Nanoparticle-based insulin delivery: route-specific barriers, innovations, and therapeutic outcomes

Diabetes mellitus (DM) remains a major global health challenge requiring life-long insulin therapy for glycemic control. While subcutaneous (SC) injection is the conventional route of insulin administration, its invasiveness and limited patient adherence underscore the need for alternative delivery strategies. Nanoparticles (NPs) have emerged as powerful carriers for insulin due to their potential to protect insulin from degradation, enhance mucosal permeability, and enable controlled and stimuli-responsive release. This review provides a comprehensive, route-by-route analysis of NPs-mediated insulin delivery systems, including SC, oral, oral transmucosal (buccal and sublingual), pulmonary, nasal, and transdermal pathways. Beyond summarising individual studies, the review critically compares formulation strategies, therapeutic outcomes, and translational limitations across routes. For each route, we highlight recent advancements, NPs design strategies, and therapeutic outcomes based on studies from the last decade. Notably, intranasal administration has demonstrated potential beyond glycemic control, particularly in emerging studies exploring insulin's neuroprotective effects in neurodegenerative disorders. Despite promising developments, barriers such as low bioavailability, formulation complexity, mucosal irritation, and safety concerns remain. By systematically comparing the advantages and limitations across administration routes, this review aims to guide future research and development towards clinically viable, non-invasive, and patient-friendly insulin therapies.