Oral insuline

[mike9876]

A company has just completed phase 1b trials of their oral insuline delivery system. If this comes to market in the future it will spare a lot of people who it suits to take from injecting insuline. A pill seems more attractive than the needle. It will also give more freedom with only needing to carry a bottle of pills when traveling.

Oramed Pharmaceuticals Successfully Completes Phase 1B Clinical Trials Of Oral Insulin Capsule (http://www.medicalnewstoday.com/articles/100244.php)

[Jill-O]

I just don't know how they will get the dosing right in an oral form?

Anyone who wants an oral form of insuling hasn't probably taken an insulin shot -- which I find to be completely painless.

And, my insulin pen is extremely convenient. I can take the injection right though my clothes if I want. It's not any more difficult than taking a pill (honest).

[HelenM]

I can't really see that an oral method would give the flexibility that is possible from MDI or using a pump.The tests have been done with type 2 so perhaps its aimed at those who need insulin suplementation rather than insulin replacement. On their website however they also describe an insulin suppository aimed at type 1s particularly children.

What I don't like is their slogan, its designed to capture investment and preys on fears.History will change when Oramed makes painless insulin delivery a reality for diabetes sufferers all over the world. Although there are some people with a real needle phobia I think that for many the main fear of injecting is fear of the unknown. I remember how surprised I was when I had to do my first injection and found it to be both easy and painless.

[kgm0612]

I hate to be the downer here.......but I just don't think it's going to work out. And if it does make it to the market, I think it will be short lived and end up next to Exubera.

Karen

[Scratch]

I hate to be the downer here.......but I just don't think it's going to work out. And if it does make it to the market, I think it will be short lived and end up next to Exubera.

Karen
Perhaps, but seeing how it probably won't require carrying around the Exubera Bong Pipe of Delivery, the oral insulin pills will have that considerable advantage to gaining a foothold in the marketplace.

[morrisma]

Don't see how an oral med, regardless of pain reduction, will ever beat the 15 minute response of my fast acting insulin.
Mike

[mike9876]

We will have to wait and see what happens but who knows it might work. But don't dismiss it when it hasn't been tried by any diabetics and only when its been tried by diabetics who injerct we will know if its a better delivery system or not..

[JediSkipdogg]

Perhaps, but seeing how it probably won't require carrying around the Exubera Bong Pipe of Delivery, the oral insulin pills will have that considerable advantage to gaining a foothold in the marketplace.

That's true...but....what form will the pills be in? Will they be 1 unit pills? 5 unit pills? 10 unit pills? Or how about 1, 3, and 5 unit pills? So now I need 12 units I have to pop 4 pills and make sure I take 4 of the CORRECT pills.

You see where I'm going with that? Not to mention if there is 3 different pills doses then you have to have THREE prescriptions each month or so. That just inflates the out of pocket expense instead of buying ONE type of insulin.

[Scratch]

That's true...but....what form will the pills be in? Will they be 1 unit pills? 5 unit pills? 10 unit pills? Or how about 1, 3, and 5 unit pills? So now I need 12 units I have to pop 4 pills and make sure I take 4 of the CORRECT pills.

You see where I'm going with that? Not to mention if there is 3 different pills doses then you have to have THREE prescriptions each month or so. That just inflates the out of pocket expense instead of buying ONE type of insulin.
I have no doubt that the delivery will be less convenient than the automated response of a completely functional pancreas.

I also suspect that delivery will be more convenient than the Exubera debacle.

[Jill-O]

We will have to wait and see what happens but who knows it might work. But don't dismiss it when it hasn't been tried by any diabetics and only when its been tried by diabetics who injerct we will know if its a better delivery system or not..

Do you take insulin? My hunch is you don't or you might have a different perspective. I take a different amount of insulin before each meal, and it varies depending on how many carbs I'm planning to eat. So like someone else said, do the pills come in one unit form? I'd rather take 1 shot vs. 16 pills before dinner (and then have to wait 30-45 minutes for it to START to work before eating...).

[Alice]

This sounds like we'd have to go back to matching our food intake to a "set" insulin dose. (Unless I'm going to sit there and slice pills with a butter knife?)...no thanks. I'd rather match my insulin to my food flexibility.

