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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

PubMedCureus2026-07-25

Rare Synchronous Occurrence of Maxillary Glandular Odontogenic Cyst and Low-Grade Mucoepidermoid Carcinoma in a Young Adult: A Case Study.

Das Asish K AK, Burman Subhasish S, Tumsare Pranay G PG, Maji Abhijit A et al.

A glandular odontogenic cyst (GOC) is an infrequent developmental cyst originating from odontogenic tissues, whereas low-grade mucoepidermoid carcinoma (LGMEC) is an uncommon malignant epithelial tumor of the minor salivary glands. The simultaneous presence of these two conditions in adjacent maxillary sites is extremely rare and presents significant challenges in both diagnosis and treatment. This case study reports on a 23-year-old female patient who exhibited swelling involving the area from the second premolar through the second molar region on the right side of the maxilla, affecting both buccal and palatal areas. Clinical and radiographic assessments indicated a buccal lesion, likely cystic in nature, and a distinct palatal mass, possibly of salivary gland origin. Histopathological analysis confirmed the presence of a GOC on the buccal side and an LGMEC on the palatal side. The management approach was tailored according to the unique biological characteristics of each lesion. The GOC was managed through enucleation, while the LGMEC required extensive local excision to ensure clear margins. Both procedures were successfully performed under local anesthesia, resulting in uneventful healing and no signs of recurrence over a 12-month follow-up period. This case underscores the critical need for comprehensive evaluation of maxillary swellings, awareness of rare synchronous pathologies, and the necessity for tailored surgical strategies based on definitive histopathological diagnoses. Early detection and appropriate treatment can significantly enhance patient outcomes in such unusual cases.

PMID 42500799
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PubMedCase reports in dentistry2026-07-25

Verruciform Xanthoma of the Buccal Mucosa: A Case Report Highlighting a Rare Architectural Variant and Diagnostic Challenge.

Shah Bikash B, Raut Toniya T, Regmee Pragya P, Keshwar Shashi S et al.

Verruciform xanthoma (VX) is a relatively uncommon, benign, reactive lesion of the oral mucosa, representing only 0.025%-0.05% of all oral pathology cases. Clinically, it often presents as an asymptomatic, solitary, yellowish-white, or red growth with a corrugated or verrucous surface. Because it frequently mimics verruco-papillary lesions, clinical diagnosis is achieved in only approximately 2% of cases. Consequently, histopathological evaluation remains the "gold standard," characterized by the pathognomonic accumulation of lipid-laden foamy macrophages (xanthoma cells) within the connective tissue papillae. This report highlights a rare presentation of VX on the buccal mucosa, a site involved in only 8.5% of documented cases. Notable findings in this case included a 10-year habit history of areca nut consumption. Rather than acting as a definitive etiological trigger, this habit served as a significant diagnostic confounder, elevating clinical suspicion of a malignant process. Histopathology confirmed the "flat" architectural variant, which is characterized by endophytic proliferation. Given the excellent prognosis following conservative surgical excision, this case emphasizes the need to include VX in the differential diagnosis of verrucous lesions to avoid overtreatment. The patients remained disease-free, with no evidence of recurrence during follow-up.

PMID 42499781
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PubMedJournal of environmental sciences (China)2026-07-25

Role of macrophage NLRP3 inflammasome activation in real-ambient particulate matter-induced abnormal hepatic glucose metabolism.

Wu Dong D, Zhang Zhen Z, Chen Sixin S, Chen Haoran H et al.

Evidence regarding the effects of particulate matter (PM) exposure on hepatic glucose metabolism and insulin resistance is limited, and its mechanisms remain unclear. Macrophages, as key regulators of the liver microenvironment, may mediate PM-induced metabolic processes. This study used an individually ventilated cage (IVC)-based real-ambient PM exposure system mouse model, co-cultured macrophages and hepatocytes, and NOD-like receptor protein 3 (Nlrp3)-knockdown model to investigate the impact of macrophages on hepatic insulin resistance (IR) and glucose metabolism under PM exposure. Our findings revealed that glycogen storage was impaired, insulin signaling was suppressed, the mRNA expression of glucose metabolism-related genes was altered, and the number of macrophages increased in the mouse liver after 15 weeks of PM exposure. Additionally, PM exposed mice exhibited reduced glucose tolerance and insulin sensitivity. In the transwell co-culture model, macrophages exposed to PM for 72 h exhibited NLRP3 inflammasome activation and IL-1β release, which were associated with lysosomal damage and cathepsin B release, accompanied by inhibition of insulin signaling and abnormal expression of glucose metabolism-related genes in hepatocytes. In vitro inhibition of NLRP3 and in vivo knockdown of Nlrp3 significantly attenuated these effects of PM exposure. Additionally, IL-1β inhibition improved glucose metabolism abnormalities. These findings reflect specific effects on insulin signaling and glucose metabolism mediated by the NLRP3 inflammasome or IL-1β. These results suggest that PM exposure leading to macrophage NLRP3 inflammasome activation and IL-1β release is an important cause of abnormal hepatic glucose metabolism, providing new insights into the underlying mechanisms of PM-related hepatic glucose metabolism and IR.

PMID 42498412
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PubMedRevista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia2026-07-25

Metformin + Insulin vs. Insulin for GDM and T2DM during pregnancy: systematic review and meta-analysis.

