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New pill can deliver insulin
- osrec 8y agoCan anyone shed some light on why this can only help type 2 and not type 1 diabetics?
- detaro 8y agoURL should probably be the source press release: http://news.mit.edu/2019/pill-deliver-insulin-orally-0207 http://news.mit.edu/2019/pill-deliver-insulin-orally-0207, since techcrunch is just a less detailed summary of that
- sithlord 8y agoStudy by Novo Nordisk. one of the fine companies responsible for raising insulin prices by thousands of percent.
- throwitaway6512 8y agoRead up on the matter. The culprits are pharmacy benefits managers who push producers to increase list prices while demanding obscene rebates that are never passed on to the consumers. Most producers don’t disclaim the rebates, but Lars Fruegaard (Novos CEO) is on record saying that it increased from 64% to 67% last year. So pharmacy benefits managers are pushing up the list price but less and less is getting through to the producers. The American system is rigged by the middlemen who approach consumers with ownership of “cheap drugs” because of the rebates, while they approach the producers with ownership of the consumers. As an alternative to that system Novo Nordisk is releasing cheaper insulin through a partnership with Walmart where it goes directly to the consumers. Openness around rebates will be a great first step to help lower prices, but the PBMs have gotten the industry into a reverse price war where everyone is overbidding each other on price in order to provide the larges rebate to PBMs. Something big has to change to revert that cause. Disclaimer: I work for Novo Nordisk.
- sdfj3423 8y ago>Read up on the matter. Slightly off-topic, but could you talk about what pharmacy benefits managers are supposed to do and actually do, for insulin especially, and their effect on the market? I Googled this term but can't make of sense of your comment based on what I've read. (The definitions of pharmacy benefits managers that I found have nothing to do with what you wrote.)
- tokai 8y agoThere is a paragraph in the wikipedia article on PBM[0] full of sources on this. [0] https://en.wikipedia.org/wiki/Pharmacy_benefit_management#Controversies_and_Litigation https://en.wikipedia.org/wiki/Pharmacy_benefit_management#Co...
- sithlord 8y agoAlthough I appreciate the $25/vial insulin sold at walmart, its unfortunate that its such an old-school version that that it makes it almost dangerous to try and manage diabetes with it *obviously better than nothing though. I know, before insurance, it costs around $240 a vial, and I know personally I go through roughly 3 vials a month. I would guess I use a lot less insulin than a lot of others too. So I know the manufacturer isn't the only one to blame, and maybe its unfair to completely blame them, but as much as the manufacturers are donating to politicians I cant imagine they are doing a lot to fight it either.
- phkahler 8y agoCan they just sell direct to consumers? Cut out the pharmacy and the insurance companies. You guys could earn more while the patient pays less.
- throwitaway6512 8y ago90% of diabetics are insured. If we stop selling to insurance and try to sell directly to these patients we would end up being more expensive than competitors and lose those customers. I mean you could argue that if they are paying their own insurence they could cancel and perhaps have a net saving on the insulin, but that seem very risky considering potential comorbidities of diabetes, and you’d lose all other coverage.
- RPLong 8y agoJesus man. Novo has invented and produced more insulin in the last 30 years than any other company or organization. I get that you're disgruntled about the price of insulin; I am, too. But put the blame where it belongs, not on the people who are producing more and more insulin to accommodate more and more diabetic lifestyles and helping to drive the price down rather than up.
- sithlord 8y agoPer a quick google <15% of type 2 diabetics use insulin. I would say this effects more type 1 diabetics than anything. Or are you trying to say peoples lifestyles are leading them to an autoimmune disease?
