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How Can You Take Insulin Orally?

Could Oral Insulin Be An Option Some Day?

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 >>

Inhaled Insulin

Inhaled Insulin

Researchers, doctors, and people with diabetes agree that injected insulin works well to manage the disease. They'll probably also say that getting insulin into your body through something other than a needle would be even better. You can't get insulin in a pill, but how about breathing it in? The idea of inhaling insulin has been around for decades. It wasn't until the 1990s that researchers made it possible. With an inhaler much like the ones people with asthma use, you breathe a fine insulin powder into your lungs. There, it enters your blood through tiny blood vessels. In June 2014, the FDA approved Afrezza. It's an inhaler with pre-measured, rapid-acting insulin you use before meals. It's not for diabetes emergencies such as diabetic ketoacidosis (DKA). Common side effects of inhaled insulin are low blood sugar, a cough, and a scratchy or sore throat. If you have type 1 diabetes, you'll still need to take long-acting insulin, too, to help control your blood sugar. If you smoke or you have a lung disease, such as asthma or COPD, you shouldn't use inhaled insulin. The FDA approved the first inhaled insulin, Exubera, in September 2006. People who had type 1 or type 2 diabetes could use it. But the drug's maker took it off the market in October 2007, because it didn't seem to catch on with patients. People thought the inhaler was too big and clunky. (The Afrezza inhaler is much smaller.) Later, the FDA was concerned that Exubera might cause lung problems including cancer. Continue reading >>

Oral Insulin

Oral Insulin

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 >>

Diabetes Medication Misconceptions

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 >>

What Is Insulin And Why Does It Need To Be Injected?

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 >>

Oral Insulin In Diabetic Dogs.

Oral Insulin In Diabetic Dogs.

Abstract Bovine crystalline insulin, mixed with an absorption enhancer, was loaded by hand into gelatin capsules, which were then coated with an azopolymer designed to deliver the insulin in the upper colon. In 34 experiments with 14 pancreatectomized mongrel dogs of both sexes, the coated capsules were administered orally after a pre-dose period of 1 h. The dogs had cannulae in the portal vein, hepatic vein and femoral artery and Doppler flow probes on the portal vein and hepatic artery. Insulin and food were withdrawn the day before an experiment. Responses measured were plasma glucose, plasma insulin, hepatic glucose production rate, hepatic plasma flow rate and plasma glucagon-like immunoactivity (GLI). Control experiments, with capsules without insulin, produced small changes from 'pre-dose' values. Insulin-containing capsules, without the azopolymer coating, resulted in some early changes consistent with upper gastrointestinal absorption. Single oral doses (66 to 400 nmol/kg) of insulin in completely coated capsules produced peaks of portal plasma insulin and transient decreases in plasma glucose, hepatic glucose production, hepatic plasma flow and plasma GLI. The changes usually began 1.5-2 h after administration of a single dose, and lasted for up to 3 h, but were not significantly related to the dose of insulin. Multiple oral doses of insulin, given at 1.5-h intervals, resulted in multiple peaks of plasma insulin, a continuing dose-dependent fall in plasma glucose to near-euglycaemia with the highest dose, and profound decreases in hepatic glucose production and plasma GLI. These data demonstrate that insulin absorbed from the gastrointestinal tract causes changes in glucose metabolism in the diabetic dog that are consistent with the action of insulin primarily Continue reading >>

Why Is Insulin Injected Instead Of Taken By Mouth?

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 >>

Oral Insulin Delivery: How Far Are We?

Oral Insulin Delivery: How Far Are We?

Go to: Abstract Oral delivery of insulin may significantly improve the quality of life of diabetes patients who routinely receive insulin by the subcutaneous route. In fact, compared with this administration route, oral delivery of insulin in diabetes treatment offers many advantages: higher patient compliance, rapid hepatic insulinization, and avoidance of peripheral hyperinsulinemia and other adverse effects such as possible hypoglycemia and weight gain. However, the oral delivery of insulin remains a challenge because its oral absorption is limited. The main barriers faced by insulin in the gastrointestinal tract are degradation by proteolytic enzymes and lack of transport across the intestinal epithelium. Several strategies to deliver insulin orally have been proposed, but without much clinical or commercial success. Protein encapsulation into nanoparticles is regarded as a promising alternative to administer insulin orally because they have the ability to promote insulin paracellular or transcellular transport across the intestinal mucosa. In this review, different delivery systems intended to increase the oral bioavailability of insulin will be discussed, with a special focus on nanoparticulate carrier systems, as well as the efforts that pharmaceutical companies are making to bring to the market the first oral delivery system of insulin. The toxicological and safety data of delivery systems, the clinical value and progress of oral insulin delivery, and the future prospects in this research field will be also scrutinized. Keywords: clinical trials, diabetes, hypoglycemic effect, insulin, nanoparticles, oral delivery system Continue reading >>

