The result is that the blood glucose level rises somewhat after eating, and within an hour or so, returns to the normal fasting level. Even the best diabetic treatment with synthetic human insulin or even insulin analogs, however administered, falls far short of normal glucose control in the non-diabetic.Complicating matters is that the composition of the food eaten (see glycemic index) affects intestinal absorption rates. Glucose from some foods is absorbed more (or less) rapidly than the same amount of glucose in other foods. In addition, fats and proteins cause delays in absorption of glucose from carbohydrates eaten at the same time. As well, exercise reduces the need for insulin even when all other factors remain the same, since working muscle has some ability to take up glucose without the help of insulin.Because of the complex and interacting factors, it is, in principle, impossible to know for certain how much insulin (and which type) is needed to cover a particular meal to achieve a reasonable blood glucose level within an hour or two after eating. Non-diabetics beta cells routinely and automatically manage this by continual glucose level monitoring and insulin release. All such decisions by a diabetic must be based on experience and training (i.e., at the direction of a physician, PA, or in some places a specialist diabetic educator) and, further, specifically based on the individual experience of the person. But it is not straightforward and should never be done by habit or routine.
A similar device, but relying on skin-penetrating "microneedles", was in the animal testing stage in 2015. Intranasal
Intranasal insulin is being investigated. A randomized controlled trial that will determine whether intranasal insulin can delay or prevent the onset of type 1 diabetes in at-risk children and young adults is expected to yield results in 2016. By mouth
The basic appeal of hypoglycemic agents by mouth is that most people would prefer a pill or an oral liquid to an injection. However, insulin is a peptide hormone, which is digested in the stomach and gut and in order to be effective at controlling blood sugar, cannot be taken orally in its current form. The potential market for an oral form of insulin is assumed to be enormous, thus many laboratories have attempted to devise ways of moving enough intact insulin from the gut to the portal vein to have a measurable effect on blood sugar.A number of derivatization and formulation strategies are currently being pursued to in an attempt to develop an orally available insulin. Many of these approaches employ nanoparticle delivery systems and several are being tested in clinical trials. Pancreatic transplantation
Another improvement would be a transplantation of the pancreas or beta cell to avoid periodic insulin administration. This would result in a self-regulating insulin source. Transplantation of an entire pancreas (as an individual organ) is difficult and relatively uncommon. It is often performed in conjunction with liver or kidney transplant, although it can be done by itself.