Abstract
One of the primary goals of diabetes management is to maintain blood glucose levels within a normal range, and insulin plays a vital role in achieving this. All Type 1 DM patients and advanced Type 2 DM patients require insulin. Insulin is administered subcutaneously, which may cause patient discomfort from the use of needles. Therefore, developing alternative routes of insulin administration has always been a major focus of diabetes research. This review aims to provide an update on the insulin formulations and delivery routes as well as strategies used to improve its stability and bioavailability for the treatment of diabetes.
Graphical Abstract
[http://dx.doi.org/10.1016/j.tips.2021.05.005] [PMID: 34148677]
[http://dx.doi.org/10.1038/nrm3351] [PMID: 22617471]
[http://dx.doi.org/10.2337/dc21-S002] [PMID: 33298413]
[http://dx.doi.org/10.1016/j.ejpb.2017.03.015] [PMID: 28336368]
[http://dx.doi.org/10.1007/s10534-005-3685-y] [PMID: 16158220]
[http://dx.doi.org/10.1021/bi0507940] [PMID: 16101301]
[http://dx.doi.org/10.1002/chem.202000337] [PMID: 32196765]
[http://dx.doi.org/10.1021/acs.jmedchem.0c00266] [PMID: 32406685]
[http://dx.doi.org/10.1021/acsbiomaterials.0c01306] [PMID: 34510910]
[http://dx.doi.org/10.1007/s12325-019-00951-4] [PMID: 31004325]
[http://dx.doi.org/10.1152/physiol.00048.2018] [PMID: 30968756]
[http://dx.doi.org/10.1155/2018/1205121] [PMID: 30116732]
[http://dx.doi.org/10.2147/DMSO.S282926] [PMID: 33273836]
[http://dx.doi.org/10.1038/nrd1067] [PMID: 12669028]
[http://dx.doi.org/10.3389/fphar.2020.00524] [PMID: 32425781]
[http://dx.doi.org/10.1016/j.biotechadv.2015.02.010] [PMID: 25728065]
[http://dx.doi.org/10.1016/S0168-3659(03)00126-3] [PMID: 12711440]
[http://dx.doi.org/10.1016/j.ejpb.2010.09.016] [PMID: 20933083]
[http://dx.doi.org/10.1007/s13726-020-00893-7]
[http://dx.doi.org/10.1016/j.jconrel.2016.12.018] [PMID: 28007514]
[http://dx.doi.org/10.1073/pnas.1722338115] [PMID: 29941553]
[http://dx.doi.org/10.1016/j.jconrel.2012.05.040] [PMID: 22659331]
[http://dx.doi.org/10.1016/j.ijpharm.2013.02.030] [PMID: 23428883]
[http://dx.doi.org/10.2174/1567201816666190620110748] [PMID: 31250754]
[http://dx.doi.org/10.2174/1567201814666171002142023] [PMID: 28969564]
[http://dx.doi.org/10.1016/j.addr.2011.12.009] [PMID: 22212900]
[http://dx.doi.org/10.1080/17425247.2018.1420050] [PMID: 29257904]
[http://dx.doi.org/10.7150/thno.54176] [PMID: 33754071]
[http://dx.doi.org/10.1039/D0SC05328G] [PMID: 33995999]
[http://dx.doi.org/10.1016/j.carbpol.2020.117202] [PMID: 33183638]
[http://dx.doi.org/10.1080/10837450.2020.1849282] [PMID: 33183103]
[http://dx.doi.org/10.1002/pat.5437]
