Gastrointestinal Tuberculosis

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Oral insulin would therefore be the best way to treat diabetic patients. Oral insulin replicates the precise physiologic pathway from portal vein into the liver as it is absorbed from the gastrointestinal tract, contrary to insulin injections which are absorbed in the systemic circulation and in the muscles (Arbit, 2009). This allows oral insulin to achieve a high porto-systemic gradient. This methodology of insulin absorption involves direct engagement of the liver, and its role in glucose metabolism is accentuated, leading to beneficial metabolic effects for diabetic patients. These effects include hyperinsulinemia (excess levels of insulin in the blood) reduction, prevention of weight gain associated with systemic insulin therapy, and reduction…show more content…
Therefore the systemic delivery of protein or peptide biologics requires the parental route of administration through subcutaneous injections, but there are multiple problems with this method of drug delivery. For systemic absorption, intact drug molecules must pass from the administration site through or between the intestinal epithelial cells to the general circulation and the target site (Lee et al.,…show more content…
The first barrier consist of gut enzymes that break down large active proteins into smaller inactive amino acids. Breakdown of the proteins is necessary to overcome the second barrier, the tight epithelium in the gastrointestinal tract. The combined barriers actively block out large active protein drugs, such as oral insulin, to produce their desired pharmacological effects (Kalra et al., 2010). The gastrointestinal tract also contains a rich collection of enzymes such as pepsin, trypsin, chymotrypson, carboxypeptidase, and pancreatin which all break insulin into amino acids (Iyer et al., 2010). The insulin that survives through the epithelium and the enzymatic barriers, arrive at the tightly bound columnar cells of the intestine. The bound columnar cells are layered with hydrophobic proteins, occludins, and a thick layer of muccin, the combination of both preventing efficient absorption of insulin (Wang, 1996). Finally, the insulin reaches the liver itself where it goes through metabolism before actually reaching the peripheral sites of action. Subcutaneous injections of insulin arrive directly at the peripheral sites and insulin is not submitted to the relentless barriers against it. The presystemic enzymes responsible for degradation of proteins and poor penetration of the intestinal membrane are the main explanations behind the difficulty of creating an
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