International Journal of Molecular Medical Science, 2024, Vol.14, No.2, 144-152 http://medscipublisher.com/index.php/ijmms 144 Review and Progress Open Access Advancements in Insulin Therapy for Type 1 Diabetes Guangying Zong, Guangman Xu Traditional Chinese Medicine Research Center, Cuixi Academy of Biotechnology, Zhuji, 311800, Zhejiang, China Corresponding email: guangman.xu@cuixi.org International Journal of Molecular Medical Science, 2024, Vol.14, No.2 doi: 10.5376/ijmms.2024.14.0017 Received: 13 Apr., 2024 Accepted: 15 May, 2024 Published: 28 May, 2024 Copyright © 2024 Zong and Xu, This is an open access article published under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Preferred citation for this article: Zong G.Y., and Xu G.M., 2024, Advancements in insulin therapy for type 1 diabetes, International Journal of Molecular Medical Science, 14(2): 144-152 (doi: 10.5376/ijmms.2024.14.0017) Abstract Type 1 diabetes is a chronic condition characterized by autoimmune destruction of insulin-producing beta cells in the pancreas, necessitating lifelong insulin therapy. Historically, insulin therapy has evolved significantly, from the discovery of insulin in the 1920s to the development of various insulin analogs and delivery systems. This study aims to provide a comprehensive overview of the advancements in insulin therapy, highlighting innovations and emerging trends. The study begins by categorizing insulin into rapid-acting and long-acting analogs, detailing their pharmacokinetics and clinical applications. Innovations in insulin formulations and alternate delivery routes, such as inhalational and oral insulin, are examined. Technological advances, including insulin pumps, continuous glucose monitoring systems, and automated delivery systems, are discussed, with an emphasis on the integration of smart technologies like mobile apps and artificial pancreas systems. Emerging trends such as smart insulins, glucose-responsive insulins, beta-cell replacement, stem cell therapies, and immunomodulatory therapies are explored. Clinical trials and evidence-based outcomes for insulin analogues and delivery systems are analyzed to compare new and conventional therapies. This study identifies key challenges in modern insulin therapy, including accessibility, cost, patient education, adherence, technological barriers, and regulatory issues. Concluding remarks emphasize the importance of continuous research and development to address these challenges and foster future innovations in insulin therapy. Keywords Type 1 diabetes; Insulin therapy; Technological advances; Emerging trends; Clinical trials 1 Introduction Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disease characterized by the destruction of insulin-producing beta cells in the pancreas, leading to an absolute insulin deficiency and resultant hyperglycemia (Warshauer et al., 2020). The disease typically manifests in childhood or adolescence, although it can develop at any age . The pathogenesis of T1DM involves a complex interplay of genetic predisposition and environmental triggers, which lead to an autoimmune response targeting the beta cells (Van Belle et al., 2011). The presence of islet-targeting autoantibodies can be detected months to years before the clinical onset of the disease, serving as biomarkers for identifying individuals at risk. Since the discovery of insulin in the early 20th century, insulin replacement therapy has been the cornerstone of T1DM management (Warshauer et al., 2020). Initially, insulin was extracted from animal pancreases, but advancements in biotechnology have led to the development of recombinant human insulin and various insulin analogs, which offer improved pharmacokinetic profiles (Warshauer et al., 2020). Despite these advancements, traditional insulin therapy requires multiple daily injections or continuous subcutaneous infusion, which can be burdensome and does not perfectly mimic the physiological insulin secretion. Recent technological innovations, such as insulin pumps, continuous glucose monitoring systems, and hybrid closed-loop systems, have significantly improved glycemic control and quality of life for patients (Schweiger, 2023). This study reviews the latest advancements in insulin therapy for Type 1 Diabetes Mellitus (T1DM), with a focus on novel treatments and technologies that enhance glycemic control, reduce the burden of disease management, and improve patient outcomes. This includes the exploration of emerging drug therapies, gene therapies, and cellular therapy interventions, which bring new hope for the future of T1DM treatment. By integrating the latest research findings, this study provides a comprehensive overview of the current status and future directions of insulin therapy for T1DM.
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