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Could this insulin pill replace injections for people with type 1 diabetes?

Discussion in 'Diabetes News' started by DCUK NewsBot, Oct 9, 2019.

  1. DCUK NewsBot

    DCUK NewsBot · Well-Known Member

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    A revolutionary insulin pill may allow people with type 1 diabetes to avoid needing to take injections, according to researchers in the US. A specialist unit at the Massachusetts Institute of Technology has developed a 3cm capsule which could carry similar levels of insulin as a standard injection. The results of the study suggest the pill is capable of reaching the small intestine intact, and that it can deliver insulin through the gut wall. Unlike many other medicines already available as pills, insulin is a protein and is broken down in the stomach before it can get to work. This raises difficulties in developing a pill capable of surviving in the acidic environment of the stomach and only releasing the insulin once it reaches the intestines. The research team has developed a special coating which allows the pill to withstand stomach acid and then disperse the insulin upon reaching the small intestine. The capsule achieves this by having a set of tiny arms that have 1 mm microneedles on them. In the small intestine, the arms unfold, and the needles penetrate through the surface of the wall of the small intestine and deliver the dose of insulin. The microneedles dissolve and the rest of the capsule passes out of the body as waste. However, further work will be required on the timing of the insulin release. The pill's arrival in the intestine depends on how quickly a person digests their food, making it difficult to gauge the correct dose around mealtimes. The capsule has so far been tested on pigs and the researchers found that the speed of action of the insulin was quicker via the capsule than it was for conventional subcutaneous (beneath the skin) injections of insulin. Prof Robert Langer, one of the authors of the research, stated that by fine-tuning how long the pill takes to open in the intestine, the team could start to tailor the time span of insulin delivery. He added: "We are really pleased with the latest results of the new oral delivery device our lab members have developed with our collaborators, and we look forward to hopefully seeing it help people with diabetes and others in the future." Karen Addington, UK Chief Executive of type 1 diabetes charity, JDRF, said: "Adults and children diagnosed with type 1 diabetes must take insulin every day, simply to stay alive. Being able to take this insulin orally, rather than via injections or a pump, could make life significantly easier. We await the next stages of this particular research with interest." The study is published in the Nature Medicine journal. Photo: Felice Frankel / Massachusetts Institute of Technology

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  2. ickihun

    ickihun Type 2 · Master

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    It's amazing what science and technology can do now.
    I'm wondering what kind of insulin it was.
     
  3. Tipetoo

    Tipetoo Type 2 · Expert

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    Most probably porcine insulin... [​IMG]
     
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  4. NicoleC1971

    NicoleC1971 Type 1 · Well-Known Member

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    Not particularly excited by this as I already have pain free delivery of insulin via my pump and never minded jabs in any case. People who don't have to inject to live seem to think that this is the worst thing about having insulin dependent diabetes. It is not.
    If the tablet allows for more rapid action of insulin i.e. from the moment digestion begins in the mouth then that would avoid the timing issue.
    More interested in the work going on in Galway re the gel capsule with beta cells within that replicate actual beta cells!
     
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  5. Diakat

    Diakat Type 1 · Moderator
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    Surely if you have to wait until it reaches the lower intestine it’ll be a later release than the food?
     
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  6. ickihun

    ickihun Type 2 · Master

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    Well I mean. Basal or bolus or both but everyone's needs of those measures are different per food and their body weight and any other medical conditions. Oh not forgetting stress.
    I just wonder how a set measure is so clever?
     
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  7. Brunneria

    Brunneria Other · Moderator
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    High protein might take 3+ hours in the stomach before moving on to the small intestine, whereas fruit or fruit juice may spend very little time in the stomach at all, and would hit the small intestine very quickly...

    How on earth can they predict how long it takes for the pill coating to dissolve enough for the 'micro needles' to be exposed.

    And does anyone like the idea of those micro-needles scratching and scraping the inside of their intestine on a meal-by-meal basis for months and years?

    One potential advantage that I CAN see, is that if the coating of the pill actually dissolves at the same time as a mixed meal is digested, then the insulin could hit at the same speed that the glucose does for people with gastropareisis. That could be an absolute game changer for them.
     
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  8. Tophat1900

    Tophat1900 Type 3c · Well-Known Member

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    I guess you wouldn't want to accidentally get it mixed up with other pills one might be taking.
     
