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International Journal of Diabetes Mellitus 2 (2010) 32–37

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International Journal of Diabetes Mellitus


journal homepage: ees.elsevier.com/locate/ijdm

Original Article

Dietary fiber psyllium based hydrogels for use in insulin delivery


Baljit Singh *, Nirmala Chauhan
Department of Chemistry, Himachal Pradesh University, Shimla 171 005, India

a r t i c l e i n f o a b s t r a c t

Article history: The present article is related to the development of psyllium based oral insulin delivery systems that
Received 27 August 2009 could release insulin in a controlled and sustained manner. Psyllium is a medicinally important gel, form-
Accepted 20 December 2009 ing glucose lowering dietary fiber and drug delivery system developed by its functionalization will have
the double potential of curing diabetes. Psyllium and acrylamide/methacrylamide based hydrogels were
prepared, and the effect of pH on the release dynamics of insulin from drug loaded hydrogels has been
Keywords: studied to evaluate the drug release mechanism. Non-Fickian diffusion mechanism has been observed
Drug delivery devices
for the release of insulin in the pH 7.4 buffer.
Hydrogels
Insulin
Ó 2009 International Journal of Diabetes Mellitus. Published by Elsevier Ltd.
Open access under CC BY-NC-ND license.
Diabetes mellitus

1. Introduction proteolytic degradation. In the basic and neutral environments of


the intestine, the complexes dissociated which resulted in rapid
Diabetes mellitus is a common problem nowadays which is gel swelling and insulin release. Within 2 h of administration of
caused by decreased production of insulin or by decreased ability the insulin-containing polymers, strong dose-dependent hypogly-
to use insulin. This leads to an increase in blood glucose level. cemic effects were observed in both healthy and diabetic rats.
Due to the inconvenience of the traditional treatment of diabetes These effects lasted up to 8 h following administration [5]. In an-
by subcutaneous administration of insulin injection, various other study, the ability of the insulin loaded hydrogels to influence
attempts have been made to develop an efficient method of insulin the blood glucose levels of the diabetic rats was investigated. The
delivery [1,2]. Usually, insulin is injected subcutaneously two to blood glucose level has been reduced for animals that received
four times to the patients in a day, because they need a relatively the insulin loaded hydrogel and the effect lasted for 8–10 h. It
constant basal level of insulin to achieve a near physiological pat- was also observed, two capsules per day of the hydrogel micro-par-
tern of insulin secretion. Therefore, there has been significant ticles containing 80 I.U./kg of insulin dose were sufficient to control
interest in the development of oral delivery systems for insulin the blood glucose level of fed diabetic rats between 100 and
that could release the drug in a constant level for longer periods; 300 mg/dl [6].
patients would be freed from the need to administer multiple Insulin-loaded polymer micro-particles composed of cross-
doses. Hydrogels have been shown to be promising candidates linked poly(methacrylic acid) and poly(ethylene glycol) are
for such a system [3,4]. multi-functional carriers, and have shown high insulin incorpora-
The goal of oral insulin delivery devices is to protect the sensi- tion efficiency, a rapid insulin release in the intestine, enzyme-
tive drug from proteolytic degradation in the stomach and upper inhibiting effects and mucoadhesive characteristics. Thus, these
portion of the small intestine. The pH responsive hydrogels have are potential carriers for insulin delivery via an oral route. Drug re-
been studied as potential drug carriers for the protection of insulin lease from the hydrogel is affected by several factors, such as pore
from the acidic environment of the stomach, before releasing in the size, degradability, size, hydrophobicity, the concentration of a
small intestine. In one case, insulin was administered orally to drug and the presence of specific hydrogel-drug interactions. Ini-
healthy and diabetic Wistar rats through pH responsive hydrogels. tially, the release mechanism from a biodegradable hydrogel is
In the acidic environment of the stomach, the gels remained un- limited by the drug’s diffusivity. Following this, a combination of
swollen due to the formation of intermolecular polymer complexes diffusion and degradation processes controls the drug’s release
and the insulin remained in the gel and was protected from from the polymeric matrix [7,8].
Polysaccharides based hydrogels enhance the intestinal absorp-
tion of insulin and increase the relative pharmacological bioavailabil-
ity of insulin; it has been investigated by monitoring the plasma
glucose level of alloxan-induced diabetic rats after oral administra-
* Corresponding author. Tel.: +91 1772830944; fax: +91 1772633014.
E-mail address: baljitsinghhpu@yahoo.com (B. Singh).
tion of various doses of insulin-loaded chitosan-nanoparticles [9].

