Abstract
Diabetes mellitus is a chronic disease that is considered a worldwide epidemic, and its control is a constant challenge for health systems. Since insulin had its first successful use, scientists have researched to improve the desired effects and reduce side-effects. Over the years, the challenge has been to increase adherence to treatment and improve the quality of life for diabetics by developing an insulin delivery system. This systematic review (SR) analyses experimental articles from 1998 to 2018 related to the development of the chitosan/insulin delivery system (CIDS). Automated support: Start tool was used to perform part of these activities. The search terms “insulin”, “delivery or release system”, and “chitosan” were used to retrieve articles in PubMed, Science Direct, Engineering Village, and HubMed. A total of 55 articles were selected. The overview, phase, model, way of administration, and the efficiency of CIDS were analyzed. According to SR results, most of the articles were published from 2010 onwards, representing 72.7% of the selected papers, and research groups from China publicized 23.6% of the selected articles. According to the SR, 51% of the studies were carried out in vivo and 45% in vitro. Most of the systems were nanoparticle based (54.8%), and oral administration was proposed by 60.0% of the selected articles. Only 36.4% performed loaded capacity and encapsulation efficiency assays, and 24 h (16.4%), 12 h (12.7%), and 6 h (11.0%) were the most frequent insulin release times. Chitosan’s intrinsic characteristics, which include biodegradability, biocompatibility, adhesiveness, the ability to open epithelial tight junctions to allow an increase in the paracellular transport of macromolecular drugs, such as insulin, and the fact that it does not result in allergic reactions in the human body after implantation, injection, topical application or ingestion, have contributed to the increase in research of CIDS over the years. However, the number of studies is still limited and the use of an alternative form of insulin administration is not yet possible. Thus, more studies in this area, aiming for the development of an insulin delivery system that can promote more adherence to the treatment and patient comfort, are required.
Highlights
Diabetes mellitus is a chronic disease that is considered a worldwide epidemic, and its control is a constant challenge for health systems worldwide
To guarantee the authenticity and reproducibility of this study, additional material was created. It contains information on 55 experimental articles from 1998 to 2018 which deal with the development of chitosan/insulin delivery systems (Table S1), strings, and the Start tool used in the development and data analyses
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Summary
Diabetes mellitus is a chronic disease that is considered a worldwide epidemic, and its control is a constant challenge for health systems worldwide. According to data publicized by the World. Health Organization [1], the estimated number of people with the disease around the world has been increasing since 1980. The outlook is that this figure will have increased to 642 million by 2040, according to the International Diabetes Federation [2]. One of the treatments for this disease is the use of exogenous insulin, especially for patients with Type 1 diabetes mellitus, insulin may be required for patients with Type 2 diabetes mellitus [1]. Since insulin had its first successful use and started to be commercialized, scientists have constantly been developing new research to improve the desired effects and reduce the collateral ones.
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