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Limenh LW, Worku NK, Melese M, Esubalew D, Fenta ET, Hailu M, Abie A, Mehari MG, Dagnaw TE, Delie AM. Effectiveness, safety, and preference of transdermal insulin compared to subcutaneous insulin in the treatment of diabetes patients: a systematic review of clinical trials. Diabetol Metab Syndr 2024; 16:197. [PMID: 39152512 PMCID: PMC11330025 DOI: 10.1186/s13098-024-01442-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 08/07/2024] [Indexed: 08/19/2024] Open
Abstract
BACKGROUND Several studies were performed on transdermal (TD) insulin delivery in vitro and in vivo, and recently, the study groups included a clinical trial in humans. Therefore, this systematic review was conducted to get summary information about the effectiveness, safety, and preferability of TD insulin in comparison with subcutaneous insulin delivery. METHODS We conducted a thorough search to find studies in the databases Cochrane Library, MEDLINE via PubMed, Web of Science Core Collection, EMBASE, Scopus, Hinari, Medlib, and Magiran until January 2024. We included 18 randomized clinical trials. RESULTS Although there are various types of TD delivery methods, the TD insulin delivery methods that have undergone clinical trials are the TD patch, micro needle TD insulin delivery, and TD insulin jet injector. Eighteen studies were conducted on TD insulin delivery, which showed either superior or comparable effectiveness, safety, and preferability of TD insulin in comparison with SC insulin. About eleven out of eighteen studies (61.1%) showed more effective blood glucose control than SC delivery, and the remaining seven studies showed comparable effectiveness with SC delivery. Eleven studies (61.1%) showed equal tolerability of TD insulin versus SC insulin, and seven studies (38.9%) showed more tolerability of TD insulin over SC insulin. In most studies, eleven out of eighteen (61.1%) showed a higher preference for TD insulin delivery over traditional SC delivery; sixth out of eighteen (33.3%) showed equal preferability for TD insulin versus SC insulin; and only one study (5.6%) showed that TD insulin delivery was less preferable than SC insulin. CONCLUSION The review revealed that clinical trials have demonstrated the effectiveness of TD insulin delivery methods such as TD patches, MN-based insulin delivery, and insulin jet injectors compared to traditional SC routes of administration. The studies showed the superior or comparable effectiveness of TD insulin in controlling blood glucose levels. Additionally, TD insulin delivery was found to be equally or more tolerable than SC insulin delivery in all studies. Overall, the majority of studies favored TD insulin delivery over traditional SC delivery methods, highlighting its potential as a preferred option for insulin administration.
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Affiliation(s)
- Liknaw Workie Limenh
- Department of Pharmaceutics, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Nigus Kassie Worku
- Department of Public Health, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Mihret Melese
- Department of Human Physiology, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Dereje Esubalew
- Department of Human Physiology, College of Medicine and Health Science, Ambo University, Ambo, Ethiopia
| | - Eneyew Talie Fenta
- Department of Public Health, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia
| | - Mickiale Hailu
- Department of Midwifery, College of Medicine and Health Science, Dire Dawa University, Dire Dawa, Ethiopia
| | - Alemwork Abie
- Department of Midwifery, College of Medicine and Health Science, Bahir Dar University, Bahir Dar, Ethiopia
| | - Molla Getie Mehari
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Injibara University, Injibara, Ethiopia
| | - Tenagnework Eseyneh Dagnaw
- Department of Public Health, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia
| | - Amare Mebrat Delie
- Department of Public Health, College of Medicine and Health Science, Injibara University, Injibara, Ethiopia
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Wang W, Men L, Wang Y, Shi C, Yin H, Li H, Zhou H, Du J. Effect of needle-free injection on psychological insulin resistance and insulin dosage in patients with type 2 diabetes. Front Endocrinol (Lausanne) 2024; 15:1379830. [PMID: 38803476 PMCID: PMC11129580 DOI: 10.3389/fendo.2024.1379830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 04/18/2024] [Indexed: 05/29/2024] Open
Abstract
Background and objective Psychological insulin resistance (PIR), which refers to the reluctance of diabetic patients to use insulin, is a frequently encountered clinical issue. Needle-free injection (NFI) offers advantages in terms of expediting insulin absorption and mitigating adverse reactions related to injection. To evaluate the effects of subcutaneous injection of insulin aspart 30 with NFI on PIR and insulin dosage in patients with type 2 diabetes mellitus (T2DM). Methods Sixty-four patients with T2DM participated in this randomized, prospective, open, crossover study. Insulin aspart 30 was administered subcutaneously to each subject via QS-P NFI and Novo Pen 5 (NP) successively. The effects of NFI on PIR were analyzed. Differences in insulin dosage, glycemic variability, and injection safety were compared at similar levels of glycemic control. Results After the administration of NFI, the insulin