Hallack Christiano C, Nogueira Bernardo Vieira BV, Bomfim Maressa M, Meireles Nathália N et al.

Evaluate the effectiveness and safety of adding metformin to insulin (M+I) versus insulin alone for pregnant women with type 2 diabetes mellitus (T2DM) or gestational diabetes mellitus (GDM), focusing on stillbirth as the primary outcome. PubMed, Embase, and Cochrane Central were searched. No date limits. Last search: January 2025. Randomized clinical trials including women with T2DM or GDM were eligible. Trials restricted to type 1 diabetes were excluded. Two reviewers extracted maternal and neonatal outcomes and assessed risk of bias with the Cochrane RoB 2 tool. Evidence certainty was graded using GRADE. Data were pooled with random-effects models and reported as risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals. Nine RCTs (2,420 women) were included, most with GDM and some with T2DM. Moderate-quality evidence indicated reduced stillbirth risk with M+I (6 RCTs, 2,196 participants; RR 0.36, 95% CI 0.14-0.90; NNT 111). Low-quality evidence suggested lower risks of gestational hypertension (4 RCTs; RR 0.68, 95% CI 0.48-0.97) and neonatal hypoglycemia (7 RCTs; RR 0.49, 95% CI 0.30-0.80). No significant differences were found for cesarean section, preterm delivery, or other neonatal outcomes. Heterogeneity, baseline imbalances, and small samples limited certainty. M+I may reduce stillbirth and some adverse outcomes compared with insulin alone, but most evidence remains low certainty. Further high-quality RCTs are needed.Registered in PROSPERO: CRD42024617330.

PMID 42500179
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PubMedMetabolism: clinical and experimental2026-07-25

Differential mirroring between in vivo insulin secretion and ex vivo islet function in individuals with and without diabetes.

Di Giuseppe Gianfranco G, Gliozzo Giulia G, Carciero Lorenzo L, Puzzangara Maria Carmen MC et al.

Insulin secretion measured in vivo reflects the integrated output of pancreatic islets within a multi-organ regulatory network, whereas ex vivo stimulation of isolated human islets captures intrinsic, islet-autonomous secretory competence. Whether these two levels of β cell function mirror each other in humans remains unclear. We studied 63 individuals undergoing partial pancreatectomy who underwent preoperative OGTT with model-based assessment of β cell function and provided pancreatic tissue for ex vivo islet isolation and glucose stimulation. Ex vivo function was quantified as the stimulation index at 16.7 mmol/L glucose (SI16.7) and related to in vivo indices of insulin secretion. SI16.7 was reduced in islet from people with T2D but showed marked inter-individual variability with overlapping distributions between individuals with and without T2D. In non-diabetic individuals, no significant associations were detected between SI16.7 and OGTT-derived indices. In contrast, in people with T2D, SI16.7 was positively associated with multiple measures of glucose-driven insulin secretion and inversely with potentiation. In multivariable analysis, a composite index of intrinsic glucose-dependent β cell competence remained independently related to SI16.7. These findings indicate that a direct correspondence between systemic β cell function and intrinsic islet secretory capacity emerges only in T2D. This state-dependent alignment suggests that loss of network-mediated regulation may unmasks islet-intrinsic defects, allowing ex vivo islet performance to better reflect in vivo insulin secretion and supporting integrated in vivo-ex vivo phenotyping as a tool for functional stratification of T2D.

PMID 42498076
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PubMedMedicine2026-07-25

Perioperative nursing care for a patient undergoing image-guided planned autologous islet transplantation after total pancreatectomy: A case report.

Yang Jianwen J, Qi Xuefeng X, Xu Qin Q, Qian Weiming W

Total pancreatectomy (TP) often leads to insulin-deficient diabetes, including unstable "brittle diabetes." Autologous islet transplantation during or after TP can prevent or treat diabetes by reinfusing functional islets into the portal vein. This case report details the perioperative nursing strategies for a patient undergoing image-guided planned autologous islet transplantation following TP. A 64-year-old male with pancreatic cancer, type 2 diabetes, and hypertension underwent TP and initial autologous islet transplantation but required a second transplantation due to poor graft function. Preoperatively, he exhibited fluctuating blood glucose (8.9-14.5 mmol/L) and anxiety about surgical outcomes. The patient was diagnosed with recurrent pancreatic cancer post-TP and chemotherapy, compounded by insulin-dependent diabetes and suboptimal islet function necessitating secondary transplantation. A multidisciplinary approach included meticulous preoperative islet quality control, intraoperative portal vein catheterization under ultrasound guidance, and dynamic monitoring of portal pressure. Postoperative care featured anticoagulation (heparin/low-molecular-weight heparin), glycemic management via insulin micropump, and thromboprophylaxis using intermittent pneumatic compression. Psychological support and preoperative education alleviated patient anxiety. Posttransplantation, blood glucose stabilized (3.9-7.7 mmol/L), enabling discontinuation of exogenous insulin. The patient was discharged on day 18 without complications such as thrombosis or hemorrhage. Multidisciplinary collaboration, tailored nursing interventions, and rigorous complication prevention ensured successful outcomes. This case highlights the critical role of structured perioperative care in achieving insulin independence after complex islet transplantation.

PMID 42499104
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