New technologies in insulin delivery

Abstract

The electronic age is bringing advances in the treatment of diabetes, and this is important because the complications of diabetes remain despite the availability of effective therapeutic tools such as insulin. These developments focus on the need to deliver accurately timed and sized doses for predicted blood glucose levels.In this review, blood monitoring methods are discussed since, although the chemistry remains based on the enzymic oxidation of glucose, the display, storage and manipulation of data have transformed recently to engage with smartphone users. Continuous glucose monitoring sensing (CGMS) types are described along with an appreciation of the shortcomings of sensor technology. The discussion includes responses to other barriers to CGMS use for reducing the HbA1c value safely so that hypoglycaemia can be avoided. The newer pumps and the emergence of the minimalised patch pumps and patch pens are described. This includes the moves to attract more type 2 users to pump use, addresses the perceived obtrusiveness noted by younger users, and reviews the obstacles to rolling out pump use more widely in the UK. Penultimately, after reference to islet implants, the combination of the continuous sensing and conventional pump strategies to form a closed loop system is described, including a summary of the electronic algorithms and the clinical performance of systems in research settings. The review closes with an explanation of how other closed loop systems have been developed including the peritoneal Medtronic and the DiaPort and a smart gel, non‐electronic design. Copyright © 2013 John Wiley & Sons.

Insulin Pump Therapy for Patients With Type 2 Diabetes Mellitus: Evidence, Current Barriers, and New Technologies

“…Compared to conventional durable insulin pumps with visible insulin infusion sets (IIS), patch pumps are usually attached directly to the skin 67 and typically deliver insulin through a short cannula from the pump to the subcutaneous tissue without an external tubing. 68 Consequently, they are usually smaller and more discreet. While some are full-featured, there are also simplified devices, which primarily are intended as insulin pen replacements.…”

Microneedles for drug delivery: trends and progress

“…(Henry et al, 1998;Park et al, 2005;Gupta et al, 2009;Swain et al, 2011;Kommareddy et al, 2013;Mansoor et al, 2013;Torrisi et al, 2013;Pierre & Rossetti, 2014). There has been a lot of research conducted on MNs for the delivery and monitoring of various drugs such as glucose control for diabetics (Ito et al, 2006;Nordquist et al, 2007;Ainslie & Desai, 2008;El-Laboudi et al, 2013;Taylor & Sahota, 2013;Ita, 2014), Alzheimer's disease (Wei-Ze et al, 2010), anticancer (Fang et al, 2008) and other conditions (Ezan, 2013). Vaccines have also been a prominent research field with numerous studies developed to allow dose sparing effects (Edens et al, 2013;Norman et al, 2014;van der Maaden et al, 2014).…”

“…There are numerous journal papers that have reviewed different types of DD technologies (Wu et al, 2012;Chandrasekhar et al, 2013;Fazil et al, 2013;Kamboj et al, 2013;Tuan-Mahmood et al, 2013;Ita, 2014;Nalwa, 2014;Wolff, 2014) and specific drug deliveries, such as insulin (Martanto et al, 2004;Zahn et al, 2005;Ito et al, 2006;Khanna et al, 2008;Taylor & Sahota, 2013;Bronger, 2014;Natayan, 2014). A number of review papers have also discussed specific technologies, e.g.…”