Insulin drug safety

Controlled-rate infusion devices, as well as feedback-regulated drug delivery devices, have the potential to improve drug safety and efficacy. With advancement in computer technology and miniaturization of precision motors, highly compact computer-controlled infusion pumps are now available for insulin delivery. These pumps, weighing about 3 to 4 ounces, can be... 

Scheen AJ. Combined thiazolidinedione-insulin therapy should we be concerned about safety Drug Sat 2004 27 841-56. 

Another type of absorption enhancer, which has been shown to have a better safety profile, is cyclodextrin (CD) [39]. CDs have been shown to form inclusion complexes with lipophilic drugs, thereby improving their aqueous solubility and stability. A powdered insulin formulation containing dimethyl-(3-cyclodextrin improved the absolute bioavailability of insulin by 13% in rabbits compared to a control liquid formulation (1%) of insulin with dimethyl-(3-cyclodextrin [40]. Recently, hydroxypropyl (3-cyclodextrin has been shown to be more effective for enhancing the nasal absorption of acyclovir than a range of other absorption enhancers in vivo [41]. 

Kamal AD, Dixon AN, Bain SC. Safety and side effects of the insulin analogues. Expert Opin Drug Saf. 2006 5 131-143. 

While there are no currently approved therapeutic protein or peptide products for delivery via the pulmonary route into the systemic circulation, the data on the efficiency, reproducibility, and safety of molecules such as insulin are particularly encouraging. From a molecular perspective, there is a general trend in the reduction of the rate and extent of absorption with increasing molecular weight, but predictive theories are lacking due to our poor understanding of the complexity and multitude of channels of entry of drugs from the respiratory tract into the systemic circulation. 

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