With oral insulin approaching later stages of development, the paper examines oral insulin in a physiological context and reports on recent progress in its development. Insulin remains indispensable for the treatment of diabetes, but its availability in injectable form has prevented its timely and broader use. The development of an oral insulin remains an ultimate goal to both enhance ease of use, and to provide therapeutic advantages rooted in its direct delivery to the portal vein and liver. By mimicking the physiological path taken by pancreatic insulin, oral insulin is expected to have a distinct effect on the hepatic aspect of carbohydrate metabolism, hepatic insulin resistance, and, at the same time, avoid hyperinsulinemia and minimize the risk of hypoglycemia.
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