treatment attitude scale score decreased (53.7 ± 7.3 vs. 58.9 ± 10.7, p<0.001), the insulin treatment adherence questionnaire score increased (46.3 ± 4.9 vs. 43.8 ± 7.1, p<0.001), and the insulin treatment satisfaction questionnaire score increased (66.6 ± 10.5 vs. 62.4 ± 16.5, p<0.001). At the same blood glucose level, NFI required a smaller dosage of insulin aspart 30 compared with that of NP (30.42 ± 8.70 vs. 33.66 ± 9.13 U/d, p<0.001). There were no differences in glycemic variability indices (standard deviation, mean amplitude of glycemic excursion or coefficient of variation) between the two injection methods. Compared with NP, NFI did not increase the incidence of hypoglycemia (17.2% vs. 14.1%, p=0.774), and it decreased the incidence of induration (4.7% vs. 23.4%, p=0.002) and leakage (6.3% vs. 20.3%, p=0.022) while decreasing the pain visual analog scale score (2.30 ± 1.58 vs. 3.11 ± 1.40, p<0.001). Conclusion NFI can improve PIR in patients with T2DM and be used with a smaller dose of insulin aspart 30 while maintaining the same hypoglycemic effect. Clinical trial registration https://www.chictr.org.cn/, identifier ChiCTR2400083658.
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Affiliation(s)
- Weiping Wang
- Department of Endocrinology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Dalian Key Laboratory of Prevention and Treatment of Metabolic Diseases and the Vascular Complications, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lili Men
- Department of Endocrinology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Dalian Key Laboratory of Prevention and Treatment of Metabolic Diseases and the Vascular Complications, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yongbo Wang
- Department of Endocrinology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Dalian Key Laboratory of Prevention and Treatment of Metabolic Diseases and the Vascular Complications, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Chunhong Shi
- Department of Endocrinology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Dalian Key Laboratory of Prevention and Treatment of Metabolic Diseases and the Vascular Complications, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Huihui Yin
- Nursing Department, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Han Li
- Nursing Department, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Haicheng Zhou
- Department of Endocrinology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Dalian Key Laboratory of Prevention and Treatment of Metabolic Diseases and the Vascular Complications, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jianling Du
- Department of Endocrinology, The First Affiliated Hospital of Dalian Medical University, Dalian, China
- Dalian Key Laboratory of Prevention and Treatment of Metabolic Diseases and the Vascular Complications, The First Affiliated Hospital of Dalian Medical University, Dalian, China
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Wu Q, Deng M, Wang W, Yu S, Wang M, Sun C, Pan Q, Guo L. A self-controlled, cross-over study of intensive insulin treatment with needle-based injection versus needle-free injection in hospitalized patients with type 2 diabetes. Front Endocrinol (Lausanne) 2023; 14:1162176. [PMID: 37501783 PMCID: PMC10369336 DOI: 10.3389/fendo.2023.1162176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/15/2023] [Indexed: 07/29/2023] Open
Abstract
Background and Aims Needle injection and needle-free injection were proven effective in improving glycated hemoglobin (HbA1c) in type 2 diabetes mellitus (T2DM) patients. However, it is unclear if needle-free and needle injections of insulin during intensive insulin therapy in hospitalized patients provide similar efficacy and safety benefits. Methods A self-controlled cross-over study was conducted on 62 patients with T2DM who received intensive long-acting and short-acting insulin injections with or without needles. The 7-point blood glucose test was performed on the 6th day after insulin administration and the injection method switched on the 7th day of hospitalization. The difference was compared in 7-point blood glucose levels. Results The blood glucose levels at fasting (mean difference=-1.09 ± 2.38mmol/L, 95% CI, -1.69 to -0.48, p=0.0007) and post-breakfast (-1.14 ± 3.02mmol/L, 95%CI, -1.91 to -0.37, p=0.004) were better when patients were receiving needle-free injections compared to when receiving a needle injection. Indeed, daily blood glucose fluctuation, which presented as the area under the curve of glycemia, was decreased in needle-free injection periods (-0.3.48 ± 9.64, 95%CI, -5.95 to -1.01, p=0.0065). There was no significant difference in the dose of long-acting insulin between the two injection methods (-0.32 ± 2.69, 95%CI, -0.99 to 0.37, p>0.05). The dose of fast-acting insulin during the needle-free period was lower than that of when patients received needle injections (-1.66 ± 6.45, 95%CI, -3.29 to -0.025, p<0.05). There was no significant difference in satisfaction between the two regimens (-0.59 ± 1.55,95%CI, -0.938 to 0.509, p=0.557), but there was a significant difference in pain experience, favoring needle-free injections (p < 0.001). Conclusion Glycemia was better controlled by needle-free insulin injections in hospitalized T2DM patients subjected to intensive glycemic control. These patients also experienced less pain than when insulin was injected with a needle.