[http://dx.doi.org/10.1016/j.carbpol.2021.117873] [PMID: 33766360]
[http://dx.doi.org/10.1016/j.apsb.2021.02.020] [PMID: 33996411]
[http://dx.doi.org/10.1016/j.ijpharm.2021.120297] [PMID: 33508345]
[http://dx.doi.org/10.1039/D0BM01772H] [PMID: 33330897]
[http://dx.doi.org/10.1016/j.xphs.2020.07.004] [PMID: 32663595]
[http://dx.doi.org/10.5530/jyp.2021.13.10]
[http://dx.doi.org/10.1016/j.ejpb.2021.02.014] [PMID: 33774161]
[http://dx.doi.org/10.1039/D0NR06104B] [PMID: 33295926]
[http://dx.doi.org/10.1007/s12010-020-03420-9] [PMID: 33026616]
[http://dx.doi.org/10.1186/s12951-020-00750-y] [PMID: 33422063]
[http://dx.doi.org/10.1016/j.ijbiomac.2020.11.190] [PMID: 33279562]
[http://dx.doi.org/10.1016/j.jcis.2020.08.010] [PMID: 32861041]
[http://dx.doi.org/10.1080/21691401.2018.1511575]
[http://dx.doi.org/10.1016/j.ijpharm.2020.119736] [PMID: 32758596]
[http://dx.doi.org/10.1111/j.1463-1326.2009.01150.x] [PMID: 20151994]
[http://dx.doi.org/10.1177/193229680900300323] [PMID: 20144297]
[http://dx.doi.org/10.1111/j.1463-1326.2010.01213.x] [PMID: 20590742]
[http://dx.doi.org/10.1111/j.1463-1326.2009.01153.x] [PMID: 20151998]
[http://dx.doi.org/10.1111/dom.14499] [PMID: 34310011]
[http://dx.doi.org/10.2174/1567201053586001] [PMID: 16305420]
[http://dx.doi.org/10.1111/j.1464-5491.2004.01160.x] [PMID: 15049938]
[http://dx.doi.org/10.1177/1932296814524871] [PMID: 24876619]
[http://dx.doi.org/10.1177/193229680900300627] [PMID: 20144401]
[http://dx.doi.org/10.1101/2022.02.15.22270708]
[http://dx.doi.org/10.1007/s40265-015-0472-0] [PMID: 26384673]
[http://dx.doi.org/10.1016/j.ejps.2013.05.005] [PMID: 23680534]
[http://dx.doi.org/10.1517/17425247.2012.737779] [PMID: 23098366]
[http://dx.doi.org/10.1038/nrd2153] [PMID: 17195033]
[http://dx.doi.org/10.1007/BF01748135]
[http://dx.doi.org/10.1016/0169-409X(95)00113-L]
[http://dx.doi.org/10.1513/pats.200409-049TA] [PMID: 16113455]
[http://dx.doi.org/10.1016/S0168-3659(00)00362-X] [PMID: 11182203]
[http://dx.doi.org/10.1046/j.1365-2125.2003.01892.x] [PMID: 14616418]
[PMID: 16122398]
[PMID: 16185367]
[http://dx.doi.org/10.3390/pharmaceutics13111878] [PMID: 34834293]
[http://dx.doi.org/10.1080/10717544.2019.1631408] [PMID: 31257946]
[http://dx.doi.org/10.1002/adhm.201800910] [PMID: 30284409]
[http://dx.doi.org/10.1016/j.jconrel.2020.04.015] [PMID: 32325175]
[http://dx.doi.org/10.7326/0003-4819-134-3-200102060-00011] [PMID: 11177333]
[http://dx.doi.org/10.2337/diacare.28.5.1077] [PMID: 15855570]
[http://dx.doi.org/10.2337/diacare.27.11.2622] [PMID: 15504996]
[http://dx.doi.org/10.2337/diacare.27.10.2356] [PMID: 15451900]
[http://dx.doi.org/10.1038/nbt1207-1331] [PMID: 18066009]
