Tweet Oral insulin is a reality: it is simply a matter of when. The realisation that insulin injections are going to have to become a part of everyday life can be extremely harrowing for many diabetics. Injection takes time, interrupts daily schedules and is considered unpleasant by many people. Children or adolescents who require daily insulin injections may find that the regimen impacts on their daily lifestyle to an even greater degree. Using insulin therapeutically is not a new practice at all, but delivery methods to make the process more bearable have not gained widespread prominence as of yet. Obviously, the priority in delivering insulin to a patient is to make sure it reaches the bloodstream intact. Alternative insulin delivery methods Many alternative delivery systems, although they work to some extent, leave the insulin broken down by digestive juices, usually too much for it to be of significant use to the body. Furthermore, the complicated environment within the stomach means that simple tablets would be unpredictable and ineffective. The solution will come, and may have already, when a pharmaceutical research company creates a tablet in which insulin can be enclosed and yet still pass through the stomach wall. Nose, mouth and lungs Three principal target areas are obvious in developing alternative insulin delivery systems: Nose Mouth Lungs Nasal delivery issues Nasal delivery into the upper airway presents severe problems, primarily that the transport system is too convoluted and would require massive, expensive quantities of insulin to reach the target area. Insulin delivery via the lungs Insulin into the lungs is a promising area: the insulin can be directly absorbed into the bloodstream through the thin walls of the lung. Insulin via the mouth Effective Continue reading >>
Life-threatening Hypoglycemia Associated With Intentional Insulin Ingestion.
Abstract There are reports of insulin overdose by injection, yet little is known regarding the potential harms of intentional oral ingestion of insulin. In this report, we describe a case of massive insulin ingestion and ensuing hypoglycemia. To our knowledge, there are no previously published cases of hypoglycemia caused by intentional insulin ingestion. A 51-year-old man intentionally ingested three 10-ml vials (total of 3000 units) of various insulins: one vial each of insulin aspart, lispro, and glargine. Four symptomatic hypoglycemic episodes, with blood glucose levels of 48, 25, 34, and 40 mg/dl, occurred approximately 1, 3, 4, and 5 hours, respectively, after ingestion. The hypoglycemia could not be explained other than the ingestion of the insulins. The patient was admitted for observation, and euglycemia occurred within 24 hours without any additional hypoglycemic episodes. Hypoglycemia treatment is reviewed in this case report, and factors that may affect systemic response of orally ingested insulin, including gastrointestinal absorption and insulin sensitivity, are discussed. In addition, the findings of our case report may provide useful insight into the development of novel oral insulin products that are currently in research. Despite poor bioavailability (1%) when taken orally, insulin may produce symptomatic hypoglycemia with a massive ingestion. Vigilant blood glucose monitoring, supportive care with glucose replacement therapy, and admission to the hospital for observation may be required. Continue reading >>
Why Is Insulin Injected Instead Of Taken By Mouth?
Insulin cannot be taken orally because it would break down in the digestive process. Insulin is a poly-peptide protein, which can be broken down by enzymes in the digestive system. By the time it reaches the small intestine, where it is absorbed, it is only a single peptide and can no longer function as insulin. Besides the chemical reasons for not ingesting insulin, there are other reasons that have more to do with the management of diabetes. Why Injection Is Better Blood sugar levels are subject to great change throughout the day. What foods were consumed, exercise, stress, illness, even time of day – all of these impact glucose levels. If this were not so, there would be no need to monitor levels with a finger prick multiple times each day. Insulin is needed to ensure that glucose is properly utilized and that levels of glucose remain stable. In order to work properly, insulin must enter the bloodstream intact. By injecting it into the subcutaneous tissue in our bodies, it is designed to be absorbed into the bloodstream without changing its properties and within a proscribed amount of time. Insulin should not be injected directly into muscle or into the bloodstream, as both will increase the speed of absorption. How fast absorption happens is also a function of what type of insulin is being used: rapid-acting, short-acting, intermediate-acting, long-acting or a mix of some of these. Each is designed to be absorbed and active over certain time frames, in order to cope with different glucose control needs, like consuming a meal or sleeping all night. Possible New Alternatives There is active research to develop alternatives to injections. One of the most promising is inhaled insulin. There was an inhaled insulin product, Exubera, on the market for about a year betwee Continue reading >>