1877-5934 Ó 2009 International Journal of Diabetes Mellitus. Published by Elsevier Ltd. Open access under CC BY-NC-ND license.
doi:10.1016/j.ijdm.2009.12.014
B. Singh, N. Chauhan / International Journal of Diabetes Mellitus 2 (2010) 32–37 33

On the other hand, the blood glucose level can also be controlled 2. Experimental
by the polysaccharides, based diet management therapy. Accord-
ing to a report by the American Diabetic Association, fiber im- 2.1. Materials and method
proves the control of blood glucose, and delays glucose
absorption and hyperinsulinaemia [10]. Viscous forms of dietary Plantago psyllium mucilage (Psy) was obtained from Sidpur Sat
fiber have been shown to improve blood glucose control by trap- Isabgol factory (Gujrat, India), acrylamide (AAm) and methacryla-
ping ingested carbohydrates inside the viscous gel formed after mide (MAAm) were obtained from Merck-Schuchardt, Germany.
digestion. As a result, sugars are absorbed into the bloodstream Sodium hydroxide, Sodium potassium tartrate and Folin’s reagents
more slowly, limiting the rise in blood glucose seen after a meal was obtained from Merck Mumbai-India. Ammonium persulphate
[11,12]. It has been suggested that the benefits of increased fiber (APS), copper sulphate and N,N0 -methylenebisacrylamide (N,N-
intake result principally from the greater consumption of soluble MBAAm) was obtained from S.D. Fine, Mumbai-India and were
forms, due to effects on gastric emptying, macronutrient absorp- used as received. Insulin was obtained from the Torrent Pharma-
tion, and reduced postprandial glucose responses [13,14]. Insolu- ceuticals Ltd., Indrad, Mehsana, India. Sodium carbonate was
ble fiber may reduce diabetes risk by the production of short obtained from Ranbaxy, SAS Nagar Punjab-India.
chain fatty acids in the colon and their effect on hepatic insulin
sensitivity [15,16]. The advantages of high-fiber diets for diabetic 2.2. Synthesis of polymers/hydrogels
patients have also been said to include the lowering of serum lip-
ids, assisted weight reduction and maintenance, along with the Reaction was carried out with 1 g of psyllium husk, definite con-
lowering of blood glucose levels [17,18]. Psyllium is one of the centration of monomer, initiator and crosslinker taken in the aque-
medicinally important gel forming glucose lowering dietary fiber. ous reaction system at 65 °C temperature for 2 h. Polymers were
It reduces hyperglycemia in diabetes via inhibition of intestinal stirred for 2 h in distilled water and for 2 h in ethanol to remove
glucose absorption and enhancement of motility [19]. Since the the soluble fraction and then were dried in oven at 40 °C. Two
glucose lowering effect of psyllium was clearly evident when types of hydrogels were prepared by using AAm and mixture of
simultaneously administered with glucose, inhibition of glucose AAm/MAAm. The hydrogels were named as psy-cl-poly(AAm)
absorption in the gut is a likely contributor to the mechanism of and psy-cl-poly(AAm-co-MAAm) hydrogels, respectively. For the
action [20]. Psyllium in the diet also improves glucose tolerance synthesis of psy-cl-poly(AAm) hydrogels 7.03  101 mol/L of
in diabetes [21,22]. This effect may be due to retarded gastric AAm and was used along with 1.095  102 mol/L of APS,
emptying, increased intestinal transit, or a modification of the 16.20  103 mol/L of N,N-MBAAm. On the other hand, the
secretion and action of digestive enzymes [23]. During the last psy-cl-poly(AAm-co-MAAm) hydrogels was synthesized by taking
two decades, several studies have been carried out to investigate, 3.52  101 mol/L of AAm and 0.58  101 mol/L of MAAm simul-
whether psyllium interferes with normal intestinal absorption of taneously in the mixture containing 0.66  102 mol/L of APS and
