Needle-free oral insulin has fewer side effects

Summary
New method, developed by Nature researchers and tested on baboons, rats and mice, allows the oral intake of insulin to control diabetes, with fewer side effects and precision in the release of the substance

Diabetes is an extremely prevalent disease in Brazil, affecting around 10% of the Brazilian population, according to data from the Vigitel 2023 survey. And a large part of this population is dependent on the use of insulin injections to control the disease, which represents a challenge in diabetes treatment.

“In diabetes there is a deficiency in the secretion or action of insulin, a hormone produced in the pancreas that is responsible for controlling blood glucose levels. So, to control blood sugar levels, some diabetic patients need to use exogenous insulin, which is usually administered through injections. The problem is that many patients are resistant and uncomfortable with the use of insulin injections, which makes it difficult to adhere to treatment. Furthermore, this method can cause hypoglycemia, with a significant drop in blood glucose levels”, highlights Deborah Beranger, endocrinologist, with a postgraduate degree in Endocrinology and Metabology from Santa Casa de Misericórdia do Rio de Janeiro (SCMRJ).

But now, researchers have developed a method that allows insulin to be taken orally and has fewer side effects. The discovery was published in January in the scientific journal Nature.

According to Deborah, although many medications are administered orally, this was not a possibility with insulin until then.

“This is because insulin is broken down during its passage through the stomach and intestine and, therefore, cannot reach the liver, where it must act”, he explains.

Fortunately, researchers have managed to circumvent this problem by creating a coating that protects insulin from being broken down by stomach acids and digestive enzymes, keeping it safe until it reaches the liver, where it is finally broken down by enzymes active only when blood sugar levels rise. are high.

“In other words, insulin is only released when glucose levels are high, but nothing happens if these levels are low, as the enzymes responsible for breaking down insulin will not be active. This reduces the risk of hypoglycemia, as the release of insulin occurs in a controlled manner according to the patient’s needs, unlike what happens with injections, in which the insulin is released all at once”, says the doctor.

More accurate results

In addition to having fewer side effects, this method of insulin therapy is also more precise, as it delivers insulin quickly to the necessary location. With injections, the substance spreads throughout the body and can cause important side effects.

“The new method delivers insulin directly to the liver, where it can be absorbed or enter the bloodstream to circulate throughout the body. On the other hand, with injections, a large part of the insulin ends up in muscles and fatty tissues, which can lead to fat accumulation and hypoglycemia”, says the endocrinologist.

The new method was tested on healthy baboons, which showed reduced blood sugar levels. It was also tested on rats and mice with diabetes, who did not suffer from hypoglycemia, fat accumulation or weight gain. And, to make oral insulin more palatable, the researchers even incorporated it into sugar-free chocolate, which was well received.

The next step is human testing, which should begin in 2025. Researchers expect the new drug to be widely available for use in two or three years.

“The oral use of insulin can represent a true revolution in the treatment of diabetes and in the quality of life of patients suffering from the condition, as, in addition to having fewer side effects, it is more practical, discreet and comfortable for the patient, with no need to be stuck with a needle and not even refrigerated”, concludes Deborah Beranger.