- RPLong 8y agoI'm saying Novo Nordisk produces insulin, and in doing so causes downward pressure on insulin prices thanks to basic economics. (When the supply of a good increases at the same level of demand, price falls.) This is true for both type 1 and type 2 diabetics. In Novo's case, they have two kinds of long-acting insulin analogue taken 1-2 times per day for both T1 and T2; they have to my knowledge the only ultra-long-acting insulin on the market, taken once every 2-3 days, most appropriate for T2, but also viable for some T1 lifestyles; they have very-rapid-acting insulin for T1 diabetics only, and they have older kinds of insulins appropriate for older patients. They offer all of these products in good supplies. I've never seen or heard of a Novo product's being unavailable at the pharmacy. So, as far as I can tell, their only influence on insulin prices is downward pressure, not upward pressure. Every new product they produce lowers the price of insulin despite industry-wide changes.
- cazum 8y agoInsulin prices have inflated by about 500% over the past two decades in the United States. Novo Nordisk's profits have seen a similar rise. Now, im no economitician, but I'd wager a vial of Fiasp® that there's more than just supply and demand going on here.
- samcday 8y ago> Once ingested, water dissolves a disk of sugar, using a spring to release a tiny needle made up almost entirely of freeze-dried insulin. The needle is injected into the stomach — which the patient can’t feel, owing to a lack of pain receptors in the stomach. Once the injection has occurred, the needle can break down in the digestive tract. That's some pretty impressive ingenuity. Also sounds kinda terrifying if the 1.0 has any kind of edge case that involves tearing holes in your stomach lining. I'm not diabetic, but I still have vivid memories of sitting with my grandmother while she constantly pricked her finger to test blood sugar and jabbing insulin pens into her abdomen. It's always stuck with me as a particularly unpleasant lifestyle to have to endure. Even still, if I were a diabetic I think I'd still be waiting a year or two after the release of something like this to make sure all the kinks have been ironed out ;)
- bitexploder 8y agoI test my insulin willingly with no diabetes. One hard squat hurts way more Than either of those activities. I have actually teared up from hard lifts. Needles are just a nuisance. The real downside to beetus is having to think about it constantly, IMO. (And managing it for kids, who don’t have perspective on blood/needles)
- naiyt 8y ago> The real downside to beetus is having to think about it constantly, IMO Pretty much this. Obviously needles and finger pricks are a bigger deal for some people, but most diabetics get used to it fairly quickly. The hard part is the constant mental drain of having to be your own pancreas. It's like you're constantly flying a plane where you have to manually maintain a certain altitude, because you'll crash and die if you fly too low or too high. It's exhausting.
- agumonkey 8y ago~meditation or similar mental massaging seems to be key at one point. Avoiding the damages of constant stress is important.
- GordonS 8y ago
- shiftoutbox 8y agoWe should be concentrating on biological cures . Not turning us into cyborgs; or finding ways to furnish the executives of pharmaceutical companies homes with the finests of wares. The cost of synthetic insulin is insane , humalin is cheeper but , glucomoters ; pumps cgms , their parts ,accessories are killing me faster then this stupid disease.
- friedegg 8y agoI can see why they're targeting type 2's, as they may need more of a fixed insulin boost than full insulin replacement that I and other type 1's need. Part of the fun being type 1 is figuring out proper adjustments to your insulin dosages based on food, activity level, stress and other factors. It's a clever design, though, and may help some people stay more compliant with their treatment.
- JohnJamesRambo 8y agoIs it not bad to have tiny needles traveling through your intestines?
- hjk05 8y agoProbably not worse than having bigger needles traveling through your skin. But public perception of the device will definately be a large obstacle to overcome if it reaches the market.
- donarb 8y agoThere is no metal needle anywhere in the product. The needles are made of freeze-dried insulin. It is injected into the stomach wall where it dissolves into the bloodstream.
- JohnJamesRambo 8y agoOh I didn’t get that on the first read through.
- ajuc 8y agoI would be scared the needle hits hard food or something else and doesn't inject the insulin with me not knowing it.
- ironrabbit 8y agoI know we're a little ways off, but this seems like a great platform to combine with automatic blood sugar measurement. Imagine taking one pill in the morning that measures your blood sugar and internally administers insulin as necessary. There are already externally attached pumps that do both (my father, a type 1 diabetic, uses one) but having an electronic device permanently attached to your stomach is a bit of a hassle.
