Advanced drug delivery system in the treatment of hyperglycemia and hypoglycemia

Carbohydrate metabolic dysfunction leads to two sets of chronic states of illness namely hyperglycemia and hypoglycemia due to varied etiological interventions. Hyperglycemia is the medical term describing an abnormally high blood glucose (blood sugar) level. The state of hyperglycemia is known as diabetes (both type 1 diabetes and type 2 diabetes) and based upon the state as well as etiology it may be classified as prediabetes or gestational diabetes. On the other hand, hypoglycemia is a state of abnormally low blood glucose level which is rarely seen and can be treated as an outcome of prolonged administration of insulin or other antidiabetic drugs. Long-term hyperglycemia is generally associated with numerous complications like renal impairment, retinal damage, etc. Insulin, insulin analogs, noninsulin oral hypoglycemic medicines, and genetic therapies are the most often used clinical treatment for diabetes mellitus. Nonetheless, due to inherent drug deficiencies, limitations of administration routes, adverse reactions associated with long-term subcutaneous injection, and various other challenges in the administration of oral antihyperglycemic drugs, such as enzymatic degradation, chemical instability, and poor gastrointestinal absorption, there is still no complete therapy strategy for diabetes mellitus management. Several delivery system-based facets have been explored to date for effective treatment of diabetes; emphasizing improved drug stability, overcoming biological barriers to increase bioavailability, and an intelligent automatized system to mimic endogenous insulin delivery and reduce the risk of hypoglycemia. This chapter seeks to provide an overview of research breakthroughs, drug therapy development trends, and applications of the advanced delivery systems in the treatment of hyperglycemia and hypoglycemia, which might serve as a guide for the use of various medications in the treatment of diabetes mellitus.