[http://dx.doi.org/10.1517/17425247.2.6.1097] [PMID: 16296812]
[http://dx.doi.org/10.1055/s-2002-19989] [PMID: 11835120]
[http://dx.doi.org/10.2337/dc15-0629] [PMID: 26253730]
[http://dx.doi.org/10.2337/dc15-0075] [PMID: 26180109]
[http://dx.doi.org/10.1097/JDN.0b013e3182274a98]
[http://dx.doi.org/10.1038/nrd.2018.183] [PMID: 30498202]
[http://dx.doi.org/10.1038/nbt.1504] [PMID: 18997767]
[http://dx.doi.org/10.1016/j.bbamem.2006.06.021] [PMID: 16945325]
[http://dx.doi.org/10.1016/j.ijpharm.2008.08.032] [PMID: 18805472]
[http://dx.doi.org/10.1081/DDC-100100984] [PMID: 11068686]
[http://dx.doi.org/10.1016/j.ijpharm.2003.09.032] [PMID: 14698582]
[http://dx.doi.org/10.1371/journal.pone.0082581] [PMID: 24349315]
[http://dx.doi.org/10.1039/c2md20059g]
[http://dx.doi.org/10.1089/dia.2006.8.369] [PMID: 16800758]
[http://dx.doi.org/10.1080/17425247.2020.1713087] [PMID: 31910342]
[http://dx.doi.org/10.1002/adhm.201601411] [PMID: 28337858]
[http://dx.doi.org/10.1073/pnas.1403995111] [PMID: 25157174]
[http://dx.doi.org/10.1002/adhm.201600086] [PMID: 26959835]
[http://dx.doi.org/10.1038/nrd1304] [PMID: 15040576]
[http://dx.doi.org/10.1016/j.actbio.2020.12.023] [PMID: 33340733]
[http://dx.doi.org/10.1111/j.2042-7158.2011.01369.x] [PMID: 22150668]
[http://dx.doi.org/10.1080/1061186X.2016.1200589] [PMID: 27282644]
[http://dx.doi.org/10.1023/B:PHAM.0000029282.44140.2e] [PMID: 15212158]
[http://dx.doi.org/10.1109/TBME.2005.845240] [PMID: 15887540]
[http://dx.doi.org/10.1089/dia.2012.0096] [PMID: 23013202]
[http://dx.doi.org/10.1073/pnas.1505405112] [PMID: 26100900]
[http://dx.doi.org/10.1002/smll.201704181] [PMID: 29479811]
[http://dx.doi.org/10.1002/adma.201506025] [PMID: 26928976]
[http://dx.doi.org/10.1038/s41551-019-0508-y] [PMID: 32015407]
[http://dx.doi.org/10.1016/j.carbpol.2020.116314] [PMID: 32507191]
[http://dx.doi.org/10.1016/j.addr.2003.10.026] [PMID: 15019750]
[http://dx.doi.org/10.1016/j.ultras.2013.07.007] [PMID: 23899825]
[http://dx.doi.org/10.1016/S0301-5629(02)00706-8] [PMID: 12659919]
[http://dx.doi.org/10.1016/S0301-5629(03)00908-6] [PMID: 12946523]
[http://dx.doi.org/10.1016/j.addr.2012.07.016] [PMID: 22960787]
[http://dx.doi.org/10.1016/j.jconrel.2011.05.003] [PMID: 21596072]
[http://dx.doi.org/10.1016/j.jconrel.2004.08.009] [PMID: 15491812]
[http://dx.doi.org/10.1080/00914037.2018.1517347]
[http://dx.doi.org/10.1016/j.ijpharm.2020.119416] [PMID: 32423875]
[http://dx.doi.org/10.1016/j.msec.2016.12.111] [PMID: 28183628]
[http://dx.doi.org/10.1021/acsami.1c11533] [PMID: 34460218]
[http://dx.doi.org/10.3389/fphar.2021.719905] [PMID: 34630098]
[http://dx.doi.org/10.1016/j.ijpharm.2021.120784] [PMID: 34111544]