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Affiliation(s)
- Quanying Wu
- Nursing Department, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Mingqun Deng
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Weihao Wang
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Shuyi Yu
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Miao Wang
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Chao Sun
- Nursing Department, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Qi Pan
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Lixin Guo
- Department of Endocrinology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
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Sun F, Gao B, Yang A, Ren L, Xing Y, Ma K, Tian L, Li S, Heng C, Liu H, Zhou J, Ji Q. Needle-free injection of basal insulin improves fasting glucose variability as assessed by continuous glucose monitoring in T2DM: a prospective randomized multicenter open-label crossover study. Expert Opin Drug Deliv 2022; 19:1725-1734. [PMID: 36378018 DOI: 10.1080/17425247.2022.2147504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Fasting glucose variability (FGV) extensively promotes the onset and development of diabetic complications. This study aimed to evaluate the FGV in type 2 diabetes mellitus (T2DM) patients administered basal insulin using a needle-free insulin injector (NFII). RESEARCH DESIGN AND METHODS This was a prospective randomized multicenter open-label crossover study. We randomly assigned 48 T2DM patients to receive basal insulin by NFII or conventional insulin pen (CIP) for 7-14 days and were then crossed over after washout. We conducted continuous glucose monitoring to investigate the FGV, our primary outcome was a composite parameter of the FGV with a fasting blood glucose target between 4.4 and 6.1 mmol/L. RESULTS The coefficient of variation for sensor glucose at 6 a.m. with CIP was 11.67 (8.70,14.81)% vs. 9.48 (6.48,12.24)% with NFII (p = 0.003), and the coefficient of variation for mean sensor glucose at 5-6 a.m. with CIP was 12.70 (9.17,16.56)% vs. 9.23 (7.01,11.98)% with NFII (p < 0.001). The overall basal insulin dosage with CIP injection was 18.00 (16.00, 20.00) IU vs. 16.00 (12.00, 19.00) IU during NFII (p < 0.003). CONCLUSION Compared with CIP, the use of the NFII to inject basal insulin improved FGV in T2DM. CLINICAL TRIAL REGISTRATION https://www.chictr.org.cn Identifier is ChiCTR2000034674.
