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insulin (Oralgen, Generex / insulin, RapidMist / Oralgen)

✓ Approved

Eli Lilly · INSR · Polypeptide

What is insulin?

insulin is a polypeptide developed by Eli Lilly. It is approved for therapeutic indications via oral (po) or sublingual (sl)/oral transmucosal.

Drug Profile

Brand NamesOralgen, Generex, insulin, RapidMist, Oralgen
CompanyEli Lilly
Drug ClassPolypeptide
Molecular TargetINSR
RouteOral (PO), Sublingual (SL)/Oral Transmucosal
StatusApproved
Sources: ClinicalTrials.gov, Eli Lilly

Mechanism of Action

Molecular Targets

insulin acts on 1 molecular target:

INSRinsulin receptor (CD220, HHF5)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

insulin is developed for 3 unique indications across 1 therapeutic area.

Therapeutic AreaConditionPhase
Metabolism and nutrition disordersType 1 diabetes mellitus✓ Approved
Metabolism and nutrition disordersType 2 diabetes mellitus✓ Approved
Metabolism and nutrition disordersGlucose tolerance impairedPhase II

Related Research Articles

PubMedRSC advances2026-11-11

Carboxymethyl cellulose from oil palm trunk slabs: physicochemical properties and performance in acyclovir buccal films.

Jantarat Chutima C, Kaewpradit Sirikanya S, Chingunpitak Jiraporn J, Srivaro Suthon S

Carboxymethyl cellulose (CMC) is widely used as a pharmaceutical excipient in mucoadhesive and film-forming drug delivery systems. This study aimed to synthesize CMC from oil palm trunk slab (OPTS) waste obtained from the bottom and middle sections of oil palm trunks and evaluate its potential for use in acyclovir-loaded buccal films. Cellulose was extracted from OPTS by dewaxing, alkali treatment, and hydrogen peroxide bleaching, followed by carboxymethylation with sodium monochloroacetate. The resulting CMC samples were characterized by Fourier transform infrared spectroscopy, differential scanning calorimetry, scanning electron microscopy, degree of substitution, viscosity, moisture content, and pH. Acyclovir-loaded buccal films were prepared using the synthesized CMC and evaluated for physicochemical properties, mucoadhesion, drug release, and ex vivo buccal permeation in comparison with films containing commercial CMC. The cellulose yields from the bottom and middle sections of OPTS were 41.43 ± 0.25% and 28.15 ± 0.33%, respectively. The synthesized CMC samples showed successful carboxymethylation, moderate degrees of substitution, and lower viscosity than commercial CMC. Buccal films prepared with the synthesized CMC exhibited satisfactory physicochemical properties and comparable mucoadhesive force, drug release, and ex vivo permeation behavior to films containing commercial CMC, although their mucoadhesive residence times were shorter. These findings indicate that OPTS waste can serve as a potential source of CMC for buccal film formulations, while further optimization of polymer viscosity and mucoadhesive retention is needed for applications requiring prolonged buccal residence. The higher cellulose yield obtained from the bottom section also indicates its potential as a productive raw material for CMC production.

PMID 43011880
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PubMedBMC oral health2026-11-11

Crestal total tissue thickness as a potential predictor of early gingival recession after anterior immediate implant placement and provisionalization: a retrospective study.

Tan Yunhan Y, Zhang Haoxiang H, Zhang Yifan Y, Wei Donghao D et al.

To preliminarily evaluate total tissue thickness at the level of the alveolar ridge crest (TTRC) as a potential preoperative predictor of early gingival recession (GR) following immediate implant placement and provisionalization (IIPP) in the maxillary aesthetic zone. This retrospective cohort study enrolled patients who underwent IIPP for a single maxillary incisor. Pre-extraction hard and soft tissue dimensions, encompassing TTRC, gingival height (GH), subcrestal total tissue thickness (TT), bone thickness (BT), and gingival thickness (GT), were measured bilaterally (buccal and palatal) by superimposing intraoral scan digital models and cone-beam computed tomography (CBCT). GR was quantified at 6 months postoperatively through alignment of pre- and post-operative digital models. Pearson correlation analysis and linear regression were performed to explore the associations between preoperative parameters and the extent of 6-month GR. Forty-nine patients were enrolled in the study. TTRC demonstrated a consistent and strong negative correlation with 6-month GR on both the buccal (r = -0.767, R2 = 0.588, P < 0.001) and palatal (r= - 0.786, R2 = 0.513, P < 0.001) aspects. In contrast, the associations between 6-month GR and both subcrestal BT and GH were weak or negligible and statistically non-significant. Notably, on the buccal aspect, subcrestal GT and TT showed stronger negative correlations with 6-month GR than BT at corresponding levels. Within the limitations of this retrospective study, TTRC exhibits stronger statistical associations with early GR following IIPP in the anterior maxilla than conventional parameters, subcrestal BT and GH. These preliminary findings suggest the importance of total tissue evaluation for postoperative implant aesthetics; however, prospective validation is warranted before routine clinical adoption. chictr.org.cn, identifier ChiCTR2600122056 (April 8, 2026).

