Alternative approaches to subcutaneous insulin injections

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Abstract
The benefits of glycemic control in patients with diabetes are well known, and evidence suggests that there is no threshold for glycemic control beyond which one would not expect a reduction in complications. To achieve new suggested glycemic targets, advancing therapy to include combination oral hypoglycemic therapy in patients with type 2 diabetes in addition to earlier use of insulin is proposed. However intensive insulin therapy has still not gained widespread acceptance due to practical and psychological barriers. As a result, many patients are unable to maintain optimal glycemic control. Insulin delivery systems designed to overcome the barrier of injections are now emerging as effective, well-tolerated, and noninvasive alternatives to subcutaneous insulin. Although none of the systems are currently available, many are now in phase 3 clinical research testing. Further studies, however, would be needed to confirm their long-term safety and efficacy.