- fredthomsen 8y agoHope the price per pill is more reasonable that current prices on insulin which are skyrocketed over 20 years.
- m3nu 8y agoFor the case of T2D, eating fewer carbs may be more effective than later reducing it with expensive insulin and fancy MIT pills. I often hear good stuff about these guys: https://www.virtahealth.com/ https://www.virtahealth.com/ (no affiliation) edit: clarify that Virta is treating T2D primarily.
- vonmoltke 8y agoEating fewer carbs is completely ineffective when your pancreas is not producing insulin in the first place.
- m3nu 8y agoI was talking about type 2 diabetes, not type 1. You're of course correct regarding type 1.
- coldpie 8y agoSpeaking as a T1D, please always specify. It's a shame these two totally unrelated diseases have the same name.
- thomasfedb 8y agoThey're not "completely unrelated" — they are an absolute and a relative deficiency of insulin production respectively. They do have significantly different aetiologies though, and the conflation is very unhelpful.
- thomasfedb 8y agoThis is a common but dangerous misconception. The human body needs insulin to function, even without dietary carbohydrate. This is why insulin dosing includes basal (continuous background) as well as mealtime insulin.
- cowpewter 8y agoYeah, eating less carbs is great for T2s like me (I don't take insulin, I control my blood sugar with a keto diet and metformin). For T1s, eating less carbs might reduce the amount of insulin they need, and make swings in blood sugar less likely, but they're still going to need some insulin.
- RPLong 8y agoInhalable insulin was a total failure, even though it worked. I don't expect this to succeed where inhalable insulin failed.
- ricardobeat 8y agoMannkind is still around, though not growing much. Why do you think it was a total failure?
- RPLong 8y agoOh, really? I thought I read an article about how the product had been discontinued. I stand corrected.
- lolc 8y agoFirst time I heard about inhalable insulin! Indeed it's unclear what the pills could offer over this.
- shawnz 8y agoWhat's the point of having this be an internal device? Why not use the same technology to make external injection devices easier to use? It seems to me like having the device be internal just increases the number of possible failure modes and makes failures harder to spot/recover from.
- bem94 8y agoDepending on what I eat, I need different ammounts of insulin, and adjust the dose acordingly using my insulin pen and needle. How does one adjust the dose in a pill? Do I take more or fewer pills? They mention the insulin is "freeze dried". What does this mean in practice? Do I need to carry around a climate controlled box with my insulin in?
- billfruit 8y agoFreeze dried foods usually remain stable at room temperature and do not require refrigeration/heating once freeze drying is completed.
- bobochan 8y agoPeople that are pancreatic insufficient take replacement enzymes in capsule form and the dose is based on their size and the amount of fat in the meal that they are eating. There is a learning curve when they start but they get pretty adept at guessing how many capsules to take.
- jayalpha 8y ago"freeze dried" "Freeze drying is a water removal process typically used to preserve perishable materials, to extend shelf life or make the material more convenient for transport. Freeze drying works by freezing the material, then reducing the pressure and adding heat to allow the frozen water in the material to sublimate." You freeze it or shock freeze it and then "distill" the water of in vacuum. The ice goes into the vapor phase, skipping the liquid phase. This process is called sublimation and part of each first year high school chemistry curriculum. The substance, insulin or other peptides, will be stable after this at room temperature for some time.
- arkades 8y agoIf this is at all attractive to people, it's going to make insulin so damned expensive. The price of insulin is already rising: there aren't all that many generic manufacturers of it, leaving them in a competition-free market. If this takes off it's going to suck up a good chunk of the marketplace, and probably leave us with maybe one or two generic manufacturers - enough to have an effective monopoly. Insulin prices will spike the same way epi pens did. Good tech. But sad re. what it's going to do to patients for a while.
- coltonv 8y agoManufacturing insulin isn't under patent or a trade secret is it? If the price of insulin rises, then manufacturing insulin becomes more economically viable, so new players will enter the arena, thus driving the price down. Is there any reason this wouldn't be subject to the normal laws of supply and demand?