Insulin Mouth Spray Works Fast, Study Shows
Insulin Mouth Spray Works Fast, Study Shows Insulin Product Sprayed Inside Cheek, Still Awaits Approval June 16, 2005 -- An insulin mouth spray works faster and seems to be just as effective as insulin injections, a new study shows. The insulin mouth spray is a product called Oral-lyn from Generex Biotechnology in Toronto. A small Generex-funded study in Israel indicates that Oral-lyn might make life easier for some people with type 1 and type 2 diabetes that need insulin. The study shows that the insulin mouth spray works faster than insulin injections, says Gerald Bernstein, MD, Generex vice president for medical affairs. Bernstein is a past president of the American Diabetes Association. "The beauty of it is, it can be taken just before you eat and just after you eat," Bernstein tells WebMD. "This is a very fast insulin. It is regular insulin, which ordinarily is slow, but when sprayed into the mouth, it gets into the bloodstream very quickly." When a healthy person eats a meal, blood sugar levels go above normal. This triggers the release of a hormone -- insulin -- which brings blood sugar levels back down again. This crucial mechanism is missing in people with type 1 diabetes and doesn't work well in people with type 2 diabetes . Self-administered insulin injections offer control over spiking blood sugar. But it's tricky. The insulin injection has to be taken ahead of mealtime. And because insulin levels don't go down as soon as blood sugar is under control, a person may have to snack to avoid a blood -sugar crash. And there's another issue. Many people, especially children with type 1 diabetes , dread having to take frequent insulin shots. That's why Generex -- and many other drug companies -- are working on different ways to deliver insulin. Other companies are Continue reading >>
Am I Tasting The Insulin In My Mouth Or Is It My... | Diabetic Connect
Am I tasting the insulin in my mouth? Or is it my imagination? By nzingha Latest Reply2011-10-11 21:54:54 -0500 I swear there is this slightly slimy slippery kinna taste in my mouth that I am suspecting must be the insulin which my body continues to fight. and at nights I get this very dry mouth I have to get up and drink water. I am having all these weird sensations and changes to my body. My eyes burn me sometimes in the morning, they have the glassy, glazed look and sometimes they burn and run water, my mouth is dry at nights, plus what I just described and I swear I am beginning to get paler in colour. My face looks puffy sometimes.. and I swear its the insulin thats causing all these weird symptoms/ changes .even my nails seem to be changing colour.. getting darker. My doc says I am in denial that I need insulin and she keeps telling me that without it I would not be alive! But its not ME who doesnt like the drugit's MY BODY! I can actually feel it when I inject it feel it as my legs and arms seem to not want it to penetrate their cells it's like it has a mind of its own and its fighting the insulin to stay out.. am I going loco or something.? I am not imagining these things.. they are for real!l Continue reading >>
Can You Ever Stop Insulin?
Once you begin using insulin to treat type 2 diabetes, can you ever get off it and go back to medications? — Anne, Minnesota For someone to go back to oral diabetes medicines after starting insulin, the pancreas must be able to produce enough insulin to maintain normal sugar levels. That being said, there are several instances in which insulin injections may be stopped. Here are a few: 1. In some individuals who have had untreated or poorly controlled diabetes for several weeks to months, glucose levels are high enough to be directly toxic to the pancreas. This means that the pancreas has not completely lost its ability to produce the critical level of insulin, but it does not work properly as a result of high glucose levels. In this instance, injected insulin can be used for several days or weeks to reduce glucose and help the pancreas to revert back to its usual level of functioning — a level that can control glucose supported by oral medicines. Once this occurs, insulin can be stopped. Remember, oral diabetes medicines work well only if the pancreas can still produce and release insulin. 