Diabetes: insulin pills instead of injections

Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.

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Insulin pills could make life easier for millions of diabetics. But insulin is digested in the intestine. Now a clever solution is in sight.

Every day again: pull out the pen, bare your stomach, pinch your skin and then stick the needle resolutely into your own tissue. Such insulin injections are essential for the survival of millions of diabetics. The therapy is not particularly pleasant.

Insulin finally in pill form?

For a long time, researchers have therefore been looking for a way to conveniently and painlessly administer insulin in pill form. But that's not that easy: the hormone that transports sugar from the blood into the body's cells is normally attacked by stomach acid like other protein building blocks and then digested in the intestine.

Scientists working with Amrita Banerjee and Samir Mitragotri from Harvard John A. Paulsen School of Medicine in Cambridge may now have found a solution to the problem.

A drug like a Swiss knife

Once swallowed, the insulin has to overcome an obstacle course before it enters the bloodstream."Our drug is like a Swiss knife that is equipped with many tools for the different challenges," says Mitragotri.

First of all, there is a shell that transports the insulin undamaged through the acidic stomach. The capsule only dissolves in the alkaline environment of the small intestine. "There are many enzymes waiting there that break down proteins such as insulin into small amino acids," says study leader Banerjee in an interview with This would normally make it unusable.

But the scientists have prepared the insulin on the basis of an ionic liquid that keeps the molecule stable. Decisive components are choline, which is also taken as a dietary supplement, and geranic acid, which is found in lemongrass and cardamom, among other things.

Difficult passage through the intestinal wall

What is missing is the passage through the tough mucous membrane with which the intestine is lined on the inside, as well as through the tightly packed cell structure that adjoins it. But these can also be overcome easily thanks to choline and geranic acid.

In experiments with rats, the researchers were able to show that the sophisticated mixture actually works. The orally ingested insulin remained effective for a full twelve hours and thus longer than insulin that entered the body via a needle.

Another advantage of the preparation: unlike traditional insulin, it remains stable for several days even at room temperature.

Slow pills

But there are still hurdles. On the one hand, no matter how fast the sluice molecules work, it takes longer for oral insulin to get into the blood than with injected insulin. Especially when readjustments have to be made with fast-acting insulins - for example because you have eaten more than planned - pills in their current form are unsuitable. "Then you'd better go for an injection," says Banerjee.

Many questions still unanswered

Another problem is that, unlike an injection, factors such as previously consumed food could slow down the passage from the intestine into the blood. That could make a more precise dosage difficult. “We are still at an early stage of development. We do not yet know how different the bioavailability of the capsules is in different people - nor to what extent it affects whether someone takes the drug on an empty or a full stomach ”; says Banerjee.

Fear of injections endangers therapy

Overall, however, the researchers are optimistic that the insulin pills could give millions of people a better quality of life. Above all, however, those who find it difficult to bring themselves to put the syringe would benefit. “Many people are afraid of the pain, or they are uncomfortable with injections in everyday life,” says Mitragotri. With them, the blood sugar control does not work adequately - with considerable health consequences.

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