PMID 43009902
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PubMedFrontiers in medicine2026-11-11

Hepatic steatosis is associated with postprandial dysglycemia in type 1 diabetes: insights from dual-modality liver assessment.

Li Shuang S, Wang Panzun P, Cai Zhihong Z, Gao Tianyu T et al.

Metabolic dysfunction-associated steatotic liver disease (MASLD) is increasingly recognized in type 1 diabetes (T1D), yet its relationship with dynamic glycemic abnormalities and the metabolic pathways underlying these associations remains incompletely understood. We investigated the associations of hepatic steatosis with conventional and continuous glucose monitoring (CGM)-derived glycemic measures in T1D and explored the potential roles of circulating insulin-like growth factor-1 (IGF-1) and insulin resistance. This cross-sectional study included 231 individuals with T1D who underwent hepatic steatosis assessment using ultrasonography and controlled attenuation parameter (CAP). Glycemic status was characterized using glycated hemoglobin (HbA1c), fasting plasma glucose, 1,5-anhydroglucitol (1,5-AG), and, in 142 participants, at least 72 h of valid CGM under standardized inpatient conditions. Multivariable linear regression, false discovery rate correction, and exploratory serial mediation analyses were performed. Ultrasound-defined MASLD was present in 50 participants (21.6%). After multivariable adjustment, ultrasound-defined MASLD and greater CAP were consistently associated with lower 1,5-AG concentrations and less favorable CGM profiles, including higher 2-hour postprandial glucose, glucose peak, mean glucose, glucose management indicator, and time above range, together with lower time in range, whereas fasting glucose was not significantly associated with hepatic steatosis. Hepatic steatosis was also associated with lower circulating IGF-1 concentrations and greater insulin resistance across multiple surrogate indices. In exploratory serial mediation analysis using TG/HDL-C as the primary insulin resistance measure, the combined indirect association through IGF-1 and insulin resistance accounted for 82.6% of the association between MASLD and lower 1,5-AG concentrations, with consistent patterns observed using alternative insulin resistance indices. Hepatic steatosis in T1D is independently associated with a distinct dysglycemic phenotype characterized particularly by short-term and postprandial hyperglycemia. Concurrent differences in circulating IGF-1 and insulin sensitivity may statistically account for a substantial proportion of this association. These findings support hepatic steatosis as a clinically relevant metabolic comorbidity in T1D and warrant prospective studies to clarify the underlying temporal and biological relationships.

PMID 43011355
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PubMedInsect science2026-11-11

ROS-dependent phosphorylation of insulin receptor and insulin receptor substrate during pupal diapause development in the cotton bollworm, Helicoverpa armigera.

Su Zhiren Z, Yang Yongpan Y, Ke Yafang Y, Xu Wei-Hua WH et al.

Insect diapause is a critical adaptive strategy characterized by developmental arrest and enhanced stress tolerance, orchestrated by intricate molecular networks. The insulin signaling pathway, which governs growth, metabolism, and stress responses, has been implicated in diapause regulation. However, the precise roles of insulin receptor (InR) and insulin receptor substrate (IRS) in modulating pupal diapause remain incompletely understood, particularly in the economically important pest Helicoverpa armigera. Here, we show that InR and IRS are associated with pupal diapause development through redox-sensitive phosphorylation cascades. Temporal profiling revealed a marked upregulation of phosphorylated InR (p-InR) and IRS (p-IRS) in diapause-destined pupal brains, concomitant with elevated phosphorylation of Akt (p-Akt) and ERK (p-ERK). Functional validation in Helicoverpa zea (HzAm1) cells, via overexpression and RNA interference (RNAi), showed that IRS positively regulates Akt and ERK signaling. Further mechanistic studies indicated that reactive oxygen species (ROS) act upstream of the phosphorylation of InR, IRS, Akt, and ERK in vitro and in vivo; these effects were reversible upon ROS scavenging. Further investigations revealed that increased p-ERK was associated with global protein ubiquitination, suggesting this kinase as a key regulator of proteasomal degradation in diapause development. Our findings delineate a ROS-InR-IRS-Akt/ERK signaling framework associated with diapause development and proteostatic regulation in H. armigera, thereby advancing our understanding of insect diapause biology and providing candidate molecular targets for future pest-management interventions.