2. Sometimes insulin is given during an acute illness such as an infection, when glucose levels can be high and the demand for insulin is greater than the pancreas can handle. After the illness is treated adequately, oral medicines can be started again. 3. Many obese individuals with diabetes who require insulin can reduce their dose or control their diabetes by taking oral medicines if they lose weight. However, the choice of insulin to manage diabetes does not always come after exhausting all oral or non-insulin options. Insulin has several advantages and is now more frequently introduced early in the management of type 2 diabetes. Continue reading >>
Understanding Oral Diabetes Medications
by Gail Brashers-Krug Today, almost 21 million Americans have diabetes, and more than 90 percent of those have type 2, or insulin resistant diabetes. Doctors often prescribe oral medications to treat type 2 diabetes, either alone or combination with insulin therapy. This article provides a guide to those oral medications. Which Diabetics Use Pills? With a few exceptions, diabetes comes in two types. Type 1 diabetes occurs when the body does not produce enough insulin on its own. To treat type 1, you must restore the proper amount of insulin—either by taking insulin (through injection or inhalation), or by receiving a transplant, either of an entire pancreas or of specialized pancreas cells, called islet cells. Type 1 cannot be treated with oral medications. Type 2 diabetes occurs when the body produces enough insulin, but gradually becomes insulin resistant—that is, loses the ability to process insulin. Type 2 is usually controlled first through diet and exercise, which improve your body’s ability to process its insulin. For most type 2 diabetics, however, diet and exercise changes are not enough. The next step is oral diabetes medication. Moreover, most type 2 diabetics eventually stop producing enough insulin, and often cease insulin production altogether. As a result, many type 2 diabetics will ultimately need insulin therapy in combination with their pills. How Do the Different Pills Work? Oral diabetes medications attack the problem in three ways. More insulin: Some pills stimulate your pancreas to produce more insulin. The first successful “diabetes pills” were the sulfonylureas (glyburide, glipizide, glimepiride, tolazamide, chlorpropamide, and tolbutamide). These are insulin secretagogues, that is, chemicals that cause your pancreas to produce more ins Continue reading >>
12 Myths About Insulin And Type 2 Diabetes
Insulin facts vs. fiction When you hear the word “insulin,” do you picture giant needles (ouch!) or pop culture portrayals of insulin users with low blood sugar (like Julia Roberts losing it in Steel Magnolias)? Either way, most people think of insulin as a difficult, painful, or potentially scary medical treatment. The problem is that if you have type 2 diabetes, you need to know the real deal before you can make an informed choice about whether or not this potentially lifesaving therapy is right for you. Here, we take a look at the facts and fiction about insulin when it comes to treating type 2 diabetes. Diabetics always need insulin Not necessarily. People with type 1 diabetes (about 5% to 10% of diabetics) do need insulin. If you have type 2, which includes 90% to 95% of all people with diabetes, you may not need insulin. Of adults with diabetes, only 14% use insulin, 13% use insulin and oral medication, 57% take oral medication only, and 16% control blood sugar with diet and exercise alone, according to the CDC. The point is to get blood sugar—which can be a highly toxic poison in the body—into the safe zone by any means necessary. Taking insulin means you’ve ‘failed’ “This is a big myth,” says Jill Crandall, MD, professor of clinical medicine and director of the diabetes clinical trial unit at the Albert Einstein College of Medicine, in the Bronx, N.Y. “Many people who try very hard to adhere to a diet, exercise, and lose weight will still need insulin.” The fact is that type 2 diabetes is a progressive illness, meaning that over time you may need to change what you do to make sure your blood sugar is in a healthy range. Eating right and exercise will always be important, but medication needs can vary. “A large percentage of people with ty Continue reading >>
What Is Insulin And Why Does It Need To Be Injected?