[http://dx.doi.org/10.1089/dia.2016.0156] [PMID: 27500713]
[http://dx.doi.org/10.1089/dia.2010.0204] [PMID: 21355717]
[http://dx.doi.org/10.1177/193229680800200107] [PMID: 19885176]
[http://dx.doi.org/10.1007/s12325-018-0703-3] [PMID: 29748915]
[http://dx.doi.org/10.1016/S0168-3659(02)00363-2] [PMID: 12618035]
[http://dx.doi.org/10.2174/157488507779422374]
[http://dx.doi.org/10.1211/0022357011775145] [PMID: 11206189]
[http://dx.doi.org/10.2165/00003088-200342130-00003] [PMID: 14531723]
[http://dx.doi.org/10.2174/1381612827666210820100723] [PMID: 34414869]
[http://dx.doi.org/10.1016/S0169-409X(98)00073-8] [PMID: 10837698]
[http://dx.doi.org/10.1016/j.jconrel.2018.12.023] [PMID: 30557648]
[http://dx.doi.org/10.1016/j.ijpharm.2019.118584] [PMID: 31376466]
[http://dx.doi.org/10.1016/j.colsurfa.2021.126624]
[http://dx.doi.org/10.1021/acsabm.0c00002] [PMID: 35025265]
[http://dx.doi.org/10.3390/pharmaceutics13060852] [PMID: 34201254]
[http://dx.doi.org/10.1016/j.xphs.2019.07.012] [PMID: 31356762]
[http://dx.doi.org/10.1016/j.ddtec.2005.05.018] [PMID: 24981756]
[http://dx.doi.org/10.1093/oxfordjournals.jncimonographs.a003443] [PMID: 11694559]
[http://dx.doi.org/10.1517/17425247.5.5.531] [PMID: 18491980]
[http://dx.doi.org/10.1517/17425247.2.3.507] [PMID: 16296771]
[http://dx.doi.org/10.1016/S0378-5173(00)00394-X] [PMID: 10867256]
[http://dx.doi.org/10.1081/DDC-120024178] [PMID: 14570303]
[http://dx.doi.org/10.1016/S0168-3659(01)00269-3] [PMID: 11389992]
[http://dx.doi.org/10.1016/S0939-6411(00)00144-2] [PMID: 11226816]
[http://dx.doi.org/10.2147/IJN.S168310] [PMID: 30233179]
[http://dx.doi.org/10.3109/00016359309041146] [PMID: 8451922]
[http://dx.doi.org/10.1016/j.addr.2005.07.003] [PMID: 16183164]
[http://dx.doi.org/10.1021/acsabm.1c01161] [PMID: 35026943]
[http://dx.doi.org/10.2174/1567201819666220112121115] [PMID: 35023456]
[http://dx.doi.org/10.1016/j.carbpol.2022.119579] [PMID: 35698397]
[http://dx.doi.org/10.3390/sym13010088]
[http://dx.doi.org/10.1016/j.ijpharm.2020.119469] [PMID: 32470482]
[http://dx.doi.org/10.3390/pharmaceutics13040565] [PMID: 33923670]
[http://dx.doi.org/10.3390/pharmaceutics12121168] [PMID: 33266132]
[http://dx.doi.org/10.2147/IJN.S318092] [PMID: 34262275]
[http://dx.doi.org/10.1080/10717544.2020.1778814] [PMID: 32597266]
[http://dx.doi.org/10.1016/j.jconrel.2020.07.037] [PMID: 32735879]
[http://dx.doi.org/10.1080/10837450.2019.1619183] [PMID: 31092092]
[http://dx.doi.org/10.1080/10837450.2020.1858319] [PMID: 33258391]
[http://dx.doi.org/10.1038/s41746-022-00603-y] [PMID: 35513479]
[http://dx.doi.org/10.1016/j.drudis.2020.10.010] [PMID: 33099022]
[http://dx.doi.org/10.1016/j.drudis.2018.11.014] [PMID: 30472429]