Jewels Doskicz is a registered nurse, freelance writer, patient advocate, health coach, and long-distance cyclist. Jewels is the moderator of Diabetic Connect’s weekly #DCDE Twitter chat, and she and her daughter both live healthfully with type 1 diabetes.
Trading syringes for pills sounds dreamy in theory, but will it ever come to fruition? With due thanks to research, swallowing insulin may not be too far in our future.
What is insulin?
Insulin is a hormone that opens channels between the bloodstream and the body's cells so sugars can be used for energy. With diabetes, medications can stimulate insulin production or it's taken through a syringe when the pancreas is no longer producing effective amounts of it.
How does an insulin pill work?
The pill or capsule would be swallowed and make its way through the digestive tract where it would then be disseminated into the blood stream and lower glucose levels. It turns out that the packaging is quite important or the stomach will destroy it along the way.
According to Fast Company, Novo Nordisk and Oramed (the underdog) are in a heated marketplace racing against one another to the FDA's finish line.
Benefits of oral insulin
The potential benefits of taking insulin by mouth are many—namely the simple act of insulin actually being taken. When medications can be taken easily and without any degree of pain it usually happens with regularity—improving disease management.
Complications of insulin taken by mouth vs. syringe
According to Reuters: This project has been around since the 30s and was "left for dead because as a protein composed of amino acids, insulin is destroyed by enzymes in the digestive system before it can do any good."
My skeptic nursing mind is immediately drawn to another aspect—the varying degrees of digestion we all possess. Many people with diabetes have something called gastroparesis which impacts the rate in which our guts process what we consume. This is a yet another disabling form of neuropathy.
Medications obviously stick around much longer with slowed gastric motility. Others may suffer autoimmune diseases that increase gastric emptying such as crohn's disease or colitis. Oral insulin may not be a good recommendation for a certain subset of diabetics for this reason.
Unpredictability of action could pose unforeseen problems not to mention the incredibly acidic environment insulin will have to fend itself against.
Will we see it in our lifetime?
According to Reuters, we may see oral insulin hit pharmacies "by the end of this decade."
I certainly hope we do. With success in producing oral insulin, the focus has shifted to safety protocols and possible side effects. Big players sniffing out the value in oral insulin are opening their checkbooks and investing in the future of diabetes management.
This treatment is not surprisingly heralded as a multi-billion dollar product.
Oral insulin is now viewed as a feasible option for diabetics and with the growth in this sector these diabetes giants would be silly not to hop on board and steer this ship straight to the pharmacy.