Recent Progress in Glucose-Responsive Insulin.

Diabetes Pub Date : 2024-09-01 DOI:10.2337/dbi23-0028
Yun Liu, Shiqi Wang, Zejun Wang, Jicheng Yu, Jinqiang Wang, John B Buse, Zhen Gu
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引用次数: 0

Abstract

Insulin replacement therapy is indispensable in the treatment of type 1 and advanced type 2 diabetes. However, insulin's clinical application is challenging due to its narrow therapeutic index. To mitigate acute and chronic risks of glucose excursions, glucose-responsive insulin (GRI) has long been pursued for clinical application. By integrating GRI with glucose-sensitive elements, GRI is capable of releasing or activating insulin in response to plasma or interstitial glucose levels without external monitoring, thereby improving glycemic control and reducing hypoglycemic risk. In this Perspective, we first introduce the history of GRI development and then review major glucose-responsive components that can be leveraged to control insulin delivery. Subsequently, we highlight the recent advances in GRI delivery carriers and insulin analogs. Finally, we provide a look to the future and the challenges of clinical application of GRI.

Article highlights:

葡萄糖反应性胰岛素的最新进展。
胰岛素替代疗法是治疗 1 型糖尿病和晚期 2 型糖尿病不可或缺的疗法。然而,由于胰岛素的治疗指数较窄,其临床应用具有挑战性。为了减轻血糖偏高带来的急性和慢性风险,葡萄糖反应性胰岛素(GRI)在临床应用中一直受到追捧。通过与葡萄糖敏感元件整合,GRI 能够根据血浆或间质葡萄糖水平释放或激活胰岛素,而无需外部监测,从而改善血糖控制并降低低血糖风险。在本视角中,我们首先介绍了 GRI 的发展历史,然后回顾了可用于控制胰岛素输送的主要葡萄糖反应元件。随后,我们将重点介绍葡萄糖反应性胰岛素输送载体和胰岛素类似物的最新进展。最后,我们展望了 GRI 的未来和临床应用所面临的挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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