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AN IDEAL INSULIN THERAPY?

A Drug carrier for constant rate Insulin release for basal insulin therapy was designed such that it

mimics the physiological insulin secretion. The initial burst release, which causes a significant issue

with other release techniques, was effectively avoided. Additionally, the plasma drug level can be

sustained for an extended period of time.


A better glycemic control…?

Diabetes cannot be cured, at least till now, the only way to deal with it is through tight glycemic

control. To achieve this goal, an ideal insulin therapy should mimic the normal physiologic secretion

of insulin, which consists of a sustained low level throughout the day (basal insulin) and relatively large

bursts after meals (bolus insulin).

To attain this goal, various technologies have been proposed, such as self-regulated insulin

release, insulin pumps, and so on. Among these methods, basal-bolus insulin therapy, in which rapid￾acting insulin is given before each meal to mimic bolus insulin for postprandial glucose control and

long-acting insulin is given at bedtime to mimic basal insulin for fasting plasma glucose control, is the

most practical and has become the gold standard in the treatment of diabetes.


Zero order Insulin release

First PEG-insulin conjugates were created. The

LBL films (layer by layer) were then made from

the conjugate and TA, with hydrogen bonding

between the PEG chain and the TA(Tannic acid)

acting as a driving force. When immersed in

aqueous solutions, the films progressively

breakdown and release PEG-insulin.

Conjugation of PEG chains onto insulin improves

the drug's physical and pharmacological

properties but has no significant effect on the

drug's in vivo potency. The kinetics of PEG￾insulin release are zero-order.



What’s new?

As can be seen, the release behaviour of the PEG￾insulin/TA films differs significantly from that of typical

drug carriers. Until now, most drug carriers have

reported drug release in a fast-then-slow pattern. Some carriers were reported to follow a zero-order release kinetics, but the release rate can be regarded constant only at a certain part of the release process.

The PEG-insulin/TA films' distinct release

behaviour can be explained by their distinct drug release mechanism. Ordinary drug carriers release the drug

through diffusion or breakdown of the carrier matrix. In contrast, the PEGinsulin/TA films in this study release PEG-insulin through the film's progressive disintegration.

Complications free…?

After the evaluation of biocompatibility studies, it didn’t show any wound infections. Histological

studies also indicate compared to untreated control, only a slightly increased number of inflammatory

cells were observed in the sample, suggesting it causes only a minor inflammatory response.


Final Thoughts…

By first PEGylating insulin and then integrating the conjugate into layer-by-layer constructed films

using tannic acid, a novel drug carrier was created (TA). Because the PEG-insulin and TA in the films

were coupled with reversible, dynamic hydrogen bonds, when soaked in aqueous solutions, the films

gradually dissolve, releasing PEG-insulin into the medium. In vitro release assays demonstrated that

PEG-insulin release followed a zero-order kinetics. A zero-order kinetics is further supported by

theoretical study based on the unique release mechanism. In vivo experiments utilising a

streptozotocin-induced diabetic rat model revealed that subcutaneous implantation of the film could

maintain a consistent plasma drug level and thereby keep fasting blood glucose levels (BGL) close to

normal.

Fasting BGL (Blood Glucose Level) can be reduced to near normal levels for an extended period

of time using this therapy. The length of action is determined by the thickness of the film. Fasting BGL

was controlled within the normoglycemic range for 16 days using a 50-bilayer film.


The next step…

Further research into the creation of an injectable drug carrier using microspheres rather than

macroscopic substrates for LBL assembly is underway.


Reference:

Blog by Nirbhay Mourya

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