Efficacy and safety of glucose sensors for delivery of insulin: A Systematic Review

Abstract

Abstract Background Diabetes is a widely spread chronic disease affecting about 463 million people in 2019. It is defined as chronic hyperglycemia caused by either an impaired action or an abnormal secretion of insulin. New diabetes medications based on glucose-sensitive delivery systems can offer better control of blood glucose levels without the need to worry about the patient diet control or the frequency of exercising. Such delivery systems are comprised of glucose-sensitive moieties such as glucose oxidase, Phenylboronic acid derivatives and Concanavalin A. These systems can be administered via different routes such as subcutaneous injections, implants, oral, transdermal and nasal. This systematic review discussed the most suitable insulin delivery system in terms of efficiency to maintain blood glucose levels in normal range, and safety in animals upon administration. Method The search was conducted using different databases such as Web of Knowledge, Pubmed, Europe PMC, Wiley Online Library, and Science direct. Results A total of 313 studies were collected and 64 studies were included after screening using inclusion and exclusion criteria based on PICOS model. The results indicated that subcutaneous implants incorporated with glucose oxidase are the most suitable and were able to maintain normal blood glucose for up to 1738\u2009hours with a single administration. This was followed by PBA intraperitoneal implant, then oral GOx. Toxicity studies were conducted for all these dosage forms indicating good biocompatibility. Conclusion The GOx subcutaneous implant was found to be the most efficient and safe insulin delivery systems offering prolonged control of glucose in diabetic patients.