Insulin Treatment Vs. Pills For Diabetes

Insulin Treatment Vs. Pills For Diabetes

Diabetes is a condition whereby your are unable to properly manage your blood sugar levels without intervention. Type 2 diabetes is a condition when your pancreas produces insufficient amounts of insulin or when your body is unable to properly utilize the insulin in your system. About 90 to 95 percent of people diagnosed with diabetes have type 2 diabetes, FamilyDoctor.org notes. Insulin injections and oral diabetic medications can be used to manage and alleviate the symptoms of type 2 diabetes. Video of the Day Insulin injections deliver the hormone insulin into your body. Insulin helps your body metabolize your blood sugar. Insulin may be classified according the length of time it takes to affect your body, the American Diabetes Association explains. Rapid-acting insulin starts affecting your body five minutes after injection and lasts about four hours. Long-acting insulin takes as much as 10 hours to begin affecting you and can remain in your system for about a day. There are six main types of oral diabetes medications, the University of Maryland Medical Center notes. Most of these medications are designed to help increase your natural sensitivity to insulin. Others are designed to reduce your liver's blood sugar production, or inhibit your body's ability to absorb starch. Insulin can induce hypoglycemia, or low blood sugar. You may experience headaches, hunger, irritability and elevated heart rate after taking insulin. You can also experience a skin rash over your body, feel faint and have breathing difficulties after taking insulin. Oral medications such as metformin, GLP-1 inhibitors, medlitinides and alpha-glucosidase inhibitors cause nausea, vomiting and diarrhea, the University of Maryland Medical Center. Thiazolidinediones can cause weight gain, fluid retentio Continue reading >>

New Oral Insulin Pill Can Replace 'painful' Injections

New Oral Insulin Pill Can Replace 'painful' Injections

US scientists have developed an oral method of administering insulin that can be a less painful alternative to millions of people worldwide with diabetes who have to inject themselves with the drug to manage their blood-sugar levels. The team has successfully encapsulated insulin using Cholestosomes-- a neutral, lipid-based particle -- that can be administered orally with tiny vesicles that can deliver insulin where it needs to go without injecting. The biggest obstacle to delivering insulin orally is ushering it through the stomach intact. Proteins such as insulin are no match for the harsh, highly acidic environment of the stomach. They degrade before they get a chance to move into the intestines and then the bloodstream where they're needed, the study said. However, the new vesicles that are made of naturally occurring lipid molecules are normal building blocks of fats, the researchers said, adding that they are unlike other lipid-based drug carriers, called liposomes. "Most liposomes need to be packaged in a polymer coating for protection. Here, we are just using simple lipid esters to make vesicles with the drug molecules inside," said lead researcher Mary McCourt, Professor at Niagara University in New York, US. Computer modelling showed that once the lipids are assembled into spheres, they form neutral particles resistant to attack from stomach acids. Drugs can be loaded inside, and the tiny packages can pass through the stomach without degrading. When cholestosomes reach the intestines, the body recognises them as something to be absorbed. The vesicles pass through the intestines, into the bloodstream, and then cells take them in and break them apart, releasing insulin. Studies with rats showed that certain formulations of cholestosomes loaded with insulin have Continue reading >>