[mike9876]

I don't take insulin but there will be a place for oral insulin in the overall market and there are bound to be plenty of diabetics who will prefer to pop 16 pills instead of taking a shot.

No doubt if you want to take insulin by injection you will still be able to, but if somebody doesn't want to take a shot of insulin they can have the pill or pills.

What the oral insulin gives people is choice and they now have a different options instead of injections.

If they will be a fast release or slow release pill there is a place for it along side the shots of insulin.

Not having taken insulin and if I was offered the choice of giving myself a shot or trying oral insulin, I would try the oral insulin and I would imagine plenty of other type 2's who are not insulin will opt for the pill over the shot.

[Jill-O]

You just don't get it because you've never taken an insulin shot. It does not hurt. I was very nervous before taking my first shot and then after I got the nerve to do it, I had to look down to be sure it was in because I did NOT feel it. Those finger tests hurt 10x more than an insulin shot which is painless and usually something you don't even feel.

I'd have a hard time believing anyone who's taken an insulin shot with modern needles would rather pop a pill (or 16 of them) and sit and wait a long time for it to kick in prior to eating.

[fgummett]

Unless this is to be used to replace a long term basal type insulin like NPH or Lantus I don't really see a practical application...

I thought the biggest issue with oral insulin is that; as insulin is a protein our digestive system is designed to break it down. This implies to me that any pill would have to dissolve after the stomach which means even slower absorption. That added to the 16 different sized pills discussion above means that I don't see this idea as a replacement for a fast acting bolus. Perhaps pills could be used as a basal boost for Type 2.

Yes there are folks who are petrified of needles and for whom the idea of multiple daily injections is scary but I can also attest that the modern needles are so fine you barely feel anything especially when compared to the finger stix!

I for one would rather they devote the research time and money on non-invasive blood glucose monitoring instead of oral insulin.

[Stuboy]

i dont think he's ever used insulin... just insuline :o i mean...

INJECTIONS DO NOT HURT.

If they wanna make life easier and less "painfull" and reduce day to day cost then come up with a decent reliable non-invasive blood glucose meter!! (like the new thumb scanning reading in development)

[MJB]

First off, I don't use insulin.

If I needed to take it, I wouldn't be scared, or put off, to inject. I've heard from enough people here that it is virtually painless and easy.

So the question that begs asking is how convenient and effective would this oral medication really be?

Nobody is going to ask their doctor for injectable aspirin or ibuprofen since the pills do the job just fine.

So, IF it works well (a BIG IF) there will definitely be a market for it.

[mike9876]

I think all of you don't get it, people who are not injecting will opt for a pill over a injection. What would any of you lot done if you were offered a pill instead of injecting insulin when you first needed insulin. I bet you would of gone for a pill instead. Jill-O you said you were really nervous at the thought of injecting insulin and I bet you would of opted for the pill then if given the choice.


Because all of you had no choice but to inject insulin none of you can really look at the oral insulin without being bias towards injecting.


First time insulin diabetics won't really care if it takes longer to work than injecting, they will just time when to take the pill before eating.

If it comes to market I believe sales will steadly increase and be a big money for Oramed Pharmaceuticals.

Stuboy all you insulineeeeeeeeeeee injecting folk can carry on as usual.

[fgummett]

I'm sure there are folks who would opt for a pill over an injection :D

To me it would be like opting for urine testing over finger sticks. Not that many moons ago finger sticks were not even available for home use, so why do you think so many people rely on them many times each day when they could just test their urine for glucose?

[mike9876]

MJB

Because you are a member of this site you heard enough to not be scared of taking insulin injections, but how many thousands of diabetics who move from meds to insulin injections who are not a member of this site or read the forums.

How many members does this site have, not hundred of thousands or millions.

The rest of the posters

I think it is a bit premature to say it will never be as easy to use as injections or as good as injections. You will need to take a handful of pills. Wait and what happens when the final product is released and then make your judgement.

[mike9876]

I have just found this on the web and it looks like a once a day pill.

The Oramed Insulin Capsule is an orally ingestible soft gel insulin capsule that the company believes will help Type 2 diabetics reduce the dependency on insulin shots and even prevent them from needing them at a later stage of the disease.

The capsule has been specially engineered to protect the insulin from the destructive effects of gastric juices. The insulin it delivers goes straight to the liver, which stores insulin and controls the dose being delivered to the body, and from there is sent out into the bloodstream.

