. A panel of clinical experts in diabetes management met in June 2026 to review the safety and efficacy of Technosphere® inhaled (TI) insulin, discuss the current obstacles that limit access for people with diabetes (PwD) to TI, identify practical strategies to overcome these obstacles, and issue a call-to-action for payers, clinicians, policymakers, professional organizations, and patient advocacy groups. This article summarizes those discussions and proposes strategies to increase access and choice for PwD.