Forum Abstract

Drug delivery providing the concentrations necessary for bio-effectiveness and the intended clinical effects is a major goal of clinical care. In addition, achieving serum levels or tissue exposure that maximizes the effectiveness of the medication often requires customized delivery modalities and patterns of delivery. Finally, the delivery routes and required frequencies of administration should be aimed at reducing adverse effects associated with the mode of delivery and enhancing patient acceptance and compliance. The most challenging drugs with regard to delivery may be those proteins that cannot currently be administered per os, because of their vulnerability to proteolysis in the gastrointestinal tract. The delivery of hormones often requires subcutaneous or intravenous delivery and, of the hormones commonly administered, insulin represents the most challenging medication to deliver as it currently requires parenteral administration, very specific delivery profiles to emulate normal physiology, and must respond to physiologic variables to achieve safe and effective levels. Treatment of diabetes with insulin will be discussed in the context of current methods of drug delivery, the barriers and limitations that result in less than effective treatment, and potential new routes of insulin delivery that might address current problems.

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