- snowmaker 8y agoYou would think so, but the market is dysfunctional because of the regulatory complexity of the US healthcare system: https://health.usnews.com/health-care/for-better/articles/2018-06-29/whats-behind-the-rising-costs-of-insulin https://health.usnews.com/health-care/for-better/articles/20...
- Qwertystop 8y agohttps://www.cbsnews.com/news/how-drug-companies-keep-insulin-prices-high/ https://www.cbsnews.com/news/how-drug-companies-keep-insulin... Looks like a patent issue (every new improvement in production methods has its own patent, so the insulins for which patents have expired are lower-quality in one way or another) plus shipping costs (refrigerated bottled liquids with a shelf life <6 months).
- lm28469 8y ago> The price of insulin is already rising That really is a sad state of affair, insulin is cheap to produce and we shouldn't live in a world where such a basic medicine is controlled by for profit organizations. At least in countries with a proper health system the cost isn't impacting on an individual level. https://beyondtype1.org/how-much-does-it-cost-to-produce-insulin/ https://beyondtype1.org/how-much-does-it-cost-to-produce-ins...
- qazqwert 8y agoor better go on a charboydred diet... and reveres the so called "chronical" diabetes but it can be nice from type 1 diabetes the problem is how could you control the insulin level.... sure on some degree but still...
- adamc 8y agoWhat's it going to cost, though? A big problem with insulin now is the cost...
- m3kw9 8y agoI’m hoping Apple will pull out a miracle and able to measure blood sugar with the Apple Watch. With that data, people can make apps to do really cool things to help that person out.
- Tobani 8y agoEven if they could, reporting on medical information has very large consequences if the information is wrong. I don't imagine it would be worth it to them to enter that arena.
- amelius 8y agoApple's focus is on "average" people, not people with diabetes. Also it saddens me to hear "I hope that company X will solve Y" instead of "I hope some university develops a method to solve Y".
- ymolodtsov 8y agoDiabetes is becoming more and more common, especially in the US. It also could be used for monitoring healthy people so they don’t fall into T2 diabetes. The problem is, at the current technology level it might not be possible. Johnson&Johnson tried to do that for decades and failed.
- jayalpha 8y agoI doubt that the apple watch will be able to do this reliably. But if someone is interested (speak investment interested) in non-invasive blood glucose measurement feel free to inquire. Peer reviewed publications available.
- thejohnconway 8y agoWe already have continuous blood sugar monitors that are good, and work with Apple Watch. The invasiveness of the patch is not a big deal in my opinion given the benefits.
- deleted 8y ago[deleted]
- visava 8y agoPlant based diet can reverse diabetes ( I and II ). For type I milk products need to be stopped. Take 1% of your bodyweight as fruits. Take 1 % of your body weight as Raw ( uncooked ) vegetables. Take 10% of that vegetable quota as green leafy vegetables. Based on China Study by Colin Campbell. e.g. weight 150 pounds 1.5 pounds fruits before 1 pm 1.5 pounds raw vegetables for the day If you are still hungry you can eat cooked food after completing daily raw fruits vegetable quota. Avoid all animal,milk,processed packaged products and heated oils. Will reverse diabetes in 3 days for newly detected patients. Add 1 day for each year you have diabetes https://biswaroop.com/ https://biswaroop.com/ https://www.youtube.com/watch?v=KgxvGu4fuGo&t=561s https://www.youtube.com/watch?v=KgxvGu4fuGo&t=561s lookup his youtube videos
- shiftoutbox 8y agoNo that can help with Type 2 diabetes only Not Type 1, or 1.5 ( A/k/a Flatbush Diabetes). The rest of the posters are talking about Type 1 or t1d, which is currently an incurable reaction to a yet unidentified pathogen . Your body attacks and destroies the pancreases ability to create insulin. The current method of management of T1D take synthetic insulin, insulin extracted from pigs , or genetically engineered insulin , check your blood sugar. Limit what you eat to limit how much insulin you need to take. As so on. Eating fruits , grains as a t1d with out taking insulin will kill you! . By the way there is a study about how 46.5% of all studies are just made up.
