REVIEW   

Minerva Endocrinologica 2020 March;45(1):49-60

DOI: 10.23736/S0391-1977.19.03055-4

Copyright © 2019 EDIZIONI MINERVA MEDICA

lingua: Inglese

Oral insulin: an update

Subhankar CHATTERJEE ¹ ✉, Chandra BHUSHAN SHARMA ¹, Carl J. LAVIE ², Anjan ADHIKARI ³, Prakash DEEDWANIA ⁴, James H. O’KEEFE ⁵

¹ Department of Medicine, Rajendra Institute of Medical Sciences, Ranchi, India; ² Department of Medicine, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, the University of Queensland School of Medicine, New Orleans, LA, USA; ³ Department of Pharmacology, R.G. Kar Medical College and Hospital, Kolkata, India; ⁴ Department of Medicine, University of California San Francisco School of Medicine, Fresno, CA, USA; ⁵ Department of Medicine, Saint Luke’s Mid America Heart Institute, University of Missouri, Kansas City, MO, USA

Insulin, either in its intravenous or subcutaneous forms, remains the standard therapy for virtually all type-1 diabetes and many of the type-2 diabetes patients in its advanced stages. With advancement of injection techniques, insulin therapy has become much more patient-friendly than ever. Still there is vast area of unmet needs regarding current practice of insulin therapy. Insulin injections are associated with poor compliance, weight gain, fears of hypoglycemia and adverse effects of systemic hyperinsulinemia. So, a search for oral insulin tablet which may closely mimic the physiological insulin secretions has always been there. This review intends to briefly describe the existing barriers of oral insulin delivery and strategies to overcome those. It also highlights the recent human studies and tries to find out the future of oral insulin in clinical context.

KEY WORDS: Diabetes mellitus, type 2; Diabetes mellitus, type 1; Insulin; Hypoglycemia