5 ms·

Indian Scientists developed Insulin Pill for diabetics

109 points by conductor 13y ago

dnautics 13y ago
one thing to worry about - insulin cross-reacts with the IGF receptor and insulin is a mild carcinogen; but insulin variants and insulin reformulations can be extremely potent carcinogens. Presumably they did IGF cross-reaction studies, but the post-digestive tract form might have different properties even, and before getting too excited, I'd want to wait for results from a longitudinal study in the clinic.
codva 13y ago
One thing I've learned from my Type 1 wife is to never get excited about this sort of stuff. Her father was a Lilly executive and they tried to get her to use the insulin nose spray back in the 80s. She passed, and a few years later it was pulled from the market as it was destroying the user's nasal passages. She was also a beta tester for a blood meter that didn't need disposable test strips. It got pulled by the FDA. I always root for advances in diabetes management, or dream of dreams, a cure. But I'm not expecting it.
- dkirkman 13y ago
  Living with a type 1 for a number of years has given me a similar view. On the other hand, very real (and often hyped) advances really do happen. When pumps first came out, they were almost magic, ditto with continuous glucose monitoring.
  - frabcus 13y ago
    My dad died in the mid-1980s from type 1 diabetes, when I was a child. Literally, because it was hard to take blood samples to monitor glucose and inject the right amount of insulin. I'm told that with modern equipment (am guessing the continuous glucose monitoring you mention) he would almost certainly have survived. So yes, not all advances like this end up working. But overall, within our short lifetimes, the best ones are creating substantial improvements.
discardorama 13y ago
Here's the link to paper, if someone wants to take a gander: http://pubs.acs.org/doi/abs/10.1021/bm401580k?journalCode=bomaf6 http://pubs.acs.org/doi/abs/10.1021/bm401580k?journalCode=bo...
jimrandomh 13y ago
> the effects of the pill lasted longer than injected insulin A non-diabetic might think this was a good thing, but it's more likely to be a serious problem. The actual research article (http://pubs.acs.org/doi/abs/10.1021/bm401580k http://pubs.acs.org/doi/abs/10.1021/bm401580k) is paywalled, so I can't see what its pharmacokinetics are, but I'm not inclined to give the benefit of the doubt; unlike most drugs, insulin needs rapid uptake, precise timing and precise dosing. Even if it did survive the digestive tract, interactions with foods that altered the effective dose, or sped up or slowed absorption, would be likely to sink it in actual use.
- marquis 13y ago
  Estrogen and progestin are given in slow-release IUDs or subdermal methods. Is science not able to apply the same?
  - pygy_ 13y ago
    Insulin is reactive. It regulates the glycemia (amount of sugar in the blood), which would vary highly in its absense depending on the time elapsed since the last meal.
  - refurb 13y ago
    Estrogen and progestin need to be at a certain, constant level. Insulin needs to be at varying levels based on blood sugar. To much insulin and you go into hypoglycemic shock.
- GunlogAlm 13y ago
  I'm a type 1 diabetic. If this wouldn't work with rapid-acting insulin, might it not be a good thing for long-acting insulin, e.g. Detemir/Levemir (which I currently take)?
  - trekky1700 13y ago
    I'm type 1 too, there's potential, but the same problem with degradation exist. If you eat something that slows down or speeds up digestion or alters it in any way, it could give you a lot of highs and lows. It's like how certain foods take longer for the carbs to be absorbed and cause lows first then highs later. Alcohol could be effected even more too.
kirtijthorat 13y ago
Now all that they need is to get it FDA approved to market in the US market. We need a sure shot remedy for diabetes which is alternatively known as "The Plague of Our Time" Read this article: http://blog.seattlepi.com/timigustafsonrd/2012/02/28/obesity-and-diabetes-%E2%80%93-the-plague-of-our-time/ http://blog.seattlepi.com/timigustafsonrd/2012/02/28/obesity...
- ars 13y ago
  > Now all that they need is to get it FDA approved to market in the US market. Yah, lets not rush the FDA. There is a very good reason they take a long long time to approve these kinds of things. You sometimes need massive studies and a long time to detect problems.
- gus_massa 13y ago
  They tested this only in rats. First they need to test this in humans. Perhaps it has nasty side effect. Perhaps the side effects appear after a few months. Perhaps human food has more variation than rat food (one day salad and the following day ice cream vs everyday apple and sunflower seeds).
- penguindev 13y ago
  We already have one for type-2. Don't eat carbs. Really, if you have an intolerance to something... why are you still eating it?
  - dkirkman 13y ago
    This isn't entirely snarky. The ACCORD trial was a spectacular failure (http://www.nejm.org/doi/full/10.1056/NEJMoa0802743 http://www.nejm.org/doi/full/10.1056/NEJMoa0802743). Nobody really knows why (as far as I know), but since high blood glucose is known to cause problems, and lowering it by giving extra insulin does not seem to help (remember that type-2's usually have high spectacularly insulin levels to begin with), we've got to consider other approaches. Avoiding carbs seems to both normalize glucose and lower insulin in type-2s, so it's not a dumb approach. On the other hand, a low carb diet tends to increase insulin resistance, so if it turns out that both the glycemia and insulin levels are not the cause of the adverse symptoms, but rather symptoms in themselves, going low carb may make everything much worse. (e.g. it might make the numbers we can measure look better, while worsening whatever metabolic abnormality is causing the diabetes in the first place)
alphakappa 13y ago
The Indian media is a bit breathless in declaring that this is the first time an insulin pill has been developed, but that doesn't seem to be the case [1]. Not to take anything away from new research, but I wish these discoveries were reported with some moderation because there's a long way between a discovery and a pill that can actually be sold. 1. http://www.reuters.com/article/2013/10/09/us-novonordisk-oramed-oralinsulin-idUSBRE99804N20131009 http://www.reuters.com/article/2013/10/09/us-novonordisk-ora...