- danhon 8y agoT1 can’t be reversed.
- visava 8y agoThis diet with stopping milk products can. Milk protein with 17 rings similar to beta cells. Body in an attempt to kill milk protein which escapes into blood without breaking down the ring structure also kills beta cells https://www.youtube.com/watch?v=4edofibXOiM https://www.youtube.com/watch?v=4edofibXOiM watch at 48 mins
- 8y ago
- phkahler 8y agoTo all the type II diabetics here, I'd suggest looking in to iodine. I'm not diabetic, but I started taking it for other reasons and as a side effect I seemed to have better blood sugar regulation. There are also doctors out there that claim it reduces insulin dependence. I'm not claiming a cure, or even an actual treatment. Just want to point some people to something that most people have never heard of.
- syntaxing 8y agoIs diabetes curable with gene therapy? I'm surprised we can cure hemophilia with gene therapy but not diabetes. Is it impossible to get your pancreas to create insulin naturally because it's missing something vital? [1] https://www.nih.gov/news-events/nih-research-matters/gene-therapy-used-treat-hemophilia https://www.nih.gov/news-events/nih-research-matters/gene-th...
- sithlord 8y agotype 1 diabetes is an autoimmune disease where your immune system kills the beta cells that live on the pancreas. you can get donar beta cells that will work but your immune system will just kill them off again. This only works with immunosuppresents which will cause 10x more issues than just taking insulin.
- syntaxing 8y agoInteresting, I never knew type 1 diabetes is an autoimmune disease. I just thought the body just stopped creating insulin because the pancreas is messed up.
- dTal 8y agoWhy would that surprise you? Hemophilia is a genetic disease, while diabetes rarely is. The pancreas has the genes it needs, it's just damaged (in type 1) or ineffective (in type 2)
- AngeloAnolin 8y agoBreakthrough like this needs to be designed so that people can afford it. It just becomes burdensome (and depressing) for people who may need it and find the cost out of reach. On the other hand, given that treating diabetes is more costly to the society in general (although more profitable for the pharma companies), shouldn't there be more research to ensure people don't get into the trap of becoming diabetic? One reason people become Type 2 diabetic is that they are completely unaware that their lifestyle and food they are eating are slowly creeping in to make them suffer with this disease. Healthy people only know about them becoming diabetic because the cycle to get your blood sugar measured (A1C Hemoglobin) is too far in between (annual checkups). If a person is more aware of his/her blood sugar levels at shorter intervals, then a proactive approach can be made so that the person can do changes that will help prevent diabetes.
- onemoresoop 8y agoBigPharma is a business and has no incentive to prevent or cure disease but to make sure the patient remains a customer
- dpatru 8y agoI just watched a lecture on diabetes by Dr John McDougall last night. He described type 2 diabetes as the body's natural way to limit weight gain. He points out that morbidly obese people are often not diabetic: lack of insulin resistance is what enabled them to keep growing. Viewed this way, diabetes is a sign that a person has reached maximum weight. Giving a person additional insulin at this point is like trying to override the body's defense mechanism and forcing it to gain even more weight. McDougall has lots of other interesting insights in the lecture and discusses how he treats diabetics. He goes into some detail about how he decides how to adjust medications and why he recommends his diet. I'm posting this here because it may be of use to people who may not have heard this information from their own doctors. The lecture is found here: https://youtu.be/UgE2IdL6tMw?t=1103 https://youtu.be/UgE2IdL6tMw?t=1103 The link starts the video at the point where McDougall starts discussing type 2 diabetes specifically. Before this he talks about insulin and type 1 diabetes.
- airstrike 8y agoThis is extremely myopic... Once you're diabetic, a lot of "bad things" happen. People don't take insulin then just to continue eating...
- dpatru 8y agoMcDougall points out at one point that it's common for people to gain weight after their doctor tells them to lose weight and puts them on insulin. Insulin promotes weight gain.