New Method To Take Insulin Orally

New Method To Take Insulin Orally

Diabetes treatment could get a whole lot easier to swallow. Dr. Robert Doyle, assistant professor of chemistry at Syracuse University has designed, tested, reproduced and patented a system for delivering insulin through an oral pill. The system could potentially be used by humans battling diabetes. With Doyle’s method, they could simply swallow a vitamin pill. More than 21 million individuals in the United States have diabetes, yet taking insulin orally has not been possible because it must go through the gastrointestinal tract, which prevents it from reaching the bloodstream. Being able to orally receive insulin would drastically change the lives of diabetics and the scope of the diseases’ treatment, researchers said. The innovation in Doyle’s research is that they have found a way to attach the insulin to vitamin B-12. The vitamin protects the insulin as it journeys through the gastrointestinal tract in a "Trojan horse" strategy. "It’s really like the holy grail of diabetes research…in terms of treatable things," said Tony Vortherms, a graduate student who worked on the project. Now the team will determine whether they can attach more insulin to the vitamin so that it can remain in the bloodstream for 12 hours. The ultimate goal would be for a diabetic to take two insulin pills a day – one in the morning and one at night – which would help them to maintain their metabolic control throughout the day, according to a news release announcing the discovery. "This would be a way to minimize the roller coaster of blood sugar levels the best we can," Vortherms said. "We still have a long way to go." The ultimate question is if and when this strategy can be used in humans. It will probably take at least five years before a pharmaceutical company will take interes Continue reading >>

Insulin Usually Better Than Oral Drugs For Type 2 Diabetes

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 >>

12 Myths About Insulin And Type 2 Diabetes

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 >>

Diabetes Pills

Diabetes Pills

There are several different kinds of diabetes medicines in addition to insulin. These medicines can lower blood sugar levels but they're not the same as insulin. Most of these medicines are available in pill form. Insulin can't be taken as a pill because acids in the stomach destroy it before it can enter the bloodstream. In type 2 diabetes, the body still makes some of its own insulin, but isn't able to make enough to keep up with the body's needs or use its own insulin effectively. Diabetes pills don't replace the body's insulin, but they can help the body make more insulin or help it more effectively use the insulin it does make. Most people who have type 2 diabetes take diabetes pills to help them keep their blood sugar levels closer to normal. People with type 1 diabetes don't use diabetes pills. They need to take insulin shots because their bodies can't make any of their own insulin. Here are some different types of diabetes medicines, grouped by how they help the body keep blood sugar levels closer to normal. Medicine That Helps the Body Make More Insulin Sulfonylureas and meglitinides like repaglinide (Prandin) and nateglinide (Starlix) are secretagagogues and all do similar things. These pills cause a person's pancreas to make more of its own insulin. Sulfonylureas have been used since the 1950s to help people lower their blood sugar levels. Over the years, newer and better versions of this drug have become available. One of the best drugs currently available in this class is glimepiride (Amaryl). Here's how these pills work: Sulfonylureas help the pancreas make more insulin. When the insulin gets into the bloodstream, blood sugar levels go down. Like people who take insulin, people who take sulfonylureas need to be careful that their blood sugar levels don't d Continue reading >>

Oral Insulin: All Mouth, Or An Injection Of Hope For Type 1 Diabetes?

Oral Insulin: All Mouth, Or An Injection Of Hope For Type 1 Diabetes?

When Danish drugmaker Novo Nordisk launched the world’s first insulin treatment for Type 1 diabetes some 90 years ago, syringes were the only delivery technology with which patients could administer the product. Syringes continued to be the most widely-used delivery method for the next fifty years until – in the mid-1980s – the first insulin pens were launched in response to patient demand for more convenient and safer alternatives. Brittany Maher-Kirk of Diabetes UK told in-Pharmatechnologist.com: “Very few people use syringes to inject insulin anymore. The vast majority of people with diabetes now will use insulin pens, and there is a wide variety available to suit the different manufacturers.”​ Pens such as Novo Nordisk’s NovoPen, Sanofi-Aventis’ OptiSet, and Lilly’s HumaPen claim to offer users a discreet syringe alternative that ensures compliance with treatment. However, there are some Type 1 diabetes patients who haven’t made the switch like Sara Kirsch who told me she injects insulin four times a day and currently uses Eli Lilly’s Lispro (for meals) and Sanofi’s Lantus for long-acting coverage at night. “On the whole, the injections are fine by me for the time being. I have had no issues relating to syringes/vial delivery other than an occasional bruise.”​ Furthermore, Sara remained indifferent to the pen, and although she was given it to try she said: “It just didn't interest me.”​ “As for the pump,”​ she continued, “the idea disgusts me. I like to be free from having to eat at a specific hour because there is insulin being pumped into me at a certain hour, and the thought of having something dug into your side and attached under your clothes sounds horrific.”​ Oral insulin​ But, despite the widespread acceptanc Continue reading >>

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