An effective oral insulin option has been an unfulfilled dream for people with diabetes since the discovery of insulin. There has been recent progress on a potential pill, but the concern is that it won’t be as effective as an injection. Even those wary of needles are likely to choose effectiveness over convenience if it means safer blood sugar levels.
But have found a way to deliver the best of both worlds—an insulin-delivering needle that people can swallow. The tiny injection is encapsulated in a sugar casing that dissolves in the stomach, where the device automatically injects into the stomach lining.
Now the question is: Are people willing to swallow a needle, even if it’s only one millimeter?
Researchers at MIT are hoping the device’s convenience outweighs its unconventionality. Researchers Robert Langer and Giovanni Traverso published their report in the journal Science in early 2019, where they described their success in pig and mouse experiments with a self-orienting millimeter scale applicator (SOMA).
The effect was similar to that of using externally injected insulin, and since there aren’t pain receptors in the stomach lining, the patient shouldn’t feel anything.
Once it reaches the stomach, the weighted device self-orients so that the needle always injects into the stomach lining. The shape of the device was inspired by the leopard tortoise, whose shell allows it to right itself even if it gets flipped on its back. The capsule is about the size of a small blueberry and contains a tiny needle made of compressed insulin. It’s held in place by a sugar disk, and when the sugar dissolves in the stomach, a spring causes the needle to inject.
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Researchers hope that, should further trials prove successful, the device could have other applications. “We see no reason why someday this couldn’t be used to deliver any protein to the body,” Langer said. For Langer and Travero, the SOMA is the latest milestone in a years-long attempt to create a swallowable injection. In 2014 they created a pill with many needles, presumably so that it could deliver medicine regardless of how it landed. This latest self-orienting device requires only one needle.
When it comes to swallowing, the fewer needles, the better.
In the pig studies, the SOMA was safely excreted without adverse effects. Researchers are now planning more trials and working with Novo Nordisk to perfect their technology.
Fear of needles affects adherence to insulin therapy and often delays its start for those with type 2 diabetes. The new device may increase both the efficacy and palatability of an insulin program, but a needle injection, even when coated in a spoonful of sugar (of sorts), may still be a tough pill to swallow.Whizzco