current status and future trends in insulin delivery systems to diabetic patients

1. CURRENT STATUS AND FUTURE
TRENDS IN INSULIN DELIVERY
SYSTEMS TO DIABETIC PATIENTS

2. TYPES OF DIABETES
There are three types of diabetes
*type-1
Results from body’s failure to produce insulin
*type-2
Results from insulin resistance
*gestational diabetes
During pregnancy

3. INSULIN
 It was isolated in 1921
 It is a harmone secreted from ß cells
 Insulin is protein consisting of two polypeptide chains,
one of 21 amino acid residues and the other of 30,
joined by two disulfide bridges.
 Insulin is the mainstay drug for the management of
type I and many of type II DM.
 Sources of insulin are 1)animal sources 2)human
biosynthetic sources(RDNA technology).

4. ROUTE OF ADMINISTRATION
 Transdermal
 Intrapulmonary
 Intranasal
 Oral
 Buccal
 And other ways

5. TRANSDERMAL ROUTE FOR THE DELIVERY
OF INSULIN :
Insulin syringes :
• disposable
• thinner needles
• more sanitary

6. TRANSDERMAL ROUTE FOR THE DELIVERY
OF INSULIN :
Insulin Pens :
• Ease of handling
• More discrete use

7. TRANSDERMAL ROUTE FOR THE DELIVERY
OF INSULIN :
Jet Injectors :
• sends insulin through the skin , using high pressure mechanism
• an option for people with severe needle phobia

8. INTRAPULMONARY ROUTE FOR THE
DELIVERY OF INSULIN:
Intrapulmonary route offers the most feasible route for the delivery of insulin
and similar products.
Advantages and disadvantages of pulmonary drug delivery:
Advantages:
1) Large surface area.
2) Avoidance of first pass metabolism.
3) Absence of degrading acidic stomach and the GI degrading enzymes
Disadvantages:
1) Asthmatic patients may not be able to obtain the required dose
2) Some metabolism do occur in the lungs
3) Mucocililary clearance
4) The need to control particle size

9. INTRANASAL ROUTE FOR THE DELIVERY OF
INSULIN:
This route offers certain advantages for drugs such as insulin.
Advantages:
1) Large surface area.
2) Ease of accessibility
3) The pharmacokinetic profile following intranasal absorption of insulin
closely mimics the 'pulsatile' pattern of insulin secretion during meal times.
Disadvantages:
1) Negligible absorption without absorption promoters.
2) rapid removal of the drug from the site of deposition in the nasal cavity by
mucocililary clearance, enzymatic degradation in the mucous layer and
nasal epithelium.
3) low permeability of the nasal epithelium and low and erratic
bioavailability.

10. ORAL ROUTE FOR THE DELIVERY OF INSULIN:
This route may be considered as the elusive goal since the discovery of
insulin.
From the patient compliance point of view, the oral route is the most
convenient and desirable route for insulin delivery.
Problems with oral delivery of insulin are mainly low bioavailability of
<2% mainly because:
1) The main barriers to its oral delivery include enzymatic degradation.
2) Lack of sufficient permeability by intestinal epithelium.
3) Insulin can also be degraded easily when subjected to the rigors of
product development.

11. BUCCAL ROUTE FOR THE DELIVERY
OF INSULIN:
Advantage of buccal delivery:
1) The liver is by-passed
2) Drug stability
3) Drug stability
4) It is pain-free

12. DEVICES USED FOR ADMINISTRATION
 Insulin syringes
 Insulin infusion pumps
 Insulin pens
 Insulin patches
 Insulin jet indicators

13. BIOAVAILABILITY
 Poor absorption of intermediate-acting insulin
preparations, or combinations of intermediate- and
rapid-acting insulin preparations, explains the difficulty
in lowering blood glucose in patients with type 2
diabetes mellitus who have had long-standing disease,
are insulin resistant, and have a flat insulin response to
a glucose load.

14. CURRENT RESEARCH
1) Rectal method for delivering insulin
2) Ocular route for delivering insulin
3) The use of powder jet’s delivery system
4) Implantable insulin pumps

15. FUTURE
 Pump technology continues to advance
 On the horizon:
 Pumping and monitoring by cell phone
 Cooler styles
 Smaller sizes
 Improved human interface
 More helpful data analysis
 Gradual progress toward a closed loop

16. CONCLUSION :
1) “Prevention is better than cure”. Many of the studies indicate that type
II DM is the result of changes in the life style brought about by
urbanization.
2) Insulin pens seems to be popular for many DM patients.
3) Products delivering insulin by intrapulmonary route seem to be the first
on the horizon. Nevertheless, the currently tested products do not
include medium or long acting insulin.
4) Insulin tablets taken orally would be the real break through in the
delivery of insulin.
5) For type I DM, the future focus should be the intervention to restore the
secretive function of the β cells of the islets of Langerhans.