The future of insulin: Innovations, AI, and the evolving role of pharmacists in diabetes care

V. Hariharasudhan

Clinical Pharmacist Trainee, Kauvery Hospital, Maa Kauvery, Trichy, Tamil Nadu

Background

Insulin Beyond the Centenary

Since its discovery in 1921, insulin has revolutionized the management of diabetes mellitus. It is a peptide hormone secreted by the beta cells of the pancreas, essential for glucose metabolism, glycogen synthesis, and energy utilization. For over a century, insulin therapy has been the lifeline for millions of diabetic patients. Today, diabetes care is moving beyond vials and syringes into an era dominated by digital health, artificial intelligence (AI), precision medicine, and smart insulin technologies. Pharmacists are now emerging as key professionals in this technological revolution — bridging the gap between innovation, clinical care, and patient education [1].

Classification of Insulin and Current Innovations

Insulin preparations differ by onset, peak, and duration of action. Modern research has enhanced both pharmacokinetics and delivery methods to mimic physiological insulin secretion more accurately. Recent advancements include ultra-rapid acting insulins (Faster Aspart), long-acting basal analogs (Degludec), and smart biosensor-based insulins [2–5].

Clinical Uses of Insulin

  • Type 1 Diabetes Mellitus: Lifelong insulin replacement is mandatory.
  • Type 2 Diabetes Mellitus: Used when oral agents fail or during stress, illness, or surgery.
  • Gestational Diabetes: Preferred when diet or oral agents are insufficient.
  • DKA/HHS: IV regular insulin is the standard of care.
  • Hyperkalemia: Insulin with glucose shifts potassium intracellularly.

Administration and Storage

Routes: Subcutaneous, intravenous, or via insulin pumps.

Storage: Keep unopened vials at 2–8°C; opened vials at room temperature up to 28 days. Avoid exposure to heat.

Adverse Effects

Hypoglycemia, weight gain, lipodystrophy, and rare allergic reactions are common adverse effects.

Artificial Intelligence and the Future of Insulin Therapy

AI and digital tools are reshaping diabetes management globally. Smart algorithms can now predict glucose fluctuations, adjust insulin doses, and support personalized treatment.

  1. Closed-loop Insulin Delivery (Artificial Pancreas) – Systems like Medtronic MiniMed™ 780G automatically adjust insulin delivery using CGM input [6].
  2. Smart Insulin Pens – Devices such as NovoPen® 6 and InPen® automatically log dose and sync data [7].
  3. Predictive Analytics – Machine learning models predict hypo/hyperglycemia in advance [8].
  4. Voice and Mobile Assistance – AI-based reminders aid medication adherence [9].

Preventing Diabetes: Technology Meets Lifestyle Medicine

Modern healthcare uses AI and wearable data for early detection and prevention of diabetes.

Examples:

LibreView and FreeStyle Libre for glucose tracking [10]

Fitbit AI integration for insulin sensitivity [11]

Digital twin models for personalized therapy [12]

Genomic + AI risk scoring [13]

Emerging Insulin Delivery Technologies

  • Microneedle patches – Painless, minimally invasive insulin delivery [14].
  • Hydrogel-based smart insulin – Glucose-responsive insulin release [5].
  • Oral insulin – Trials like Oramed ORMD-0801 are promising [15].
  • Bioartificial pancreas – Stem-cell derived insulin encapsulated for normal secretion [16].

Role of Clinical Pharmacists in the Digital Era

Pharmacists interpret AI-generated dosing data, identify device issues, educate patients on smart pen and CGM use, monitor adherence via telehealth, and contribute to multidisciplinary diabetes teams [1,7,9].

Preventive Strategies: Combating the Diabetes Epidemic

  • Promote healthy diet and physical activity.
  • Use mobile health apps for glucose and BP tracking.
  • Screen high-risk groups using AI tools [13].
  • Early metformin therapy in prediabetes as per ADA 2024 [2].
  • Support digital awareness campaigns (ABDM) [17].

Conclusion

Insulin remains the cornerstone of diabetes therapy, but the future lies in precision-driven, AI-integrated, patient-centered care. With smart devices, biosensors, and predictive analytics, management is becoming safer and more efficient. Pharmacists are key players ensuring technology translates into improved outcomes.

References

[1]          American Diabetes Association. Standards of Medical Care in Diabetes – 2025.

[2]          IDF Diabetes Atlas, 11th Edition, 2024.

[3]          Novo Nordisk: Tresiba® Clinical Brochure.

[4]          U.S. FDA: Afrezza (Inhaled Insulin) Approval Summary.

[5]          Nature Biomedical Engineering (2023): Smart Insulin Systems.

[6]          Medtronic: MiniMed™ 780G Overview.

[7]          Novo Nordisk: NovoPen® 6 and InPen® Guides.

[8]          Journal of Diabetes Science and Technology (2024): Predictive AI in Insulin Titration.

[9]          Health Affairs (2023): Voice-Based Interventions in Diabetes Care.

[10]       Abbott: FreeStyle Libre – LibreView Platform Guide.

[11]       Fitbit Health Solutions: Insulin Sensitivity & Wearables White Paper.

[12]       Nature Medicine (2023): Digital Twins in Chronic Disease Management.

[13]       BMJ Open Diabetes Research (2023): AI-Based Diabetes Risk Prediction.

[14]       Journal of Drug Delivery (2022): Microneedle Technology Review.

[15]       Oramed Pharmaceuticals: Oral Insulin Pipeline Update.

[16]       Harvard Stem Cell Institute: Bioartificial Pancreas Research.

[17]       Ministry of Health and Family Welfare: Ayushman Bharat Digital Health Blueprint (2024).

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