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THE PHARMA REVIEW (AUGUST 2008)

Insulin Therapy: Painless Delivery Modes

Dr. Parul Lakhanpal, Dr. Deepak Kumar Rai

Abstract: Diabetes is recognized as a serious illness throughout the world. The insufficient or nil production of insulin is the main cause of diabetes mellitus. For the past 80 years subcutaneous injections have been the only route to deliver insulin in diabetic patients. However over the years need for non-invasive insulin were strongly felt because of reluctance both on part of physicians and patients to initiate insulin therapy despite the well established benefits of tight glycemic control. Extensive research and developments are going on in the field of insulin delivery techniques and needle-free insulin delivery appeared to be the most wonderful and emerging approach to treat the condition. Delivering insulin by alternative routes is a current topic of interest in today’s era. This review article discusses the novel and most upcoming emerging technologies that are still in an infancy stage including pulmonary insulin, nasal, oral, buccal, dermal, ocular, rectal, vaginal, trans-mucosal and implantable insulin pumps.
 
The discovery of insulin in 1922 by Frederick Banting and his colleagues at the University of Toronto was one of the greatest medical breakthrough of the 20th century. In fact, a headline appeared in a newspaper called Banting “the conqueror of diabetes. In the next few years long acting insulin like protamine zinc insulin (1930), Neutral Protamine Hagedorn i.e., NPH (1946) and insulin zinc i.e., Lente (1952) were discovered. In the year 1975 the first premixed insulin was launched. Advances in chromatography in 1960 and 1970 led to the production of more highly purified insulins. In 1979, human insulin became the first pharmaceutical agent to be produced by the recombinant DNA technology.1 However; all these insulin preparations were given by SC or I.V. injection. Frequent need of insulin injections, fear about the painful administration of insulin injections and moreover the concern about hypoglycemia and weight gain have definitely put a barrier on patient’s acceptability. Thus a kind of reluctance was seen by both patients and healthcare professionals to start insulin therapy. Since 1920, several researchers are looking for some alternative and painless modes of delivering insulin to restore normal glucose levels in diabetic patients.
 
In this new era of development not only is the variety of insulin preparations available growing, so are the methods for administering insulin. In this review article we have tried to cover some of the alternative painless routes of Insulin delivery like pulmonary, nasal, buccal, dermal, ocular, rectal, vaginal, trans-mucosal and implantable insulin pumps.
 

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