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  9. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    Interesting, but I can't see how the capsule will be able to deliver a very small amount, as I can sometimes just take 0.5 insulin for breakfast. or for that matter, the right dose for the amount of carbs, plus fats/protein too. I hope one day, a break through in the developing of a less intrusive way of delivering Insulin will happen, but I can't see it happening in my lifetime, because if I had a choice, I would much rather take a pill any day, than injections.
     
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  10. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    I was thinking similar. Seems like something that could be potentially very dangerous in pill form.
     
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  11. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    I have made a mistake taking the wrong Insulin ( others have too) so it's not just in pill form that could be dangerous. Looking at the pill, I can't see me mixing this up with other's !!
    This is what it's may look like, but still early days.
    Also, it may be difficult for children to take.
    [​IMG]



    [​IMG]
    Could this insulin pill replace injections for people with type 1 diabetes?
     
  12. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    That goes without saying, but it just seems to me that there's maybe a bit more scope for error in accidentally swallowing a pill that may kill you. Taking insulin is a dangerous business, and popping a pill is a lot easier than having to think about injections. It wouldn't necessarily be a show-stopper, of course, but I reckon it would definitely be an extra safety concern.
     
  13. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    We, as humans make many mistakes in life and with all types of medication, but looking at this pill ( I did upload an image) it is certainly very different looking.
     
  14. Tophat1900

    Tophat1900 Type 3c · Well-Known Member

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    It would certainly have to be very identifiable. I can't say I have ever taken the wrong insulin by mistake as the two I use are very different looking and very different coloured pens. I'm hoping that doesn't change now that I have said that....lol

    I also wouldn't want to drop a pill with my dog hanging around, but who knows what the pill would look like if it makes it to market. So, can't really know what it might end up looking like at this point or perhaps the image you posted is how it might look.

    I just can't see a use for it myself, taking such small amounts of insulin seems easier then having to find the right dosage by pill form, but things may well change in the future. Who knows.
     
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  15. Robinredbreast

    Robinredbreast Type 1 · Oracle

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    My two pens are different looking too, it's just one of those things that happen. The pill image is from the Newsbot post and it certainly looks quite futuristic in appearance.

    Yes, who knows what the future may bring, but I wont be pinning my hopes on it.
    Edited
     
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  16. Dark Horse

    Dark Horse · Well-Known Member

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    The cells lining the gut are renewed every few days. The old cells are sloughed off and pass out of the body in faeces. https://en.wikipedia.org/wiki/Intestinal_epithelium
     
  17. Brunneria

    Brunneria Other · Moderator
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    Yes. My understanding is that cell turnover is around 3-5 days.
    So (assuming 3 meals a day, for 4 days, and the capsule(s) being taken for each meal), that is 12 scrapes in per cell lifespan. Plus basal, if that were delivered by capsule.

    I’m speaking as someone with a history of a dodgy, super sensitive gut and longterm inflammation, so I’m probably a bit more cautious about this idea than someone with a more cast iron digestive tract.
     
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  18. Jim Lahey

    Jim Lahey I reversed my Type 2 · Well-Known Member

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    I had similar thoughts. If these things are getting insulin into the bloodstream by penetrating the gut lining then one has to wonder what else will get through that is not supposed to :nailbiting:
     
  19. Jaylee

    Jaylee Type 1 · Moderator
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    An interesting concept I heard of years ago... The stomach acid has been the issue to overcome.
    I think the original idea was some sort of digestible capsule?

    There have been other ideas regarding tech pumping insulin at a site in the small intestine too?

    Bearing in mind where the pancreas is connected. The duodenum? I suppose it makes sense to have some sort of insulin delivery in that area, where there is none produced.

    I'm also wondering if a different method of absorption might lower the amount of insulin needed without altering diet..?
    But then I'm also thinking about "sick days" & fasting.. Maybe an aborted meal?

    If the pill works? I can almost see the days of regimented meals & snacking return...
     
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  20. LittleGreyCat

    LittleGreyCat Type 2 · Well-Known Member

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    I immediately had the mental image of a diabetic ready meal with built in insulin dose.

    Total fantasy, of course, but that would be interesting technology!
     
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