109 points by conductor 13y ago

one thing to worry about - insulin cross-reacts with the IGF receptor and insulin is a mild carcinogen; but insulin variants and insulin reformulations can be extremely potent carcinogens. Presumably they did IGF cross-reaction studies, but the post-digestive tract form might have different properties even, and before getting too excited, I'd want to wait for results from a longitudinal study in the clinic.

codva 13y ago

One thing I've learned from my Type 1 wife is to never get excited about this sort of stuff. Her father was a Lilly executive and they tried to get her to use the insulin nose spray back in the 80s. She passed, and a few years later it was pulled from the market as it was destroying the user's nasal passages. She was also a beta tester for a blood meter that didn't need disposable test strips. It got pulled by the FDA. I always root for advances in diabetes management, or dream of dreams, a cure. But I'm not expecting it.

dkirkman 13y ago
Living with a type 1 for a number of years has given me a similar view. On the other hand, very real (and often hyped) advances really do happen. When pumps first came out, they were almost magic, ditto with continuous glucose monitoring.
- frabcus 13y ago
  My dad died in the mid-1980s from type 1 diabetes, when I was a child. Literally, because it was hard to take blood samples to monitor glucose and inject the right amount of insulin. I'm told that with modern equipment (am guessing the continuous glucose monitoring you mention) he would almost certainly have survived. So yes, not all advances like this end up working. But overall, within our short lifetimes, the best ones are creating substantial improvements.

discardorama 13y ago

Here's the link to paper, if someone wants to take a gander: http://pubs.acs.org/doi/abs/10.1021/bm401580k?journalCode=bomaf6 http://pubs.acs.org/doi/abs/10.1021/bm401580k?journalCode=bo...