If it does work it will save a lot of people from developing complications.


Here is the full link

www.mfa.gov.il/MFA/Israel+beyond+politics/Israeli+patent+moves+closer+to+achieving+oral+insu lin+treatment+25-Jun-2007.htm][/url]

I read on another site trials of oral insulin are being carried to see if type 1 can be delayed for 4 to 7 years and reduce the need for insulin in type 1's.

Here is the full link for type 1 study.

Study Tests Oral Insulin to Prevent Type 1 Diabetes, January 31, 2007 News Release - National Institutes of Health (NIH) (http://www.nih.gov/news/pr/jan2007/niddk-31.htm)

[MJB]

mike9876,

Yes, I was just speaking for myself and my experience/knowledge.

I work with another T2 who has stated to me that he doesn't think he could inject himself.

I stand by my last statement, if it works well there will definitely be a market for it.

[Jill-O]

I think all of you don't get it, people who are not injecting will opt for a pill over a injection. What would any of you lot done if you were offered a pill instead of injecting insulin when you first needed insulin. I bet you would of gone for a pill instead. Jill-O you said you were really nervous at the thought of injecting insulin and I bet you would of opted for the pill then if given the choice.


Because all of you had no choice but to inject insulin none of you can really look at the oral insulin without being bias towards injecting.


First time insulin diabetics won't really care if it takes longer to work than injecting, they will just time when to take the pill before eating.

If it comes to market I believe sales will steadly increase and be a big money for Oramed Pharmaceuticals.

Stuboy all you insulineeeeeeeeeeee injecting folk can carry on as usual.

I had a choice. I could have stayed on the pills and tried a higher dosage to get better control. I chose to go on insulin injections just a few months into my diagnosis in order to get a handle on things more quickly. Yes, I was nervous before I took my first shot I was nervous before I drove a car the first time, before I rode a horse the first time, before the first day at a new school, before my first real job, before my first time speaking in front of an audience... but does that mean it isn't worth that initial fear once you get it done the first time?

Honestly, the people who have taken injections have seen both sides for the fence -- before we knew what it was like and after we knew what it was like. When everyone that's taken a shot is tellng you it's not a big deal and you still want to think it's something awful --- what's the point in discussing? You think you know about a miracle fix to a problem that is NOT a problem for anyone who actually needs / uses insulin.

[fgummett]

Reading the full article it is clearly aimed at Type 2 and they do have some interesting ideas about delivering the insulin to the liver which then uses it the same as natural insulin... although I admit I don't understand how they could do that.

The Oramed Insulin Capsule is an orally ingestible soft gel insulin capsule that the company believes will help Type 2 diabetics reduce the dependency on insulin shots and even prevent them from needing them at a later stage of the disease.

The capsule has been specially engineered to protect the insulin from the destructive effects of gastric juices. The insulin it delivers goes straight to the liver, which stores insulin and controls the dose being delivered to the body, and from there is sent out into the bloodstream.

"The advantage of this," Kidron told ISRAEL21c, "is that the route of the insulin from our capsule imitates the real route taken by the body. When you inject insulin it goes straight to the bloodstream and the liver has no control over it. Hence you become insulin dependent. In our case, the liver only releases the amount of insulin that the body needs. Our insulin compliments the insulin that the body is already able to produce so that a patient never becomes insulin dependent. It mimics the physiological delivery of insulin. It's a real revolution."

The company believes the oral therapy, which would replace existing medications used by Type 2 diabetics early in their disease, can preserve and possibly enhance pancreatic and liver function. "We believe that people who take the capsule will be able to avoid having to take insulin injections later in the disease," says Kidron. "Hopefully they will never have to inject, but this capsule will help them control insulin levels for the rest of their lives."

If the capsule works it could possibly benefit tens of millions of people.

[mike9876]

Trials are starting Q2 this year for phase 2 and will last 7 months to test saftey of the capsules. Next year phase 3 will if all goes well and if they are in the UK I will try and get on the phase 3 trials.

A lot of silence when it was known how these capsules will work. Just think all other diabetes meds not needed and insulin injection could be reduced, who knows with the right dose insulin injects could be a thing of the past for some people.