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Revolutionizing type 1 diabetes management: Exploring oral insulin and adjunctive treatments - 16/06/24

Doi : 10.1016/j.biopha.2024.116808 
Mohsen Nabi-Afjadi a, , 1 , Samane Ostadhadi b, 1, Mahsa Liaghat c, d, Ajay Prakash Pasupulla e, Sajjad Masoumi f, Fatemeh Aziziyan a, d, Hamidreza Zalpoor d, g, Leila Abkhooie h, i, Vahideh Tarhriz j,
a Department of Biochemistry, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran 
b Department of Cell and Molecular Biology and Microbiology, Faculty of Biological Science and Technology, University of Isfahan, Isfahan, Iran 
c Department of Medical Laboratory Sciences, Faculty of Medical Sciences, Islamic Azad University, Kazerun Branch, Kazerun, Iran 
d Network of Immunity in Infection, Malignancy & Autoimmunity (NIIMA), Universal Scientific Education & Research Network (USERN), Tehran, Iran 
e Oral and Maxillofacial Pathology, School of Medicine, Colllege of health Sciences, Wachemo University, Hosanna, Ethiopia 
f Department of Medical Biotechnology, National institute of Genetic Engineering and Biotechnology, Tehran, Iran 
g Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran 
h Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran 
i Department of Medical Biotechnology, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran 
j Cardiovascular Center of Excellence, Louisiana State University Health Sciences Center, New Orleans, LA, USA 

Corresponding authors.

Abstract

Type 1 diabetes (T1D) is a chronic autoimmune condition that affects millions of people worldwide. Insulin pumps or injections are the standard treatment options for this condition. This article provides a comprehensive overview of the several type 1 diabetes treatment options, focusing on oral insulin. The article is divided into parts that include immune-focused treatments, antigen vaccination, cell-directed interventions, cytokine-directed interventions, and non-immunomodulatory adjuvant therapy. Under the section on non-immunomodulatory adjunctive treatment, the benefits and drawbacks of medications such as metformin, amylin, sodium-glucose cotransporter inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 Ras), and verapamil are discussed. The article also discusses the advantages of oral insulin, including increased patient compliance and more dependable and regular blood sugar control. However, several variables, including the enzymatic and physical barriers of the digestive system, impair the administration of insulin via the mouth. Researchers have looked at a few ways to get over these challenges, such as changing the structure of the insulin molecule, improving absorption with the use of absorption enhancers or nanoparticles, and taking oral insulin together with other medications. Even with great advancements in the use of these treatment strategies, T1D still needs improvement in the therapeutic difficulties. Future studies in these areas should focus on creating tailored immunological treatments, looking into combination medications, and refining oral insulin formulations in an attempt to better control Type 1 Diabetes. The ultimate objective is to create accurate, customized strategies that will enhance glycemic management and the quality of life for individuals with the condition.

Il testo completo di questo articolo è disponibile in PDF.

Abbreviations : T1D, ATG, G-CSF, CTLA-4, Th, GLP-1, GAD65, NTS, SGLT2, CHGA, MSCs, IRS-1, IGF1R, IPS, UC-MSCs, PDX1, PLGA, CAGE, TMC, PKC, JNK, IKKb, NO, JAK/STAT, PIP3, MTORC2, AS160, GLUT4

Keywords : Type 1 diabetes (T1D), Oral insulin, Immune therapy, cell therapy, Antigen vaccination


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