Carolyn N. Kinder
Technolgy for diabetes advancement for the delivery of insulin has changed. Technology advancements have led to new forms of insulin, such as human insulin produced through genetic engineering, better ways for doctors to monitor blood glucose levels and for people with diabetes to test their own blood glucose level at home, and development of external and implantable insulin pumps that deliver appropriate amounts of insulin, replacing daily injections.
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New Insulin and insulin delivery systems can make this easier while offering additional benefits of lifestyle flexibility and improved glycemic control. This section of the unit will discuss a few of these technologies.
Insulin Inhalers
Insulin inhalers, an insulin delivery, that are about the size of flashlight and uses rapid acting insulin. The sprayed insulin is inhaled into the mouth and coats the mouth, throat and tongue. The insulin passes quickly into the bloodstream. Scientists have shown some success at controlling inhaled insulin at controlling blood glucose levels. Inhaled insulin does not replace longer-acting insulin. Long-acting insulin would still be needed.
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There are several disadvantages of using inhaled insulin. For example, you have to inhale a lot of insulin to get the amount the body needs because only a small percentage of the inhaled insulin actually reaches the bloodstream and lowers blood glucose. Insulin inhalers waste a lot of insulin for that reason.
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In addition, scientists have questions about the safety of delivering insulin to the lungs. They think the lungs are a great place to deliver a drug because of the large surface area and ready absorption. But absorption of insulin is not a normal function of the lungs, so the long-term safety remains a problem.
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Buccal insulin is similar to inhaled insulin in many ways, but has a different delivery system. Buccal has a device that delivers a spray of insulin like what you'd get out of a can of spray. Instead of going into the lungs, the insulin is absorbed in the lining at the back of the mouth and throat. The good news is that it avoids any problems from putting large amounts of insulin into the lungs. However, there is still a large amount of insulin wasted.
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Oral Insulin
In this unit I have discussed insulin pumps, inhaled insulin, and insulin sprays just to name a few. It is important to mention that insulin taken as a pill is quickly broken down in the stomach makes it useless for lowering blood glucose levels. Insulin cannot be used as a pill form by itself, so scientists are packaging insulin by using a special coating or by altering it to get it through the stomach. Insulin pills are one way to advance this research. For example, Insulin pills are another way of delivering insulin into the cells of the body. The insulin pill is a new polymer, which is used as a coated pill. When used as a pill coating, it allows insulin to get into the bloodstream without being destroyed by the digestive system. Insulin pills however have only tested on animals. Some scientists question whether insulin in pill form will prove useful.
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Transdermal Insulin Delivery System
The skin is an amazing organ because it is difficult for anything to get pass it. A major function of the skin is to keep things out of the body and just allow a few selected things pass. For example, Insulin is too large to get through the skin without a lot of help. Trying to develop something to do that is very hard. However, scientists have been working on patches using electrical currents, ultrasound waves, and chemical to help transport insulin through the skin. Scientists are a long way from developing a delivery system as of now, but any successes for transdermal-delivery delivery are likely to come with basal delivery of relatively small amounts over time.
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Islet Cell Transplant
The pancreas is a narrow organ about the length of your hand that is located in back of the stomach. The pancreas releases enzymes into the small intestine to break down nutrients. It also releases hormones such as insulin into the bloodstream to help the body to use glucose. In Type1diabetes the pancreas releases little or no insulin.
To help the pancreas to release glucose, a new treatment for diabetes is now in clinical trials. This new islet cell transplant or the Edmonton technique is for people with Type1 Diabetes. The procedure is still evolving, but the islet cell transplant has resulted in seven patients becoming insulin free for up to 14 months after treatment.
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The islet cell transplant uses islet cells from the pancreas of two or more donor pancreases. The cells are transplanted into a person with diabetes and then special medications are given to prevent rejection of the new cells. It contains insulin-secreting cells that borrow nutrients from the body to keep producing insulin indefinitely.
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The challenge for patients who have the transplant is that even though a person may become free of the need of insulin, the medications to prevent rejection of new tissue must be taken for a lifetime.
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In order to get islet cells transplant, patients have participated in clinical trials. Although survival rates for transplant continue to improve, there are many unanswered questions about their long-term function. However, what is known about the islet cell transplant is patients immune system play a major role in the success of their survival.
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