New Approaches to Improve the Intranasal Absorption of Insulin
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Abstract
Insulin is essential for type 1 and advanced type 2 diabetics to maintain blood glucose levels and prolong lives. Due to its large molecular weight and short half-life, it has been usually administered subcutaneously accompanied with side effects such as the possibility of hypoglycemia episodes, weight gain, pain, local tissue necrosis, infection, nerve damage and inadequate post meal glucose control. In order to overcome these limitations, alternative delivery routes of insulin are expected to provide better safety and compliance for the patient. Non-invasive insulin delivery system represents one of the most challenging goals for pharmaceutical industry. Nasal insulin delivery has been extensively studied as an alternative to subcutaneous injection for the treatment of diabetes. The pharmacokinetic profile of nasal insulin is similar to that obtained by intravenous injection. Nasal drug administration has been used as an alternative route for the local or systemic availability of drugs restricted to intravenous administration. This is due to the large surface area, porous endothelial membrane, high total blood flow, the avoidance of first-pass metabolism and ready accessibility. The nasal administration of drugs, including numerous compound, peptide and protein drugs, for systemic medication has been widely investigated in recent years. Drugs are cleared rapidly from the nasal cavity after intranasal administration, resulting in rapid systemic drug absorption. This review describes the main barriers preventing nasal insulin absorption and special attention is given to new approaches to improve the intranasal absorption of insulin, including the application of new safe absorption enhancers and the use of appropriate delivery systems. It seems that bioadhesive delivery systems or water-insoluble powders with absorption enhancers are the most promising methods for intranasal delivery of insulin.
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