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Abstract: It has been now well proven that
adequate control of blood sugar delays or prevents the
complications associated with diabetes. The targeted
glycemic control is necessary to reduce the incidence of
diabetic complications and often requires a more
intensive insulin regimen with multiple insulin
injection for patients with Type-1 diabetes mellitus.
However, the only viable option to administer insulin is
through painful sub-cutaneous injections. Off late,
various non-invasive delivery options (dermal, nasal,
oral etc) mimicking normal endogenous insulin release
has been explored. This article reviews the barriers to
conventional insulin therapy and various newer
strategies for delivering insulin.
Introduction
The goal for delivering exogenous insulin in patients
with diabetes is to mimic as closely as possible the
normal physiological insulin secretion seen in
non-diabetic individuals. Results from various clinical
trials have demonstrated that glycemic control can
prevent or delay the progression of diabetic
complications such as retinopathy, neuropathy and
nephropathy. Also, lower glycolysated haemoglobin
(HbA1c) is associated with lower rate of cardiovascular
diseases. Thus, in order to achieve optimal glycemic
control, a more intensive insulin therapy both for
patients with Type 1 diabetes (autoimmune destruction of
pancreatic β-cells) and an early introduction in the
management course of Type 2 diabetes has gained
considerable support.
Barriers to Insulin Therapy
Insulin is usually administered to diabetic patients
through subcutaneous injection. However, the problems
encountered with subcutaneous insulin injections are
pain, allergic reactions and insulin lipodystrophy
around the injection site. To overcome these frequently
encountered problems with the use of sub-cutaneous
insulin, various pharmaceutical companies are searching
for newer drug delivery systems for safe and efficient
insulin delivery.
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