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Affiliation(s)
- Fei Sun
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, P.R. China
| | - Bin Gao
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, P.R. China
| | - Aili Yang
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, P.R. China
| | - Lijun Ren
- Department of Endocrinology, Xi'an International Medical Center Hospital, Xi'an 710100, P.R. China
| | - Ying Xing
- Department of Endocrinology, Xi'an Daxing Hospital, Xi'an 710000, P.R. China
| | - Kaiyan Ma
- Department of Endocrinology, Shangluo Central Hospital, Shangluo 726000, Shaanxi, P.R. China
| | - Li Tian
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, P.R. China
| | - Simin Li
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, P.R. China
| | - Chunni Heng
- Department of Endocrinology, Tangdu Hospital, Air Force Medical University, Xi'an 710038, P.R. China
| | - Hao Liu
- The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology, Xi'an Jiaotong University, Xi'an 710049, P.R. China.,Bioinspired Engineering and Biomechanics Center (BEBC), Xi'an Jiaotong University, Xi'an 710049, P.R. China
| | - Jie Zhou
- Department of Endocrinology and Metabolism, Xijing Hospital, Air Force Medical University, Xi'an 710032, P.R. China
| | - Qiuhe Ji
- Department of Endocrinology and Metabolism, Xijing Hospital, Air Force Medical University, Xi'an 710032, P.R. China
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Jiang Y, Li X, Yu L, Tong W, Chen P, Wang S, Zhao K, Tan X, Gao F, Yu H, Li G, Li L, Zhang Y, van den Born E, Zhou Y, Tong G. Immune efficacy of a candidate porcine reproductive and respiratory syndrome vaccine rHN-NP49 administered by a Needle-free intradermal delivery system in comparison with intramuscular injection. Vaccine 2021; 39:5557-5562. [PMID: 34412921 DOI: 10.1016/j.vaccine.2021.08.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/04/2021] [Accepted: 08/08/2021] [Indexed: 11/25/2022]
Abstract
Porcine reproductive and respiratory syndrome (PRRS) is one of the major drivers of economic loss in the swine industry worldwide. In commercial pig production, vaccination is the first option in an attempt to control infectious diseases. Pigs are therefore often immunized with different vaccines, and almost all of them are delivered via the intramuscular (IM) route. However, the IM injection may result in physical damage, stress reactions, and is labor demanding. An alternative route is urgently needed to reduce the disadvantages of conventional vaccination. In this study, a needle-free intradermal (ID) delivery system was evaluated for delivering a live PRRS vaccine as compared with the traditional needle-syringe method. Fifty-two 4-week-old piglets were divided into six groups: piglets in groups A-C were immunized using ID delivery system with 104, 105 and 106 TCID50 of PRRS candidate vaccine strain rHN-NP49, respectively; piglets in group D were immunized IM with 105 TCID50 of rHN-NP49; and group E and F were used as challenge and control groups, respectively. At 28 days post vaccination, piglets in group A to E were challenged with a lethal dose of highly-pathogenic PRRSV. Similar results were found in viremia and antibody response among the ID and IM groups during the immunization stage. After challenge, similar results were found in average body weight gain, viral shedding, serum viral load, and clinical score among the immunization groups, with a higher protection ratio in the ID group compared with IM group with the same immunization dose. These results demonstrated that the ID delivery system could provide similar or even better protection compared with IM route, and could be an effective route for PRRS vaccination.
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Affiliation(s)
- Yifeng Jiang
- Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai 200241, PR China
| | - Xianbin Li
- Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai 200241, PR China
| | - Lingxue Yu
- Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai 200241, PR China
| | - Wu Tong
- Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai 200241, PR China
| | - Pengfei Chen
- Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai 200241, PR China
| | - Shuaiyong Wang
- Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai 200241, PR China
| | - Kuan Zhao
- Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai 200241, PR China
| | - Xiangmei Tan
- Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai 200241, PR China
| | - Fei Gao
- Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai 200241, PR China
| | - Hai Yu
- Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai 200241, PR China
| | - Guoxin Li
- Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai 200241, PR China
| | - Liwei Li
- Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai 200241, PR China
| | - Yujiao Zhang
- Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai 200241, PR China
| | | | - Yanjun Zhou
- Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai 200241, PR China.
| | - Guangzhi Tong
- Department of Swine Infectious Diseases, Shanghai Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Shanghai 200241, PR China; Jiangsu Co-Innovation Center for the Prevention and Control of Important Animal Infectious Disease and Zoonosis Yangzhou University, Yangzhou 225009, PR China.
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Kong X, Luo M, Cai L, Zhang P, Yan R, Hu Y, Li H, Ma J. Needle-free jet injection of insulin glargine improves glycemic control in patients with type 2 diabetes mellitus: a study based on the flash glucose monitoring system. Expert Opin Drug Deliv 2021; 18:635-641. [PMID: 33317342 DOI: 10.1080/17425247.2021.1863945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: To investigate the effects of insulin glargine injection given with a QS-P jet injector on the glucose profile using a professional mode flash glucose monitoring (FGM) system in patients with type 2 diabetes mellitus (T2DM).Research design and methods: In this randomized, controlled, cross-sectional study, 66 patients with T2DM who received insulin glargine (12-18 IU/day) injection were enrolled. The patients were randomly divided into group A (jet injector before insulin pen) and group B (insulin pen before jet injector). Each subject injected insulin daily before breakfast. We analyzed the changes in the glucose profile using a professional mode FGM system.Results: Treatment with a jet injector led to significantly lower 24-h mean glucose, maximum blood glucose, area under the curve (AUC) > 10.0 mmol/L, time above range and increased AUC < 3.9 mmol/L and time below range than those when using an insulin pen. There was no difference in glycemic variability between the two groups. We observed that patients using a jet injector had significantly lower mean glucose between 12:00 to 22:00.Conclusions: Needle-free jet injection of insulin glargine was more effective than use of an insulin pen for good glycemic control in patients with T2DM.Clinical trial registration: www.clinicaltrials.gov identifier is NCT04093284.
