Oral delivery of glucagon-like peptide-1 and analogs: alternatives for diabetes control?

Francisca Araújo1, Pedro Fonte, Hélder A Santos

  • 1Department of Pharmaceutical Sciences, Centro de Investigação em Ciências da Saúde, Health Sciences Research Center,Instituto Superior de Ciências da Saúde, CESPU, Gandra, Portugal.

Insights

New therapies for type 2 diabetes mellitus (T2DM) are needed. This review explores challenges and strategies for oral administration of glucagon-like peptide-1 (GLP-1) to improve T2DM treatment.

Area of Science:

  • Pharmacology and Endocrinology
  • Drug Delivery Systems

Background:

  • Type 2 diabetes mellitus (T2DM) is a global health challenge with current treatments having limitations.
  • Glucagon-like peptide-1 (GLP-1) shows therapeutic potential for T2DM but faces administration challenges.

Purpose of the Study:

  • To review the obstacles hindering oral administration of GLP-1.
  • To highlight innovative strategies for overcoming these barriers in GLP-1 drug delivery.

Main Methods:

  • Literature review of existing research on GLP-1 and oral drug delivery technologies.
  • Analysis of challenges including peptide degradation and low bioavailability.
  • Examination of formulation and delivery strategies to enhance oral absorption.

Main Results:

  • Oral administration of GLP-1 is impeded by gastrointestinal degradation and poor membrane permeability.
  • Various strategies, including chemical modification, nano-encapsulation, and absorption enhancers, are being explored.
  • These approaches aim to protect GLP-1 and facilitate its uptake for improved T2DM management.

Conclusions:

  • Overcoming the hurdles of oral GLP-1 administration is crucial for developing more convenient T2DM therapies.
  • Successful oral delivery systems could significantly improve patient compliance and therapeutic outcomes.
  • Continued research into advanced drug delivery is essential for realizing the full potential of GLP-1 for type 2 diabetes.

Related Concept Videos

Glucagon-like Receptor Agonists01:24

Glucagon-like Receptor Agonists

Incretins include glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), which stimulate insulin secretion post-meals. In type 2 diabetes, GIP's efficacy is reduced, making GLP-1 a viable drug target. GIP originates from preproGIP.
GLP-1, when administered in high doses intravenously, triggers insulin secretion, inhibits glucagon release, slows gastric emptying, reduces food intake, and restores normal insulin secretion. However, its rapid inactivation by the...
Oral Hypoglycemic Agents: Glinides01:06

Oral Hypoglycemic Agents: Glinides

Repaglinide (Prandin) and Nateglinide (Starlix), known as glinides, are oral insulin secretagogues that stimulate insulin release from pancreatic β cells by closing the ATP-sensitive potassium channels (KATP channel). Repaglinide controls insulin release from pancreatic β cells by managing potassium efflux. It shares two binding sites with sulfonylureas and also has a unique site, indicating overlapping mechanisms of action. With a rapid onset and a 4-7 hour duration, it effectively manages...
Hypoglycemia and Glucagon01:15

Hypoglycemia and Glucagon

Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
Insulin Formulations: Types and Delivery01:27

Insulin Formulations: Types and Delivery

Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into rapid-acting...
Insulin: Dosing Regimen and Adverse Effects01:16

Insulin: Dosing Regimen and Adverse Effects

Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
Insulin: Biosynthesis, Chemistry, and Preparation01:25

Insulin: Biosynthesis, Chemistry, and Preparation

The endoplasmic reticulum (ER) of pancreatic β-cells synthesizes preproinsulin, which consists of a signal peptide, A and B chains, and a C-peptide. Preproinsulin is then cleaved and folded into proinsulin, which translocates to the Golgi apparatus for sorting and packaging into secretory granules. In these granules, enzymatic clipping generates insulin and C-peptide.
Damage or functional impairment of β-cells inhibits insulin production, leading to diabetes. Diabetes treatment primarily uses...