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The final appraisal determination ecommends that:

• Inhaled insulin can be used in patients who have evidence of poor glycaemic control despite other attempts to stabilise them.
  
• Patients should receive adequate educational support.
  
• Inhaled insulin can be used is patients who have a persistent fear of injections as diagnosed by a diabetes specialist or mental health professional, or in those patients who have severe or persistent problems with injection sites.
  
• Treatment can continue beyond six months if there is clinical evidence of improvement.
  
• Initiation of treatment should take place in a specialist centre.
  
• Healthcare professionals should collect data on the use of inhaled insulin as part of a co-ordinated prospective observational study.

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Diabetes