Research to develop a pill form of insulin is showing promise at the University of British Columbia in western Canada. The goal is to eliminate the need for diabetics to inject themselves with the lifesaving medication.

According to the World Health Organization, there are an estimated 422 million diabetics worldwide. The disease claims 1.5 million lives each year. The U.S. Centers for Disease Control and Prevention estimates 30 million Americans have diabetes.

Although widely available in the developed world, current forms of insulin require refrigeration, which can be a stumbling block in developing nations.

An oral version of insulin, in the form of an everyday pill, could change everything, making it easier and cheaper to transport and distribute — even to remote regions of the planet.

Researchers at the University of British Columbia in Vancouver think they might have discovered a formula for a pill that effectively delivers a full dose of insulin to a patient’s liver — where it is needed to regulate blood sugar levels — without dissipating uselessly in the stomach.

The trick is to not swallow the pill, according to Anubhav Pratap-Singh, an assistant professor at the school’s Faculty of Land and Food Systems and the project’s lead researcher. He said the pill can be absorbed in the mouth by wedging it between the cheek and gums. In laboratory studies on rats, full doses of insulin reached the liver, he said.

“So we are getting quite a high amount of yield and so we hope that this will be more economical,” Pratap-Singh said.

Pratap-Singh started studying oral insulin in 2018, inspired to help his diabetic father, who has to inject insulin multiple times a day. He said a pill form would increase the quality of life for millions of patients who use insulin around the world.

“Instead of having to take insulin and having to travel with it in refrigerated boxes, one will simply have [a] normal capsule or tablet in a normal wrapper, which will be shelf stable, and very, very affordable,” Pratap-Singh said.

Dr. Daniel Drucker is professor of medicine at the Lunenfeld-Tanenbaum Research Institute and the University of Toronto. He said previous attempts at oral insulin failed to efficiently deliver enough of the drug within the body. To compensate, huge pill doses were required that would have driven prices higher for the drug.

“We have to pay the manufacturing costs of a large amount of insulin in this case that never makes it into the body,” Drucker said.

Drucker said new insulin pumps, which act as an artificial pancreas, have become increasingly effective in treating diabetes. He also said the development of cell-based insulin replacement therapy, which would create beta cells that automatically release necessary insulin, look promising.

For Pratap-Singh and other researchers, the next steps involve years of further testing of what could be a revolutionary method of insulin delivery.
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