Insulin soluble bovine 100units/ml solution for injection 3ml cartridges

BackgroundGlucagon-like peptide-1 receptor agonists, originally developed for managing type 2 diabetes, have gained attention for their weight-reducing and broader biological effects. Among these, their influence on human mesenchymal stem cells remains underexplored, despite the critical role of mesenchymal stem cells in tissue regeneration and secretion of bioactive factors.MethodsThis systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify and evaluate in vitro studies investigating the effects of glucagon-like peptide-1 receptor agonists and their analogues on human mesenchymal stem cell functions, including proliferation, differentiation, signaling, apoptosis, and tissue-specific applications. Risk of bias was assessed using an adapted Quality Assessment Tool for In Vitro Studies (QUIN) tool.ResultsThirty-eight eligible studies were identified. Glucagon-like-peptide-1 receptor agonist, like native glucagon-like peptide-1, Exendin-4, and Liraglutide, exert context-, dose-, and timing-dependent effects on human mesenchymal stem cells. They modulate proliferation and overall promote osteogenesis while inhibiting adipogenesis. Key pathways, including Wnt/β-catenin, bone morphogenetic protein 2/Smad, phosphoinositide 3-kinase/Akt and protein kinase A, play a role in this. Furthermore, these agents modulate inflammation, reduce apoptosis, and improve stem cell functions even under diabetic or inflammatory conditions. Exendin-4 facilitated tenogenic and insulin-producing cell differentiation, particularly in engineered scaffolds or genetically engineered human mesenchymal stem cells.ConclusionGlucagon-like peptide-1 receptor agonists modulate key pathways in human mesenchymal stem cells to influence survival, differentiation, and metabolic function, suggesting promising therapeutic potential beyond glycemic control. However, heterogeneous experimental designs and limited translational data necessitate further standardized and in vivo research to define clinical applications.

Abstract licence: CC BY

Diabetes mellitus is characterised by an elevated blood glucose concentration. Over the last two decades, a plethora of new agents have emerged to help treat the condition, of which several classes of agent have been shown to reduce the risk of cardiovascular morbidity and mortality. In addition, there have been several developments in the pharmacology of insulin, improving the pharmacokinetics and pharmacodynamics of insulin analogues to better mimic physiological insulin concentrations in the liver, skeletal muscle, and other tissues. Furthermore, the technologies used to deliver insulin and measure glucose have improved; for example, in the UK, hybrid closed loop systems are now the standard of care for people with type 1 diabetes mellitus. This review focuses on insulin and insulin delivery. We consider the history of insulin development and the pharmacology of newer insulin analogues. We also describe the novel technologies available and the considerations that need to be made by anaesthetists, surgeons, and other members of the perioperative team when looking after someone with diabetes mellitus on these insulins, or using these devices, to ensure safe care and the avoidance of complications.

Abstract licence: CC BY