PMID 43012655
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PubMedObesity reviews : an official journal of the International Association for the Study of Obesity2026-11-11

Oops! I Cut It Again: Modulatory Proteolysis in Metabolic Health and Disease.

Pánico Pablo P, Velasco Myrian M, Ortíz-Huidobro Rosa Isela RI, Larqué Carlos C et al.

Proteolysis is an irreversible posttranslational modification that modulates protein stability, localization, interactions, and function. There are four intracellular proteolytic systems (calpains, caspases, ubiquitin-proteasome system, and lysosomes) and several extracellular proteases (metalloproteases and serine proteases). In this work, we review the diverse effects of proteolysis on the physiology of tissues vital for metabolic homeostasis as well as the contribution of proteolytic systems to the development of metabolic diseases. Proteolytic systems regulate processes essential for maintaining metabolic homeostasis, including insulin secretion, insulin sensitivity and glucose uptake, adipose tissue physiology, muscle mass, and lipid metabolism in the liver. Concordantly, dysregulation of these systems contributes to the development of metabolic diseases, such as metabolic syndrome, insulin resistance, obesity, sarcopenia, and metabolic dysfunction-associated steatotic liver disease, acting both as causal and aggravating factors.

PMID 43010172
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PubMedEuropean journal of case reports in internal medicine2026-11-11

Combined Calcium Channel Blocker And Angiotensin-Converting Enzyme Inhibitor Overdose.

Kahal Fares F, Guérard-Poirier Natasha N, Ji Cheng C, Gursahaney Ashvini A et al.

Combined overdoses of angiotensin-converting enzyme inhibitors and calcium channel blockers are rare but associated with more severe toxicity than either agent alone. A 48-year-old woman presented to the emergency department nine hours after intentionally ingesting 40 tablets of amlodipine (10 mg) and 40 tablets of ramipril (10 mg). On arrival, she was hypotensive and tachycardic. Initial management included fluids, intravenous calcium and insulin bolus followed by high-dose insulin euglycaemic therapy (HIET). Despite escalating vasopressor support, she developed mixed vasoplegic and cardiogenic shock complicated by acute kidney injury, fluid overload, respiratory failure and metabolic acidosis, necessitating intubation and continuous renal replacement therapy. Improvement in haemodynamics was only achieved by day 9. She was transferred from the intensive care unit (ICU) on day 20 with residual weakness from ICU-acquired myopathy and was ultimately discharged after 66 days, with a prolonged hospitalisation attributed to delirium and deconditioning. Severe combined angiotensin-converting enzyme inhibitors (ACEI) and calcium channel blockers (CCB) overdose may cause prolonged, refractory haemodynamic instability requiring extended high-dose insulin euglycaemic therapy (HIET), vasoactive support and fluid administration. Concentrated insulin, dextrose and vasopressor preparations may help mitigate fluid overload. Angiotensin II may be a potential treatment for refractory vasoplegia, although evidence and availability remain limited. Secondary complications can prolong recovery beyond the duration of drug toxicity. This case highlights the need for individualised, multidisciplinary management, early HIET, vasoactive support and fluid-sparing strategies in severe combined ACEI and CCB overdose. Management of severe combined calcium channel blocker and angiotensin-converting enzyme inhibitor overdose may require prolonged resuscitation with high-dose insulin euglycaemic therapy, vasoactive support and fluid administration. The cumulative fluid requirements of these therapies, combined with complications such as acute kidney injury, can contribute to severe fluid overload. The use of concentrated insulin, dextrose and vasopressor preparations may help limit the iatrogenic fluid accumulation.Clinicians should anticipate and proactively manage secondary complications, including acute kidney injury, volume overload, respiratory failure and infection, as these complications may independently prolong recovery beyond the expected duration of drug toxicity.Combined angiotensin-converting enzyme inhibitor and calcium channel blocker overdose lacks established management guidelines and requires individualised, multidisciplinary care based on clinical severity and response to therapy.

PMID 43012017
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