carbohydrate in healthy volunteers [24] and in type 1 [25] and 9.73  103 mol/L of N,N-MBAAm. These hydrogels were used to
type 2 diabetic patients [26]. The improvement in glucose toler- study the release dynamics of the drug from the drug loaded
ance produced by consumption of viscous fiber is due to slower hydrogels.
absorption of carbohydrates, rather than mal-absorption. Intimate
mixing, allowing physical interaction between food and fiber,
2.3. Release dynamics of insulin from drug loaded hydrogels
seems to be important in converting the carbohydrate to what
might be termed a slow-release form [27]. The mechanism of ac-
2.3.1. Preparation calibration curves
tion of gel forming fiber is related to the ability to increase the vis-
In this procedure, the absorbance of a number of standard solu-
cosity of the gastrointestinal contents, and thus, interfere with
tions of the reference substance at concentrations encompassing
motility and absorption [28].
the sample concentrations were measured on the UV Visible Spec-
Psyllium mucilage obtained from the seed coat by mechanical
trophotometer (Cary 100 Bio, Varian) and calibration graph was
milling/grinding of the outer layer of the seeds and yield amounts
constructed. The concentration of the drug in the sample solution
to approximately 25% of the total seeds yield. Mucilage is fibrous,
was read from the graph as the concentration corresponding to
hydrophilic and forms the clear colorless mucilaginous gel by
the absorbance of the solution. Three calibration graphs of insulin
absorbing water. The gel nature and composition of the polysac-
were made to determine the amount of drug release from the drug
charides extracted from the seeds of the Plantago ovata has been
loaded polymeric matrix respectively for distilled water, pH 2.2
reported in literature. The gel forming fraction of the alkali-
buffer and pH 7.4 buffer [29].
extractable polysaccharides is composed of arabinose, xylose and
traces of other sugars. Beside its sugar lowering property, it has
been reported for the treatment of constipation, diarrhea, inflam- 2.3.2. Drug loading to the polymer matrix
mation bowel diseases-ulcerative colitis, obesity in children and The loading of a drug onto hydrogels was carried out by a swell-
adolescents and high cholesterol [29]. ing equilibrium method. The hydrogels were allowed to swell in
In view of the pharmacological importance of psyllium polysac- the drug solution of known concentration for 24 h at 37 °C and
charides to reduce glucose absorption and drug delivery devices then dried to obtain the release device.
based on hydrogels, psyllium, if suitably tailored to prepare the
hydrogels, can act as the double potential candidates to develop 2.3.3. Drug release from polymer matrix
novel drug delivery systems. Therefore, the present study is an In vitro release studies of the drug were carried out by placing
attempt to synthesize psyllium and poly(AAm) and poly(AAm- dried and loaded sample in definite volume of releasing medium
co-MAAm) based hydrogels by using N,N0 -methylenebisacrylamide at 37 °C temperature. The amount of insulin released was assayed
(N,N-MBAAm) as crosslinker and ammonium persulfate (APS) as spectrophotometrically by Lowry method [30]. The absorbance of
initiator and thereafter use as drug delivery devices. It also dis- the solution was measured at wavelength 768.0 nm, 753.0 nm
cusses the in vitro release dynamics of insulin in a different release and 758.0 nm, respectively, for release in distilled water, pH 2.2
medium, for the evaluation of release mechanism and diffusion buffer and pH 7.4 buffer after every 30 min in each case. The pro-
coefficients. cedure for the Lowry method is as follows.
34 B. Singh, N. Chauhan / International Journal of Diabetes Mellitus 2 (2010) 32–37

