‘Exciting results’ as new tablet offers oral alternative to insulin injections

Researchers have developed an insulin tablet that may be just as effective as taking the hormone via an injection.
Previous tablets lose some of their ability to lower blood glucose as they travel through the digestive system, often accumulating in the stomach.
The new pill is absorbed into the liver after 30 minutes and lasts up to four hours.

Scientists from the University of British Columbia, Canada, have discovered that insulin from their latest iteration of oral tablets is absorbed as effectively as the injected form of the hormone.

People with type 1 diabetes are insulin-dependent, meaning they can no longer produce the hormone insulin. Due to this, they often have to take multiple insulin injections daily to regulate their blood sugar levels. These injections are often described as causing some discomfort or pain.

Sometimes, a person with type 2 diabetes may also have to take insulin injections, particularly if they have high blood sugar levels.

“These exciting results show that we are on the right track in developing an insulin formulation that will no longer need to be injected before every meal, improving the quality of life, as well as mental health, of more than nine million Type 1 diabetics around the world.” said professor Dr Anubhav Pratap-Singh, the principal investigator from the Faculty of Land and Food Systems.

Inspired by his father’s experience of living with diabetes, requiring injections up to 3-4 times a day, Dr Pratap-Singh sought to develop a non-injectable insulin solution.

While the tablets have only been tested on rats so far, it could mean a non-injectable version of insulin could be available for human use in the future.

Although most oral insulin tablets currently being developed typically release insulin slowly over a period of two to four hours, rapid-acting insulin injections can fully release the hormone in as little as 30 to 120 minutes.

Previous oral solutions take longer to be absorbed, with most of the insulin dose settling in the stomach rather than reaching its intended destination in a person’s liver.

Insulin is produced in the pancreas, it is then utilised in the liver to aid in regulating blood sugar or glucose.

The team wanted to see how they could increase the absorption rate of oral insulin tablets, so they created a pill that isn’t swallowed but dissolves when placed between the gum and cheek.

“For injected insulin we usually need 100iu per shot. Other swallowed tablets being developed that go to the stomach might need 500iu of insulin, which is mostly wasted, and that’s a major problem we have been trying to work around,” said Yigong Guo, first author of the study and a PhD candidate working closely on the project.

The researchers employed a new method using the buccal mucosa (a thin membrane within the lining of the inner cheek and back of the lips), to help deliver insulin straight to the liver without losing any of the dose.

“Even after two hours of delivery, we did not find any insulin in the stomachs of the rats we tested. It was all in the liver and this is the ideal target for insulin — it’s really what we wanted to see,” Yigong added.

Dr Pratap-Singh hopes that the study could move on to human trials given more time and funding. Alongside improving the quality of life of people with diabetes, he believes the tablets his team are developing could be more sustainable, cost-effective and accessible.

“That is a lot of environmental waste from the needles and plastic from the syringe that might not be recycled and go to landfill, which wouldn’t be a problem with an oral tablet,” Dr Pratap-Singh concluded.

This study was initially published in Scientific Reports.