Siddiqui N I, Rahman S, Nessa A
Department of Endocrinology, Mymensingh Medical College, Mymensingh & Editor, Mymensingh Medical Journal, Mymensingh, Bangladesh.
Mymensingh Med J. 2008 Jan;17(1):102-10.
Delivery system of insulin is vital for its acceptance and adherence to therapy for achieving the glycemic targets. Enormous developments have occurred in the delivery system of insulin during the last twenty years and each improvement was aimed at two common goals: patients convenience and better glycemic control. Till to date, the various insulin delivery systems are: syringes/vials, injection aids, jet injectors, transmucosal delivery, transdermal delivery, external insulin infusion pump, implantable insulin pumps, insulin pens and insulin inhalers. Syringe/vial is the oldest and conventional method, still widely used and relatively cheaper. Modern plastic syringes are disposable, light weight with microfine needle for patients convenience and comfort. Oral route could be the most acceptable and viable, if the barriers can be overcome and under extensive trial. Insulin pen device is an important milestone in the delivery system of insulin as it is convenient, discrete, painless, attractive, portable with flexible life style and improved quality of life. More than 80% of European diabetic patients are using insulin pen. Future digital pen will have better memory option, blood glucose monitoring system, insulin dose calculator etc. Insulin infusion pump is a good option for the children, busy patients with flexible lifestyle and those who want to avoid multiple daily injections. Pulmonary route of insulin delivery is a promising, effective, non-invasive and acceptable alternative method. Exubera, the world first insulin inhaler was approved by FDA in 28 January 2006. But due to certain limitations, it has been withdrawn from the market in October 2007. The main concern of inhaled insulin are: long term pulmonary safety issues, cost effectiveness and user friendly device. In future, more acceptable and cost effective insulin inhaler will be introduced. Newer avenues are under extensive trial for better future insulin delivery systems.
胰岛素给药系统对于胰岛素被接受以及患者坚持治疗以实现血糖目标至关重要。在过去二十年中，胰岛素给药系统取得了巨大进展，每一项改进都旨在实现两个共同目标：方便患者以及更好地控制血糖。迄今为止，各种胰岛素给药系统包括：注射器/药瓶、注射辅助工具、喷射注射器、经粘膜给药、经皮给药、外部胰岛素输注泵、植入式胰岛素泵、胰岛素笔和胰岛素吸入器。注射器/药瓶是最古老的传统方法，至今仍被广泛使用且相对便宜。现代塑料注射器为一次性使用，重量轻，配有超细针头，方便患者使用且舒适。如果能够克服障碍并经过广泛试验，口服途径可能是最可接受且可行的。胰岛素笔装置是胰岛素给药系统中的一个重要里程碑，因为它方便、隐秘、无痛、美观、便于携带，适应灵活的生活方式并改善生活质量。超过80%的欧洲糖尿病患者正在使用胰岛素笔。未来的数字笔将具备更好的存储功能、血糖监测系统、胰岛素剂量计算器等。胰岛素输注泵对于儿童、生活方式灵活的忙碌患者以及那些希望避免每日多次注射的患者来说是个不错的选择。肺部胰岛素给药途径是一种有前景、有效、无创且可接受的替代方法。世界上首个胰岛素吸入器Exubera于2006年1月28日获得美国食品药品监督管理局（FDA）批准。但由于某些局限性，它已于2007年10月退出市场。吸入式胰岛素的主要问题包括：长期肺部安全性问题、成本效益以及用户友好性。未来，将推出更可接受且成本效益更高的胰岛素吸入器。为了未来更好的胰岛素给药系统，新的途径正在进行广泛试验。
