Scientists design new oral capsule that may end the era of painful insulin jabs

Many drugs, especially those made of proteins, cannot be taken orally because they are broken down in the gastrointestinal tract before they can take effect.

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Patients with diabetes have to inject insulin daily or even more frequently. (Representative image)
BOSTON: Scientists have designed an oral capsule which can deliver insulin and other drugs - that usually have to be injected - to the lining of the small intestine and release them for uptake into the bloodstream.

Many drugs, especially those made of proteins, cannot be taken orally because they are broken down in the gastrointestinal tract before they can take effect, according to the study published in the journal Nature Medicine.

One example is insulin, which patients with diabetes have to inject daily or even more frequently.


The researchers at Massachusetts Institute of Technology (MIT), working with scientists from Danish pharmaceutical company Novo Nordisk, have designed a new drug capsule that can carry insulin or other protein drugs and protect them from the harsh environment of the gastrointestinal tract.

When the capsule reaches the small intestine, it breaks down to reveal dissolvable microneedles that attach to the intestinal wall and release drug for uptake into the bloodstream.

"We are really pleased with the latest results of the new oral delivery device our lab members have developed with our collaborators, and we look forward to hopefully seeing it help people with diabetes and others in the future," said Robert Langer, a professor at MIT.
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In tests in pigs, the researchers showed that this capsule could load a comparable amount of insulin to that of an injection, enabling fast uptake into the bloodstream after the microneedles were released.
​Many drugs, especially those made of proteins, cannot be taken orally because they are broken down in the gastrointestinal tract before they can take effect​. (Representative image)
Many drugs, especially those made of proteins, cannot be taken orally because they are broken down in the gastrointestinal tract before they can take effect. (Representative image)

The team previously developed several novel strategies for oral delivery of drugs that usually have to be injected.

Those efforts include a pill coated with many tiny needles, as well as star-shaped structures that unfold and can remain in the stomach from days to weeks while releasing drugs.

"A lot of this work is motivated by the recognition that both patients and health care providers prefer the oral route of administration over the injectable one," said Giovanni Traverso, an assistant professor at MIT.
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Earlier this year, they developed a blueberry-sized capsule containing a small needle made of compressed insulin.

Upon reaching the stomach, the needle injects the drug into the stomach lining.
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In the new study, the researchers set out to develop a capsule that could inject its contents into the wall of the small intestine.

Most drugs are absorbed through the small intestine, Traverso said, in part because of its extremely large surface area - 250 square metres, or about the size of a tennis court.

He noted that pain receptors are lacking in this part of the body, potentially enabling pain-free micro-injections in the small intestine for delivery of drugs like insulin.

To allow their capsule to reach the small intestine and perform these micro-injections, the researchers coated it with a polymer that can survive the acidic environment of the stomach, which has a pH of 1.5 to 3.5.

When the capsule reaches the small intestine, the higher pH (around 6) triggers it to break open, and three folded arms inside the capsule spring open.

Each arm contains patches of one-millimetre-long microneedles that can carry insulin or other drugs.

When the arms unfold open, the force of their release allows the tiny microneedles to just penetrate the topmost layer of the small intestine tissue. After insertion, the needles dissolve and release the drug.

"We performed numerous safety tests on animal and human tissue to ensure that the penetration event allowed for drug delivery without causing a full thickness perforation or any other serious adverse events," MIT PhD recipient Alex Abramson said.

In tests in pigs, the researchers showed that the 30-millimetre-long capsules could deliver doses of insulin effectively and generate an immediate blood-glucose-lowering response.

They also showed that no blockages formed in the intestine and the arms were excreted safely after applying the microneedle patches.

Cut Sugar, Lose Body Fat & Quit Smoking: Lifestyle Habits To Ditch Diabetes
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Diabetes is among the fastest growing health issues today in India.



The rising prevalence of diabetes is primarily driven by a combination of various factors such as rapid urbanisation, sedentary lifestyles, unhealthy diets, tobacco use, and even increased life expectancy.



Although there are certain factors one can't change such as your genes, age or past behaviours, but there are many actions one can take to reduce the risk of diabetes.



Dr Varsha Khatry, Head - Medical and Scientific Affair at Roche Diabetes Care India shares some easy ways to not only reduce the risk of diabetes, but also prevent it.

Diabetes is among the fastest growing health issues today in India.The rising prevalence of diabetes is primarily driven by a combination of various factors such as rapid urbanisation, sedentary life..
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One of the primary reasons for diabetes is body weight. Being overweight is a big risk factor for diabetes.

According to studies by WHO, every kilogram of weight loss reduces the risk of diabetes risk by 16 per cent. Moving toward a healthy weight helps control blood sugars.

Your doctor, a dietitian and a fitness trainer can get you started on a plan that will work for you.
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Eating sugary foods and refined carbs can put individuals at risk of developing diabetes. The human body rapidly breaks these foods down into small sugar molecules, which are absorbed into your bloodstream. The resulting rise in blood sugar stimulates the pancreas to produce insulin, a hormone that helps sugar get out of the bloodstream and into the body's cells. The body's cells are resistant to insulin's action, so sugar remains high in the blood when it comes to patients with the condition of prediabetes. To compensate, the pancreas produce more insulin, attempting to bring blood sugar down to a healthy level.

Over time, this can lead to progressively higher blood sugar and insulin levels, until the condition eventually turns into Type 2 diabetes. Replacing sugar or refined carbs with foods that have less of an effect on blood sugar may help reduce your risk of diabetes.
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Unhealthy habits such as smoking and drinking too much alcohol can make diabetes and its complications worse. Too much alcohol may cause chronic inflammation of the pancreas (pancreatitis), which ca..
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Lowering body sugar through exercise is one of the most effective ways to reduce the risk of diabetes, but it has to be done regularly. Ideally, one should exercise for a minimum of 150 minutes a week. One doesn't have to become a gym rat. Break up your workouts into smaller chunks - like half an hour a day, five days a week. One can also take up walking, runing or cycling. Talk to your doctor about an exercise plan before you start. Physical activity also releases compounds your body makes called endorphins, which elevate your mood.
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