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Affiliation(s)
- Xiaocen Kong
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Menghui Luo
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Ling Cai
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Peng Zhang
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Rengna Yan
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Yun Hu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Huiqin Li
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
| | - Jianhua Ma
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Jiangsu, China
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Mercuri M, Fernandez Rivas D. Challenges and opportunities for small volumes delivery into the skin. BIOMICROFLUIDICS 2021; 15:011301. [PMID: 33532017 PMCID: PMC7826167 DOI: 10.1063/5.0030163] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 01/09/2021] [Indexed: 05/04/2023]
Abstract
Each individual's skin has its own features, such as strength, elasticity, or permeability to drugs, which limits the effectiveness of one-size-fits-all approaches typically found in medical treatments. Therefore, understanding the transport mechanisms of substances across the skin is instrumental for the development of novel minimal invasive transdermal therapies. However, the large difference between transport timescales and length scales of disparate molecules needed for medical therapies makes it difficult to address fundamental questions. Thus, this lack of fundamental knowledge has limited the efficacy of bioengineering equipment and medical treatments. In this article, we provide an overview of the most important microfluidics-related transport phenomena through the skin and versatile tools to study them. Moreover, we provide a summary of challenges and opportunities faced by advanced transdermal delivery methods, such as needle-free jet injectors, microneedles, and tattooing, which could pave the way to the implementation of better therapies and new methods.
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Affiliation(s)
- Magalí Mercuri
- Instituto de Nanociencia y Nanotecnología (CNEA-CONICET), Av. Gral. Paz 1499, 1650 San Martín, Buenos Aires, Argentina
| | - David Fernandez Rivas
- Mesoscale Chemical Systems Group, MESA+ Institute, TechMed Centre and Faculty of Science and Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, The Netherlands
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Villarruel Mendoza LA, Scilletta NA, Bellino MG, Desimone MF, Catalano PN. Recent Advances in Micro-Electro-Mechanical Devices for Controlled Drug Release Applications. Front Bioeng Biotechnol 2020; 8:827. [PMID: 32850709 PMCID: PMC7405504 DOI: 10.3389/fbioe.2020.00827] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/29/2020] [Indexed: 01/27/2023] Open
Abstract
In recent years, controlled release of drugs has posed numerous challenges with the aim of optimizing parameters such as the release of the suitable quantity of drugs in the right site at the right time with the least invasiveness and the greatest possible automation. Some of the factors that challenge conventional drug release include long-term treatments, narrow therapeutic windows, complex dosing schedules, combined therapies, individual dosing regimens, and labile active substance administration. In this sense, the emergence of micro-devices that combine mechanical and electrical components, so called micro-electro-mechanical systems (MEMS) can offer solutions to these drawbacks. These devices can be fabricated using biocompatible materials, with great uniformity and reproducibility, similar to integrated circuits. They can be aseptically manufactured and hermetically sealed, while having mobile components that enable physical or analytical functions together with electrical components. In this review we present recent advances in the generation of MEMS drug delivery devices, in which various micro and nanometric structures such as contacts, connections, channels, reservoirs, pumps, valves, needles, and/or membranes can be included in their design and manufacture. Implantable single and multiple reservoir-based and transdermal-based MEMS devices are discussed in terms of fundamental mechanisms, fabrication, performance, and drug release applications.
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Affiliation(s)
| | - Natalia Antonela Scilletta
- Departamento de Micro y Nanotecnologia, Instituto de Nanociencia y Nanotecnología, CNEA-CONICET, San Martín, Argentina
| | | | - Martin Federico Desimone
- Universidad de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Instituto de la Química y Metabolismo del Fármaco (IQUIMEFA), Facultad de Farmacia y Bioquímica, Buenos Aires, Argentina
| | - Paolo Nicolas Catalano
- Departamento de Micro y Nanotecnologia, Instituto de Nanociencia y Nanotecnología, CNEA-CONICET, San Martín, Argentina
- Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Buenos Aires, Argentina
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