2.3.3.1. Reagents used for Lowry method. Reagent A: sodium carbon- the propagation of the reaction. In the presence of crosslinker
ate (2% w/v) in 0.1 N sodium hydroxide solution was prepared by N,N-MBAAm (CH2@CHCONHCH2 NHCOCH@CH2) four reactive sites
dissolving 20 g of sodium carbonate and 4 g of sodium hydroxide are generated and these sites can be linked both with the radical on
in 1 L of distilled water. the psyllium and the poly(AAm)/poly(MAAm) and formed a cross-
Reagent B: copper sulphate solution (1% w/v) was prepared by linked three-dimensional networks, which have been used to study
dissolving 1 g of copper sulphate (AR) in 100 mL of distilled water. the in vitro release of the model drugs.
Reagent C: sodium potassium tartrate solution (2% w/v) was
prepared by dissolving 2 g of the salt in 100 mL distilled water. 3.1. Characterization
Reagent D: alkaline copper reagent: 1 mL each of reagents B and
C was mixed with 98 mL of reagent A and vortexed. This reagent FTIR spectra of psyllium, psy-cl-poly(AAm) and psy-cl
was prepared freshly. poly(AAm-co-MAAm) polymers were recorded in KBr pellets on
Nicolet 5700 FTIR (THERMO) shown in (Fig. 1a–c). The broad
2.3.3.2. Procedure for Lowry method. To 1 mL of the standard pro- absorption bands at 3421.6 and 3415.6 cm1 were observed due
tein solution containing 10–100 lg of protein or released insulin to –OH and NH stretching of –OH and NH groups present in psy-
sample solution were added 4 ml of reagent D and the contents cl-poly(AAm), and psy-cl poly(AAm-co-MAAm) polymers and FTIR
were mixed. After 10 min of incubation at room temperature, absorption bands due to C@O stretching of amide has been prom-
0.4 mL of Folin’s reagent was added and the contents were vor- inently witnessed at 1664.3 and 1664.8 cm1 for respective poly-
texed immediately. A reagent blank with 1 mL of distilled water mer matrix. The bands at 1042.3 and 1041.9 cm1 were observed
(or buffer solution of respective pH) was also processed in same due to C–N stretching of amide present in all the three modified
manner as described above. After 30 min of incubation at room samples apart from usual peaks in psyllium.
temperature, the blue color developed was measured at kmax. The
calibration curve was constructed and computed to calculate the 3.2. Release dynamics of insulin from drug loaded hydrogels
concentration of the insulin released from the sample. While calcu-
lating the insulin concentration in the unknown sample, the dilu- 3.2.1. Release dynamics of insulin from psy-cl-poly(AAm) hydrogels
tion factor has been taken into account [30]. In present studies, the release profile of insulin from per grams
of the drug loaded hydrogels has been shown in the Fig. 2. The
amount of insulin release in pH 7.4 buffer and distilled water
2.3.4. Preparation of buffer solution
was higher than the release medium of pH 2.2 buffer. After 24 h
Buffer solution of pH 2.2 was prepared by taking 50 mL of 0.2 M
the total amount of drug release, (23.22 ± 2.01) lg, (16.65 ± 1.69)
KCl and 7.8 ml of 0.2 N HCl in volumetric flask to make volume
200 ml with distilled water. Buffer solution of pH 7.4 was prepared
lg (33.21 ± 1.82) lg per g of gel have been observed, respectively,
in distilled water, pH 2.2 buffer and pH 7.4 buffer. The diffusion
by taking 50 mL of 0.2 M KH2PO4 and 39.1 mL of 0.2 N NaOH in vol-
exponent ‘n’ has 0.81, 0.38 and 0.60 values and gel characteristic
umetric flask to make volume 200 ml with distilled water [31].
constant ‘k’ has 0.87  102, 8.39  102 and 2.73  102 values
in distilled water, pH 2.2 buffer and pH 7.4 buffer, respectively.
2.4. Mechanism of swelling and drug release from polymer matrix The values of ‘n’ indicate a non-Fickian diffusion mechanism for
the release of drug in case of pH 7.4 buffer and distilled water. In
The mechanisms of swelling and drug release have been dis- this mechanism, the rate of polymer chain relaxation and the rate
cussed in detail in our earlier study [29]. Swelling of polymers of drug diffusion from these hydrogels are comparable. On the
has been classified into three types of diffusion mechanisms, on other hand, a Fickian type of diffusion mechanism occurs in case
the basis of relative rate of diffusion of water into polymer matrix of pH 2.2 buffer. The values of the initial diffusion coefficients for
and rate of polymer chain relaxation [32–35]. The values of diffu- the release of insulin were observed to be higher than the values
sion exponent ‘n’ and diffusion coefficients have been evaluated of average and late time diffusion coefficients in each release med-
for the swelling of the polymers and for the release of the drug ium indicating that in the start, rate of diffusion of drug from the
from the polymer. The values of diffusion coefficients have been polymeric matrix was higher (Table 1).
evaluated for the release of the drug from the polymer, and the re-
sults are presented in Table 1.
3.2.2. Release dynamics of insulin from psy-cl-poly(AAm-co-MAAm)
hydrogels
3. Results and discussion The release of insulin, entrapped in a hydrogels, occurs only
after water penetrates the network to swell the polymer and dis-
Polymeric networks were synthesized by chemically induced solve the drug, followed by diffusion along the aqueous pathways
polymerization through free radical mechanism. APS has generated to the surface of the device. In the present studies, the release pro-
the reactive sites, both on the psyllium and monomer, leading to file of insulin from per grams of the drug loaded hydrogels has