- airstrike 8y agoIt doesn't. Eating too much and exercising too little promotes weight gain.
- ng12 8y agoRight. And the insulin injections allow them to continue their lifestyle of eating too much and exercising too little. Their body is literally rejecting food and that's the problem insulin solves. It does not solve the root issue. If you spend a lot of time around diabetics you'll met many people who have lost appendages and continue to live an morbidly unhealthy lifestyle.
- bitwize 8y agoSo it's a roughly gömböc-shaped capsule, then?
- waynecochran 8y agoDoesn't this have to work 100% of the time if you rely on it? I mean if it works 99% of the time your odds are low you'll make it thru a year. It seems like a cool idea, but the mechanism does seem like it would work not every time.
- auiya 8y agoThis still seems dangerous to the stomach lining over time. Why not suppositories?
- phyzome 8y agoAnd what happens if it gets stuck in your esophagus?
- adventist 8y agoAs a TYPE 1 Diabetic. All I can say is AMEN!
- smashingx 8y agoAnd what happens to the pill? Does it get absorbed by the body?
- deleted 8y ago[deleted]
- jeffdavis 8y agoType I diabetic here. The injections are really not a significant problem for me. A lot of people may recoil at the thought of injecting themselves often, as though it's painful. It's either not painful or maybe a little, but I just don't care much. Much worse things about being diabetic are: * Danger of low blood sugar * Trying to get the right dose * Timing the dose so it is effective at the right time * Carrying around a bunch of stuff that I need or may need, like insulin and glucose tablets * Trying to keep the insulin cold enough or fresh enough that it retains its potency * Keeping my phone on and charged all the time, which has my blood sugar readings, and checking it at times where it might seem like I'm rude. I'd rather use a watch or special device, but the special devices are strangely bulky and don't hold a charge, and watches apparently can't receive blood sugar readings yet (without a phone also present). None of those things are very terrible. Treatment is much better now. But they are all way worse than the tiny insulin needle injections.
- colordrops 8y agoMaybe better for children? The needle is probably their biggest concern.
- jeffdavis 8y agoI was diagnosed around 12. It was briefly a concern until I actually did it. The blood checking pokes are much worse, because they have to actually draw blood. Usually fine but sometimes quite painful or difficult. Now I use a continuous glucose monitor (CGM) and it's much better.
- georgebarnett 8y agoWeirdly, it’s not age but an individual perception thing. Many many people don’t really notice or care about the needles (me included) because as OP parent posted, we have other stuff to deal with that takes up way more mental space. I guess this isn’t apparent because the needles are the obvious bits but then rest is all the “thinking” that invisibily surrounds the injection. There are however many people who just can’t wrap their head around needles and can’t do it. The needles themselves are tiny so it’s not that - it’s just how they perceive the world. Any technology that helps these people and makes their lives easier should be embraced.
- th3o6a1d 8y agoThis seems like a solution without much of a problem.
- th3o6a1d 8y agoThis seems like a solution looking for a problem.
- maxander 8y agoA potential huge impact of this advance is inspiring further research into peptide-based drugs; this is a whole new paradigm with the potential to be comparable or better than the small-molecule drugs we currently focus on, but the poor marketability of injections has kept most pharmaceutical companies from being very interested in them.
- bleair 8y agoI view this is interesting research about medicine that has nearly zero usefulness for actually treating diabetes in humans. Since this is a technical audience, if you're diabetic I can't speak highly enough of the opensource efforts combining a cgms (like a dexcom) with a pump and then software running on android or iphon or raspberry pi to create a "feedback loop" to slowly but usefully bring blood sugar back to desired range. For more see: For an overview https://diyps.org/2017/08/09/what-you-should-know-about-closed-looping-diy-like-openaps-or-otherwise/ https://diyps.org/2017/08/09/what-you-should-know-about-clos... iPhone version call Loop https://loopkit.github.io/loopdocs/ https://loopkit.github.io/loopdocs/ raspberry pi https://openaps.org/ https://openaps.org/