Abstract
Type-1 diabetes is characterized by high blood glucose levels due to a failure of insulin secretion from beta cells within pancreatic islets. Current treatment strategies consist of multiple, daily injections of insulin or transplantation of either the whole pancreas or isolated pancreatic islets. While there are different forms of insulin with tunable pharmacokinetics (fast, intermediate, and long-acting), improper dosing continues to be a major limitation often leading to complications resulting from hyper- or hypo-glycemia. Glucose-responsive insulin delivery systems, consisting of a glucose sensor connected to an insulin infusion pump, have improved dosing but they still suffer from inaccurate feedback, biofouling and poor patient compliance. Islet transplantation is a promising strategy but requires multiple donors per patient and post-transplantation islet survival is impaired by inflammation and suboptimal revascularization. This review discusses how nano- and micro-technologies, as well as tissue engineering approaches, can overcome many of these challenges and help contribute to an artificial pancreas-like system.
Highlights
Diabetes mellitus (DM) is a chronic metabolic disorder characterized by elevated blood glucose levels (BGLs)
Diabetes is diagnosed using one of the following criteria: glycated hemoglobin (HbA1c) ≥ 6.5% (48 mmol mol−1); fasting plasma glucose ≥ 126 mg dL−1 (7.0 mmol L−1), in which fasting is defined as no caloric intake for at least 8 h; two-hour plasma glucose ≥ 200 mg dL−1 (11.1 mmol L−1) during an oral glucose tolerance test (OGTT); or random plasma glucose ≥ 200 mg dL−1 (11.1 mmol L−1) [4]
Zhang et al demonstrated that chitosan coating makes poly(lactic acid-glycolic acid) (PLGA) particles more mucoadhesive compared to uncoated ones, thereby prolonging insulin retention on the mucosa resulting in improved oral bioavailability [26]
Summary
Diabetes mellitus (DM) is a chronic metabolic disorder characterized by elevated blood glucose levels (BGLs). It is one of the most challenging global health issues affecting more than 450 million people worldwide and this number is estimated to increase to 693 million by 2045 (Figure 1) [1,2,3].
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