Table 1
Results of diffusion exponent ‘n’, gel characteristic constant ‘k’ and various diffusion coefficients for the release of insulin from drug loaded polymers in different medium at 37 °C.

Drug in releasing medium Diffusion exponent ‘n’ Gel characteristic constant ‘k’  102 Diffusion coefficients (cm2/min)
Initial Di  104 Average DA  104 Late time DL  104
Psy-cl-poly(AAm)
Distilled water 0.81 0.87 18.0 16.95 2.25
pH 2.2 buffer 0.38 8.39 7.47 19.88 1.60
pH 7.4 buffer 0.60 2.73 19.69 20.44 3.19
Psy-cl-poly(AAm-co-MAAm)
Distilled water 0.60 3.29 8.33 7.61 1.69
pH 2.2 buffer 0.40 10.69 5.82 12.75 2.01
pH 7.4 buffer 0.57 3.46 7.83 7.96 1.34
B. Singh, N. Chauhan / International Journal of Diabetes Mellitus 2 (2010) 32–37 35

(a) 100 **psy

95

2121.1
3805.3 3863.4
3754.4

749.3
90

898.3
%Transmittance

1637.7
1560.3
85

3909.4

469.5
1398.2
1269.4
80

1458.2
2926.3

1728.0

1161.3
75

3425.6

1078.3
70

65

60
4000 3000 2000 1000
Wavenumbers (cm-1)

(b) 100 **psyaam

95

897.7
90

85
%Transmittance

2145.7

80

474.5
75 1457.5

70

1042.3
65
2926.1

1664.3

60
3421.6

55

50
4000 3000 2000 1000
Wavenumbers (cm-1)

(c) 95 **AAm MAAm Psy


2366.4

90
85
898.6

80
75
1255.9

70
624.7
%Transmittance

2865.8

65
480.2
1455.4

60
2925.3

1605.5

55
3200.0

50
1095.9

1041.9
3415.6

45
1664.8

40
35
30
25
20
15
10
5
0
4000 3500 3000 2500 2000 1500 1000 500
Wavenumbers (cm-1)

Fig. 1. FTIR of (a) psyllium, (b) Psy-cl-poly(AAm) and (c) Psy-cl-poly(AAm-co-MAAm) hydrogels.

been shown in the Fig. 3. The amount of insulin release in pH 7.4 pH 2.2 buffer. After 24 h total amount of drug release,
buffer and distilled water was higher than the release medium of (52.66 ± 1.29) lg, (28.68 ± 0.88) lg and (53.90 ± 0.77) lg per g of
36 B. Singh, N. Chauhan / International Journal of Diabetes Mellitus 2 (2010) 32–37

Distilled water
Psyllium in the diet also improves glucose tolerance in diabetes
35
pH 2.2 buffer [21,22] This effect may be due to retarded gastric emptying, in-
pH 7.4 buffer
creased intestinal transit or a modification of the secretion and ac-
Amount of drug released (µg/g of gel)

30
tion of digestive enzymes [23]. The human body needs blood
glucose to be maintained in a very narrow range. Insulin and gluc-
25
agons are the hormones which make this happen. It is the produc-
tion of insulin and glucagons by the pancreas which ultimately
20
determines if a patient has diabetes, hypoglycemia, or some other
sugar problem. Psyllium has been proposed as a possible treatment
15
for high blood sugar levels. Studies in humans suggest moderate
reductions in blood sugar levels after a single dose of psyllium,
10
with unclear long-term effects [36]. The brief discussion about
the role of insulin in glucose lowering and in regulating glucose
5
metabolism will be praiseworthy.
People who do not produce the necessary amount of insulin
0
have diabetes. There are two general types of diabetes. Insulin is
30 60 90 120 150 180 210 240 270 300 1440
Time (min.) a hormone that regulates the amount of glucose (sugar) in the
blood and is required for the body to function normally. Insulin
Fig. 2. Release profile of insulin from drug loaded psy-cl-poly(AAm) hydrogels in is produced by cells in the pancreas, called the islets of Langerhans.
different medium at 37 °C.
These cells continuously release a small amount of insulin into the
body, but they release surges of the hormone in response to a rise
60
in the blood glucose level. Without insulin, the blood glucose
Distilled water builds up in the blood and the cells are starved of their energy
pH 2.2 buffer source. The cells will begin to use fat, the energy source stored
pH 7.4 buffer
Amount of drug released (µg/g of gel)

