A new intelligent insulin that can be taken in capsules, “or better yet in a piece of chocolate”, sugar-free obviously. Could be closer to the dream of a life without needles for those who live with diabetes and are forced to inject insulin daily. A problem that a huge number of people have in common, if we consider that around 425 million people live with the sweet blood disease in the world and of these around 75 million are those who take insulin every day. Within a few years it could be available to them an alternative to syringes or insulin pumps. A team of scientists has in fact found a new way to supply the body with 'smart' insulin. The results of their research are published in the journal 'Nature Nanotechnology'. And the finish line of human trials is also approaching, expected for 2025, with the hope that the new medicine will be ready for use within 2-3 yearsexperts say.
In detail, the authors of the study managed to encapsulate insulin in tiny nanocarriers. The particles obtained are 1/10,000 the width of a human hair. So small that you can't even see them with a normal microscope. “This way of taking insulin is more precise because it transports it quickly to the areas of the body that need it most – explains one of the researchers involved in the study, Peter McCourt of UiT Norway's Arctic University – When the drug is injected with a syringe it spreads throughout the body where it can cause unwanted side effects.”
Destination: liver, one stop: this is the mission. It was researchers from the University of Sydney and the Sydney Local Health District who, in collaboration with UiT, discovered many years ago that it was possible to deliver medicines to the liver via nanocarriers. The method was then further developed in Australia and Europe. Many medicines can be taken orally, but insulin cannot. McCourt explains that the problem with using it with nanocarriers is that it breaks down in the stomach and therefore doesn't get to where it's needed. This was a major challenge, which the researchers now say they have solved. “We created a coating to protect the insulin from degradation by stomach acids and digestive enzymes on its way through the digestive system, keeping it safe until it reaches its destination, the liver,” says McCourt.
The system is much more similar to how it works in healthy people
The coating that protects the insulin is then broken down in the liver by enzymes that are active only when blood sugar levels are high, releasing the molecule where it can then work, in the liver, muscles and fat, to remove sugar from the blood. “This means that when blood sugar is high, there is a rapid release of insulin, and more importantly, when blood sugar is low, no insulin is released,” says Nicholas J. Hunt of the University of Sydney, who together with her colleague Victoria Cogger leads the project.
It is a more practical and tailor-made method for managing diabetes, he highlights, because it significantly reduces the risk of hypoglycemia occurring and allows the controlled release of insulin based on the patient's needs, unlike injections. The system is much more similar to how insulin works in healthy people. In those who are not affected by the disease, the pancreas produces insulin which first passes through the liver, where much of it is absorbed and keeps blood sugar levels stable. In the method developed by the experts, the nanocarrier releases insulin into the liver, where it can be absorbed or enter the blood for circulation. It also means fewer side effects, experts point out. And no needles.
Oral insulin has been tested on worms (nematodes), and on mice and rats with diabetes. And now about the baboons in the National Baboon Colony in Australia. “To make oral insulin appealing we incorporated it into sugar-free chocolate, and this approach was well received,” smiles Hunt. Twenty healthy baboons took part in this study, they received the medicine and their blood sugar level was lowered. Now the last step remains: testing the new method on humans. “Human trials will begin in 2025 led by the spin-out company Endo Axiom Pty” to examine in phase 1 safety and incidence of hypoglycemia in healthy people and people with type 1 diabetes, Hunt informs. “We are excited to see if we will be able to reproduce in humans the results of the absence of hypoglycemia seen in baboons, it would be a huge step forward. The experiments follow strict quality requirements and must be conducted in collaboration with doctors to ensure that are safe for test subjects.” If all goes well, “we will study how it can replace injections for diabetes patients in phase 2 trials.” The researchers hope that the new medicine could be ready for use within 2-3 years.
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