Prakash V Diwan
Indian Pharmacopeia Commission, India
Title: Pursuit of oral insulin is a reality: Is it simply a matter of when?
Biography
Biography: Prakash V Diwan
Abstract
Oral insulin delivery has been a promising and interesting research area and can revolutionize treatment. Several studies have achieved positive results which includes nanotechnology. Considerable problems of developing oral insulin are because of small therapeutic index and short half-life which limits the success. Several insulin delivery systems, such as tablets, capsules, intestinal patches, hydrogels, microparticles and nanoparticles, have been explored to deliver insulin without much success. Various types of nanoparticles are currently studied for insulin delivery in diabetes treatment such as polymeric biodegradable nanoparticles, polymeric micelles, ceramic nanoparticles, liposomes and dendrimers. Exubera, as the fi rst and until now only inhaled insulin with a market approval, was not a market success due to insuffi cient uptake in the market. Th e intestinal micropatches for oral insulin delivery is well thought approach. Th e colon-specifi c drug delivery system has many advantages. Encapsulation of insulin in vitamin B12-coated dextran nanoparticles has been considered in complementing diabetes therapy by taking advantage of enhanced insulin absorption through vitamin B12 intrinsic factor receptor ligand-mediated endocytosis via intestine ileocytes. Artifi cial pancreas is the future of diabetes treatment. It is known that intestinal epithelial cells have insulin receptors on their apical surfaces. Researchers think that β-cell implants or Island of Langerhans transplants would be a more feasible and perhaps better option. Current research has been going on to deliver insulin experimentally and this has been achieved by the developing smart insulin patch. Oral version of acylated insulin analog with a half-life of ~70 hours is a great breakthrough. Th e herbal medicines are symbol of safety in contrast to synthetic drugs. Th e life style is becoming techno savvy and we are moving away from nature. Th e 80% of world population is using herbal medicines. Gymnema sylvestre also increases the amount of insulin in the body and increase the growth of β-cells in pancreas and many more in armamentarium of Indian herbal wealth. Most of the developments of these companies have failed in phase II clinical studies, showing insufficient metabolic control in patients with diabetes. However, researchers are concerned that oral insulin could raise the risk of certain types of cancer. Addressing these issues successfully will create a new paradigm in diabetes treatment. Future advance in drug delivery could still make it a reality.