Routine insulin doses could be given using an inhaler in future

Exubera has been hailed as possibly "one of the biggest steps forward since the discovery of insulin in 1922," by Simon O'Neill, of Diabetes UK.

But Ian Small of Norfolk's Therapeutic Advisory Group (TAG) said: "Caution should be exercised in prescribing as it is not suitable for some patients."

The drug is expected to be licensed in May this year after an inquiry.

'Double red' status

Even before the UK medicines watchdog, the National Institute for Health and Clinical Excellence (NICE), has assessed its clinical effectiveness and cost, some primary care trusts have already provided detailed information for diabetes sufferers.

The Diabetesuffolk.com website reports that inhaled insulin has been studied in clinical trials involving over 3,000 adults and has been approved for use by the drug licensing authorities in Europe and America.

Consultants and GPs in Norfolk & Waveney will not be prohibited from prescribing this drug, in accordance with NICE guidance, once it has been licensed for use in the UK Ian Small

The more cautious approach adopted in Norfolk concerns confusion about its use and it has been given a "double red" status in prescribing advice information.

This means that TAG, which controls prescribing for primary care trusts in Norfolk and Waveney, believes its effectiveness is uncertain or not proven, there are better alternatives, and there are cost or funding implications.

Ian Small said: "Consultants and GPs in Norfolk & Waveney will not be prohibited from prescribing this drug, in accordance with NICE guidance, once it has been licensed for use in the UK.