Bhagi Medha, Kaur Jasmine, Dhar Arti, Bhat Audesh
Centre for Molecular Biology, Central University of Jammu, UT of Jammu and Kashmir, 181143, India.
Department of Pharmacy, Birla Institute of Technology and Sciences Pilani, Hyderabad, Telangana, 500078, India.
Curr Pharm Biotechnol. 2025;26(7):1050-1068. doi: 10.2174/0113892010287216240324050651.
Diabetes is a medical condition associated with impaired glucose regulation caused either due to insufficient insulin production or resistance to insulin (Type 2 diabetes, gestational diabetes) or the absence of insulin through the selective killing of beta cells in the pancreas (Type 1 diabetes). Irregular insulin production leads to various health complications. To prevent such complications, patients must adhere to medical recommendations before availing of any advanced insulin therapy(ies), considered productive for the treatment. Natural insulin, although highly effective in controlling blood glucose levels, patients are often at risk of developing hypoglycemia and many other complications. This has led to the development of insulin analogs, the modified variants of natural insulin having a minimal risk of causing hypoglycemia. Besides the development of analogs, the mode of insulin delivery is also considered critical in achieving better glycemic control in diabetic patients. Until recently, various exogenous insulin delivery methods were practiced, but effective glycemic control without any associated risk and ease of delivery remains a subject of paramount concern. It countered attenuation or delayed onset of diabetes-associated complications without a permanent cure, raising an unmet demand for insulin formulations and delivery methods that offer stability, biocompatibility, reproducibility, precision dosing, non-immunogenicity, and safety. The current practice utilizes non-physiological delivery methods with less invasive administration routes, offering glycemic stability and therapeutic effectiveness. This review focuses on the recent advances made and future perspectives envisioned about newer insulin therapies and delivery methods that tend to improve the management of diabetes by inculcating ideas to reduce the disease's severity and improve the quality of life.
糖尿病是一种与血糖调节受损相关的病症，其病因要么是胰岛素分泌不足或对胰岛素产生抵抗（2型糖尿病、妊娠期糖尿病），要么是胰腺中的β细胞被选择性杀伤导致胰岛素缺乏（1型糖尿病）。胰岛素分泌不规律会引发各种健康并发症。为预防此类并发症，患者在采用任何被认为对治疗有效的先进胰岛素疗法之前，必须遵循医嘱。天然胰岛素虽然在控制血糖水平方面非常有效，但患者往往有发生低血糖和许多其他并发症的风险。这促使了胰岛素类似物的研发，即天然胰岛素的改良变体，其引发低血糖的风险最小。除了类似物的研发，胰岛素给药方式在实现糖尿病患者更好的血糖控制方面也被认为至关重要。直到最近，人们实践了各种外源性胰岛素给药方法，但在没有任何相关风险且给药方便的情况下实现有效的血糖控制仍然是一个至关重要的问题。它可以对抗糖尿病相关并发症的减轻或延迟发作，但无法实现永久治愈，这就引发了对具有稳定性、生物相容性、可重复性、精确给药、非免疫原性和安全性的胰岛素制剂和给药方法的未满足需求。目前的做法是采用侵入性较小的非生理性给药方法，以提供血糖稳定性和治疗效果。本综述重点关注了在新型胰岛素疗法和给药方法方面取得的最新进展以及对未来的展望，这些疗法和方法旨在通过灌输减轻疾病严重程度和改善生活质量的理念来改善糖尿病的管理。