Dear Diabetes Educator, My name is Lori and my doctor told me I have diabetes and need to take insulin. I don’t understand what insulin is and why I need to use a needle to inject it. I would like to take an insulin pill instead. Please explain this to me. Dear Lori, Thank you for your question. Insulin is a hormone made in the beta cells of the islets of Langerhans which is located in the pancreas. When you eat, the fats proteins and carbohydrates in our food is broken down to be used by our body. These substances are called macronutrients and are needed for growth and maintenance. The carbohydrates in our food are broken down to glucose as part of the digestion process. Glucose travels through the bloodstream to the cells in our body to be used as energy. To enter most cells, insulin is needed. Without insulin, glucose builds up in the bloodstream. When the body cannot make insulin or make enough insulin, it must be taken through injection. Pills that are used to help control diabetes are not insulin. These pills are to help the body use the insulin it already makes. The hormone insulin is made up of proteins that if taken by mouth is denatured by the digestive process. This would inactivate the insulin. Therefore, when the body can’t make insulin, it can’t be taken in pill form and at this time must be injected. *Please ask your physician and medical team for guidance in understanding the types of insulin you need and when and how much to take. You should also learn how to properly inject your insulin. Ask your doctor if you can see a diabetes educator to learn all about insulin and other aspects of taking care of your diabetes. Continue reading >>
What is this stuff I have to take? Is it a drug? Will it make me better, so I don't have to take it anymore? What does it do? Why can't I just drink it, or take a big shot once a month? And why are there so many different types? Will there ever be something better? Insulin is a hormone, normally produced in sufficient amounts by the healthy human pancreas. Its role is to facilitate the final digestion of glucose by the human body. When insulin is lacking (diabetes), glucose remains undigested in the blood. The body isn't being fed, and the high blood sugar can cause damage, the ramifications of diabetes. The two major types of diabetes (type 1 and type 2, IDDM and NIDDM) are separated by presence of insulin. The pancreas of the type 1 diabetic has ceased producing insulin, and insulin must be injected. This injected insulin is a replacement, and, barring the transplantation of a healthy pancreas, will need to be continued for life. The type 2 (NIDDM) diabetic has an impaired insulin supply. He or she doesn't have enough, or has some difficulty assimilating it (insulin resistance), or both. Lifestyle and diet changes, and oral medications, some of which stimulate the failing pancreas to produce more insulin, are used in treatment. Many veteran type 2 diabetics find their insulin supply, already impaired, has lessened to the point where they need to inject insulin. Insulin cannot be taken by mouth because it is digestible. Oral insulin would be obliterated in the stomach, long before it reached the bloodstream where it is needed. Once injected, it starts to work and is used up in a matter of hours. Depending on a number of factors, individuals vary insulin volume, type, and frequency, to optimize blood glucose management. That there are so many different formulations of i Continue reading >>
Insulin Usually Better Than Oral Drugs For Type 2 Diabetes
According to a study published in , the combination of insulin and metformin may not benefit individuals with type 2 diabetes. Although the combination results in less weight gain, improved blood glucose control and less need for insulin, the researchers state that further research is required in order to provide solid evidence regarding the benefits and harms, as well as the risks of premature death. The study was conducted by researchers from the Copenhagen Trial Unit, Steno Hospital and the Copenhagen University Hospital. At present, guidelines recommend metformin, an oral blood glucose reducing medication, for type 2 diabetics starting insulin treatment. The researchers examined 2,217 individuals aged 18+ with type 2 diabetes. Among the trials examined, the team found insufficient reports of important patient outcomes, such as total mortality and death from heart disease. According to 20 trials, levels of HbA1c (a measure of average blood glucose levels over time) were reduced when insulin and metformin was taken together. Furthermore, the researchers found that the combination of drugs considerably reduced weight gain and body mass index (BMI) by an average of 1.6 kg. The researchers state that additional studies are required in order to research the long term benefits and harms of the combination, as it increases the risk of severe hypoglycaemic attack. In this week's BMJ podcast, Trish Groves, the deputy editor of BMJ, talks to lead author Bianca Hemmingsen about how this study was able to draw on more data than prior studies, and how the researchers examined major complications and mortality instead of surrogate outcomes, such as blood sugar levels and weight. In addition, Dr. Hemmingsen highlights the insufficient evidence for determining if the combination or Continue reading >>
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Could Oral Insulin Be An Option Some Day?
