ORAL INSULIN AND ITS FUTURE TRENDS
*Shithin Ann Varghese, Dr. Beena P and Dr. Elessy Abraham
ABSTRACT
Diabetes mellitus is a serious pathologic condition that is responsible
for major health care problems worldwide and costing billions of
dollars annually. Diabetes mellitus is a group of metabolic disorders
with a number of etiologies characterized by hyperglycemia along with
impairment of carbohydrate, fat and proteins metabolism. It can occur
due to an imbalance of insulin secretion, insulin action or both.
Diabetes mellitus management is associated with the episodes of
hypoglycemia. The hypoglycemia complications are mainly associated
in elderly and also in some cases of type I diabetes subjects.
Furthermore, prolonged insulin deficiency and longer disease duration increase the risk of
hypoglycemia in type II diabetes mellitus. Diabetes and its associated complications are the
possible cause of morbidity and mortality worldwide. This calls for a firm action in part of its
therapeutic potential. Insulin replacement therapy has been used in the clinical management
of diabetes mellitus for more than 84 years. The present mode of insulin administration is by
subcutaneous route through which insulin is presented to the body in a non-physiological
manner having many challenges. Challenges of oral route of administration are: rapid
enzymatic degradation in the stomach, inactivation and digestion by proteolytic enzymes in
the intestinal lumen and poor permeability across intestinal epithelium because of its
molecular weight and lack of lipophilicity. Liposomes, microemulsions, nanocubicles, and
forth have been prepared for the oral delivery of insulin. Chitosan-coated microparticles
protected insulin from gastric environment of the body and released intestinal PH.
Limitations to the delivery of insulin have not been resulted in fruitful results to date and
there is still need to prepare newer delivery systems, which can produce dose-dependent and
reproducible effects, in addition to increased bioavailability.[1] We haven’t developed a type
of oral insulin that can make it through the digestive system unharmed. The acids in our
stomach breakdown oral insulin before it can get into the liver. That means it’s not effective by the time it reaches our liver. Furthur, our body has trouble absorbing insulin from our intestines. The mucus layer in our intestines is thick and studies have shown that only low levels of insulin pass through this lining and into your bloodstream. As a result, some researchers believe that high doses of insulin would be needed to be effective in managing diabetes.
Keywords: Liposomes, microemulsions, nanocubicles.
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