jimrandomh 13y ago

> the effects of the pill lasted longer than injected insulin A non-diabetic might think this was a good thing, but it's more likely to be a serious problem. The actual research article (http://pubs.acs.org/doi/abs/10.1021/bm401580k http://pubs.acs.org/doi/abs/10.1021/bm401580k) is paywalled, so I can't see what its pharmacokinetics are, but I'm not inclined to give the benefit of the doubt; unlike most drugs, insulin needs rapid uptake, precise timing and precise dosing. Even if it did survive the digestive tract, interactions with foods that altered the effective dose, or sped up or slowed absorption, would be likely to sink it in actual use.

marquis 13y ago
Estrogen and progestin are given in slow-release IUDs or subdermal methods. Is science not able to apply the same?
- pygy_ 13y ago
  Insulin is reactive. It regulates the glycemia (amount of sugar in the blood), which would vary highly in its absense depending on the time elapsed since the last meal.
- refurb 13y ago
  Estrogen and progestin need to be at a certain, constant level. Insulin needs to be at varying levels based on blood sugar. To much insulin and you go into hypoglycemic shock.
GunlogAlm 13y ago
I'm a type 1 diabetic. If this wouldn't work with rapid-acting insulin, might it not be a good thing for long-acting insulin, e.g. Detemir/Levemir (which I currently take)?
- trekky1700 13y ago
  I'm type 1 too, there's potential, but the same problem with degradation exist. If you eat something that slows down or speeds up digestion or alters it in any way, it could give you a lot of highs and lows. It's like how certain foods take longer for the carbs to be absorbed and cause lows first then highs later. Alcohol could be effected even more too.

kirtijthorat 13y ago

Now all that they need is to get it FDA approved to market in the US market. We need a sure shot remedy for diabetes which is alternatively known as "The Plague of Our Time" Read this article: http://blog.seattlepi.com/timigustafsonrd/2012/02/28/obesity-and-diabetes-%E2%80%93-the-plague-of-our-time/ http://blog.seattlepi.com/timigustafsonrd/2012/02/28/obesity...

ars 13y ago
> Now all that they need is to get it FDA approved to market in the US market. Yah, lets not rush the FDA. There is a very good reason they take a long long time to approve these kinds of things. You sometimes need massive studies and a long time to detect problems.
gus_massa 13y ago
They tested this only in rats. First they need to test this in humans. Perhaps it has nasty side effect. Perhaps the side effects appear after a few months. Perhaps human food has more variation than rat food (one day salad and the following day ice cream vs everyday apple and sunflower seeds).
penguindev 13y ago
We already have one for type-2. Don't eat carbs. Really, if you have an intolerance to something... why are you still eating it?
- dkirkman 13y ago
  This isn't entirely snarky. The ACCORD trial was a spectacular failure (http://www.nejm.org/doi/full/10.1056/NEJMoa0802743 http://www.nejm.org/doi/full/10.1056/NEJMoa0802743). Nobody really knows why (as far as I know), but since high blood glucose is known to cause problems, and lowering it by giving extra insulin does not seem to help (remember that type-2's usually have high spectacularly insulin levels to begin with), we've got to consider other approaches. Avoiding carbs seems to both normalize glucose and lower insulin in type-2s, so it's not a dumb approach. On the other hand, a low carb diet tends to increase insulin resistance, so if it turns out that both the glycemia and insulin levels are not the cause of the adverse symptoms, but rather symptoms in themselves, going low carb may make everything much worse. (e.g. it might make the numbers we can measure look better, while worsening whatever metabolic abnormality is causing the diabetes in the first place)

alphakappa 13y ago

The Indian media is a bit breathless in declaring that this is the first time an insulin pill has been developed, but that doesn't seem to be the case [1]. Not to take anything away from new research, but I wish these discoveries were reported with some moderation because there's a long way between a discovery and a pill that can actually be sold. 1. http://www.reuters.com/article/2013/10/09/us-novonordisk-oramed-oralinsulin-idUSBRE99804N20131009 http://www.reuters.com/article/2013/10/09/us-novonordisk-ora...