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THE PHARMA REVIEW (OCTOBER 2008)

Newer Strategies for Insulin Delivery

Raman Sehgal

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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