Insulin pill shows early promise as a novel form of diabetes therapy

Diabetes patients may soon benefit from a novel insulin pill that gives them another blood sugar management option, says a team of U.S. researchers.

While a number of individuals suffering from diabetes are required to have regular insulin shots, the discomfort of injections can pose a huge barrier to their compliance, according to researchers from the University of California Santa Barbara. This could reportedly lead to mismanagement of treatment and complications and even hospitalisation.

According to the researchers, the pill could circumvent the uneasiness associated with the needle while potentially providing a more effective dose.

“When you deliver insulin by injection, it goes first through the peripheral bloodstream and then to blood circulation in the liver,” explained Samir Mitragotri, a professor in the Department of Chemical Engineering who specialises in targeted drug delivery. Oral delivery would take a more direct route as well as a better option from a physiological point of view, he added.

While oral medications to assist the body with insulin production have been around for a while, a pill that delivers insulin remains a highly sought goal of diabetes medicine. Researchers who have previously attempted to develop the medication were challenged in getting it past the hostile proteolytic environment of the stomach and intestine without destroying the protein itself.

Amrita Banerjee, a postdoctoral researcher in the Mitragotri Lab, has cracked the code with a combination of enteric-coated capsules and insulin-loaded mucoadhesive polymer patches.

The new pill, according to the team, has demonstrated its ability to survive stomach acids with the protection of the enteric-coated capsule and deliver its payload to the small intestine. The capsule then opens up to release the patches that adhere to the intestinal wall, preventing access of proteolytic enzymes to insulin and, with the aid of a permeation enhancer, depositing insulin that can pass through to the blood.

This is the first essential step in proving that the patches can deliver insulin, Mitragotri said. However, like any other novel therapy, it must undergo additional stages of testing and improvement before it can be considered a viable treatment for diabetes, the team cautioned.

In addition to offering a new approach to insulin delivery, the drug-loaded mucoadhesive patches show early promise for other forms of therapy as well, according to the researchers.

Using the method, many proteins that are currently injected can be delivered orally, Mitragotri said. Other protein-based therapies such as growth hormones, antibodies and vaccines could potentially be put into patch form for painless delivery and improved patient compliance, he added.

According to Diabetes Australia, diabetes is the epidemic of the 21st century and the biggest challenge confronting the country’s health system. There are approximately 1.7 million Australians suffering from the condition, and about 280 individuals develop diabetes every day. The total annual cost impact of diabetes in Australia is estimated at $14.6 billion.

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