Will the future be needle-free for diabetics?



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By Serena Gordon

HealthDay Reporter

Monday, June 25, 2018 (HealthDay News) – For many diabetics, one of the most dreaded aspects of managing their condition is the need to inject insulin several times a day. But Harvard researchers have discovered a way to deliver insulin into a pill, and it seems to work well – at least in rats.

Many questions remain: What is the appropriate dose compared to injected insulin? Will it be delivered consistently? And, the biggest, will it work well in people, too?

That's why more research is needed, said lead author of the study, Samir Mitragotri, a professor of bioengineering at Harvard University.

"What we have shown is that we can administer insulin and that it is safe in the intestine, which would be a non-invasive, easy-to-use and easy-to-use treatment. use, "he said.

Insulin is a hormone that helps to bring sugar from the foods you eat into the cells for use as fuel. People with diabetes often lack enough insulin to meet the needs of the body, although the exact cause varies depending on the type of diabetes.

Oral insulin has not been available, because insulin is digested in the stomach, said Mitragotri.

But the injectable forms – which can be delivered by a needle or a small tube inserted under the skin and attached to an insulin pump – are painful, which can cause people to skip their medication, he noted.

To develop oral insulin, the researchers had a number of challenges. If an oral insulin has passed the acid from the stomach, the intestines have presented another problem. Insulin is a big molecule, and the intestinal wall is a barrier for most large molecules, say the researchers.

The first step to overcome these barriers was to place the insulin in an ionic liquid, which Mitragotri likened to liquid salts. The insulin-ionic liquid combination was then covered with a coating that allows the pill to pass through the intact stomach. It is then dissolved in the small intestine.

From there, oral insulin moves to the large intestine. With the help of ionic liquids, insulin molecules can pass through the intestinal wall into the bloodstream.

Continued

An advantage of this form of insulin is that it is more stable in storage than injectable insulin. Current insulins are good for about 28 days once they are out of the fridge. But oral insulin is good for at least two months, and probably longer, said Mitragotri.

The current study reported an oral insulin test in rats. The researchers found a steady decline in blood glucose (glucose) up to 45 percent in animals.

"He lowered blood sugar for at least 12 hours," said Mitragotri.

Whenever someone takes insulin, there is a risk of taking too much and causing a dangerous drop in blood sugar (hypoglycemia). But Mitragotri said that because oral insulin takes time to be released, the risk is reduced.

More studies will have to be done, including in larger animals, before human trials can begin. But hopefully, Mitragotri said he was expecting human trials to start in three to five years.

It is difficult to estimate the cost of oral insulin, he added. But the ionic liquid and coating materials are not expensive, so it is expected that the cost will be similar to that of current insulins.

Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York, reviewed the results.

"It's good that people are trying to find the holy grail of oral insulin, and we would always be happy with a new insulin delivery system. Current results on the Rodents are much better than I've seen in the past, "said Zonszein.

"But the problems we have are many," added Zonszein. It's hard to know how this insulin could be used because the release of insulin is too variable, he said.

The report was published online June 25 Proceedings of the National Academy of Sciences.

HealthDay WebMD News

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SOURCES: Samir Mitragotri, Ph.D., Hiller Professor of Bioengineering, Hansjorg Wyss Professor of Biologically Inspired Engineering, John A. Paulson School of Engineering and Applied Science, Wyss Institute, Harvard University, Boston; Joel Zonszein, MD, Director, Clinical Diabetes Center, Albert Einstein Medical College Hospital, Montefiore Medical Center, New York; June 25, 2018,Proceedings of the National Academy of Sciences, online



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