Type 1 diabetes and many cases of type 2 diabetes are treated with insulin injections. For decades, these injections have been the only way to deliver insulin. You might wonder, why hasn’t an easier way to give insulin been developed? The truth is, for more than 80 years, people have been trying to develop a form of insulin you can swallow. Pharmaceutical companies, government agencies, and universities have done extensive research in hopes of developing this “holy grail” of diabetes treatment. Where do we stand in the process? If you have any type of diabetes, keeping your blood sugar levels within your target range is vital. Not doing so raises your risk of serious health problems such as blindness, heart disease, kidney disease, and nerve damage. To keep your blood sugar levels in a safe range, you have to follow your diabetes treatment plan. For many people with diabetes, this involves insulin injections. These injections can be inconvenient, they require training to self-administer, and they may need to be given several times per day. And, of course, they involve needles, which many people don’t like. For all of these reasons, many people don’t follow their diabetes treatment plan, which can lead to severe complications. So, the idea that you could get your dose of insulin by simply swallowing a pill appeals to many people. Doctors believe that the ease of using a pill could make more people willing to start and maintain a successful insulin therapy routine. That could lead to better control of their diabetes. With injectable insulin, you use a needle to inject the insulin into the fatty tissue beneath your skin. From there, the insulin travels to your bloodstream. It goes into general circulation throughout your body and then travels to your liver. Oral Continue reading >>
Why do I need to take insulin? When you digest food, your body changes most of the food you eat into glucose (a form of sugar). Insulin allows this glucose to enter all the cells of your body and be used as energy. When you have diabetes, your body doesn’t make enough insulin or can’t use it properly, so the glucose builds up in your blood instead of moving into the cells. Too much glucose in the blood can lead to serious health problems. All people who have type 1 diabetes and some people who have type 2 diabetes need to take insulin to help control their blood sugar levels. The goal of taking insulin is to keep your blood sugar level in a normal range as much as possible so you’ll stay healthy. Insulin can’t be taken by mouth. It is usually taken with injections (shots). It can also be taken with an insulin pen or an insulin pump. How often will I need to take insulin? You and your doctor will develop a schedule that is right for you. Most people who have diabetes and take insulin need at least 2 insulin shots a day for good blood sugar control. Some people need 3 or 4 shots a day. Do I need to monitor my blood sugar level? Yes. Monitoring and controlling your blood sugar is key to preventing the complications of diabetes. If you don’t already monitor your blood sugar level, you will need to learn how. Checking your blood sugar involves pricking your finger to get a small drop of blood that you put on a test strip. You can read the results yourself or insert the strip into a machine called an electronic glucose meter. The results will tell you whether or not your blood sugar is in a healthy range. Your doctor will give you additional information about monitoring your blood sugar. When should I take insulin? You and your doctor should discuss when and how you Continue reading >>
Why Is Insulin Injected, Instead Of Taken By Mouth?
Insulin is a peptide hormone, meaning it is essentially a protein. If you were to take it orally, your stomach enzymes would break it down into amino acids, causing it to lose its functional capacity. This is the reason it is injected, so that it directly enters the blood stream, thus bypassing the stomach and the entire gastrointestinal tract, thereby avoiding digestion by enzymes. It is noteworthy however, that since injectable insulin is inconvenient for the patients, oral preparations of insulin are currently under development and trial. Continue reading >>
Diabetes Medication Misconceptions
If you or a loved one has recently been diagnosed with type 1 or type 2 diabetes, you may have some questions about how the diseases are treated. There are many misconceptions about diabetes medications, mainly because the treatment for type 1 and type 2 diabetes can be very different. One of the most pervasive myths about diabetes--both forms of it--is that the disease can be treated by simply refining your diet or exercising more. While this is certainly an option for some people with type 2 diabetes, it is absolutely untrue for people with type 1. Type 1 diabetes is an auto-immune disease that occurs when the body’s disease fighting system, the immune system, destroys all your body's insulin-producing cells. Insulin is a vital agent that your body needs to convert food into energy. If your body is not producing insulin, you must take it by injection or a pump to live. Insulin currently cannot be taken by mouth because the digestive juices in your stomach and intestine will break down the insulin before it has a chance to get into your bloodstream to do its job. If you have type 2 diabetes, you may or may not have to take insulin injections, depending on a variety of factors. Contrary to popular belief, insulin injections are not for people with diabetes who have been "bad"—instead, taking insulin is a reflection of insulin production by the pancreas. People diagnosed with type 2 diabetes in general are still producing some insulin, although the amount they produce is not enough for their needs. Their cells may also be resistant to the effects of insulin, which makes them require more insulin than a person who does not have diabetes. Frequently when type 2 diabetes is diagnosed, weight loss, exercise, and changes in how much you eat can bring blood glucose levels Continue reading >>