50 for emergencies. When this happens for too long a time, the body
produces ketones, chemicals produced by the liver. Ketones can
poison and kill cells if they build up in the body over an extended
40 period of time. This can lead to serious illness and coma. In addi-
tion to its role in regulating glucose metabolism, insulin increases
DNA replication and protein synthesis via control of amino acid up-
30
take, modification of the activity of numerous enzymes, decreased
proteolysis, forces reduction in conversion of fat cell lipid stores
20 into blood fatty acids, decreased gluconeogenesis, increases amino
acid uptake into cells, forces cells to absorb serum potassium,
forces arterial wall muscle to relax, increasing blood flow, espe-
10 cially in micro arteries; lack of insulin reduces flow by allowing
these muscles to contract. Although the specific treatments can
30 60 90 120 150 180 210 240 270 300 1440 vary greatly by subtype of disease, all diabetes treatments have
Time (min.) the same goal; to adequately regulate blood glucose in order to
Fig. 3. Release profile of insulin from drug loaded psy-cl-poly(AAm-co-MAAm)
prevent the primary and secondary effects of hyperglycemia.
hydrogels in different medium at 37 °C. Overall the hydrogels can act as double potential drug delivery
systems for the delivery of insulin. These pH responsive hydrogels
can make the site specific delivery of the proteins. Mahkam has
gel have been observed, respectively, in distilled water, pH 2.2 buf- investigated the protective ability of the hydrogel for insulin in
fer and pH 7.4 buffer. The diffusion exponent ‘n’ have 0.60, 0.40 and the harsh environment of the stomach, insulin and insulin-incor-
0.57 values and gel characteristic constant ‘k’ have 3.29  102, porated polymer-bonded drug by treating with a simulated gastric
10.69  102 and 3.46  102 values in distilled water, pH 2.2 buf- solution that contained endopesidase pepsin [37]. The results of
fer and pH 7.4 buffer, respectively. As the values of ‘n’ indicates a this study indicated that all insulin has been degraded immedi-
non-Fickian or anomalous diffusion mechanism for the release of ately after contact with gastric fluid. The main cause of degradation
drug in case of pH 7.4 buffer and distilled water. It means that was the proteolytic enzyme, pepsin. After being treated with gas-
the rate of polymer chain relaxation and the rate of drug diffusion tric fluid, all of hydrogels demonstrated a protective effect on insu-
from these hydrogels are comparable. On the other hand, Fickian lin and the biological activity remained after the treatment with
type of diffusion mechanism occurs in case of pH 2.2 buffer. The gastric fluid of hydrogels [37]. In one case study it is reported by
values of the initial diffusion coefficient for the release of insulin Wood and coworkers that hydrogels enhances insulin absorption
was observed to be higher than the value of average and late time and holds great promise as an oral insulin delivery system. The
diffusion coefficient in each release medium indicating that in the pH-sensitive complexation hydrogels composed of methacrylic
start, rate of diffusion of drug from the polymeric matrix was acid and functionalized polyethylene glycol (PEG) tethers, referred
higher. to as P(MAA-g-EG) WGA, can be used for oral protein delivery sys-
The present drug delivery system will have the double potential tem. The PEG tethers have been functionalized with wheatgerm
to control the glucose level in the blood. This will release the insu- agglutinin (WGA), a lectin that can bind to carbohydrates in the
lin in the colon in a controlled and sustained manner, and polymer intestinal mucosa, to improve residence time of the carrier and
degradation in the colon will release the psyllium, which itself has absorption of the drug at the delivery site. The ability of P(MAA-
been proposed as a glucose lowering agent. Since the glucose low- g-EG) WGA to improve insulin absorption has been observed in
ering effect of psyllium was clearly evident when simultaneously two different intestinal epithelial models. In Caco-2 cells P(MAA-
administered with glucose, the inhibition of glucose absorption g-EG) WGA improved insulin permeability 9-fold as compared
in the gut is a likely contributor to the mechanism of action [20]. with an insulin only solution, which was similar to the improve-
B. Singh, N. Chauhan / International Journal of Diabetes Mellitus 2 (2010) 32–37 37

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