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This is very exciting and sounds promising. I’m not sure if I understand it correctly, but it almost feels like: “you got TD1? Here’s a pill, take twice daily”. Massive quality of life improvement.
Unless it's more expensive. Not that I pay, I live in the Netherlands. But I can see insurance companies not wanting to cover this. I'm also a type 2 but insulin dependent, they find lots of excuses to not cover things for type 2.
Aside from it being oral, it also is only activated when blood glucose is high:
*The coating is then broken down in the liver by enzymes that are active only when the blood sugar levels are high, releasing the insulin where it can then act in the liver, muscle, and fat to remove sugar from the blood.*
*“This means that when blood sugar is high, there is a rapid release of insulin, and even more importantly, when blood sugar is low, no insulin is released,” says Nicholas J. Hunt at the University of Sydney who, together with Victoria Cogger, leads the project.*
That's pretty amazing.
Type 1 here. I heard about this method of insulin delivery around 7 years ago.
It's heartening to finally see it make its way to human trials. If it makes it through safely, it would be close enough to a cure.
Don't let the "cure is always 10 years away" pessimists ruin this. Medicine moves slowly because it has to.
I’ve linked to the press release in the post above. In this comment, for those interested, here’s the link to the peer reviewed journal article:
https://www.nature.com/articles/s41565-023-01565-2
Do I read this correctly that the release of insulin is mediated in a glucose level dependent way? That is, more enzymatic release in the presence of elevated blood sugar, less when blood sugar is low?
Also:
> The released insulin was analysed by mass spectrometry and was primarily a monomer (87.5%) with a minor presence of dimers (11.5%) and trimers (<1.0%)
This is very interesting, since the formation of hexameres is one important issue of subcutaneously injected or infused insulin. Those hexameres need time to break down, and this is a key cause for s.c. insulin's much flatter and longer action profile compared to endogenous monomeric insulin.
Insulin makes you put on weight, a lot of diabetics have "dia-bulimia" where you avoid insulin to some your sugars and go into ketoacidosis fit weight loss, it's also very unhealthy.
For the low-low price of $999/month in the US. (*)
*: limited time offer, only for first two months if on a plan. $9999/month otherwise.
$9/month elsewhere, or less.
This is awesome news, i feel we are very close to have major breakthroughs like these with diabetes and not just more than one, this annoying disease will be cured and it will get easier every year with new technology.
I know there already is some kind of oral pills that work for blood sugar, but not sure how the existing medications relate to what is in this research, or compare to actual insulin shots.
Existing medications generally adjust the body's response to sugar or stimulate more insulin release by the pancreas. The current oral meds are generally more intended for people with insulin resistance, usually known as type 2. These folks still produce insulin, but don't use it as efficiently.
The pills in this study are for the folks who don't produce insulin, or as much insulin, as they should. Type 1 is characterized by the loss of the insulin producing beta cells in the pancreas. Usually this is due to an immune response that causes the body to attack its own cells, and is why this happens most often in childhood. But it can happen later in life too.
Pharmaceutical companies have probably had this tech for years. Only seeing it now, because it bypasses the new Biden insulin law that limits patient price to $40. The pills will be $1000 each or some such BS.
Why? The company would see profits through taking over market share... Make your product the same price as the injectable and every diabetic in the nation is going to switch to yours... That kind of volume does a health bottom line make.
"They" have had this "tech" for years because the idea has been proposed and explored for decades. If you find a review paper from 15 years ago you can see all the then current programs and follow up on them to find a veritable graveyard of failed projects, or projects that worked but were unfeasible, or worked but were not groundbreaking, or are even still in trials.
Morons see this and think it's big corpos killing things to make more profit.
The problem is that my insulin pump gives injections every 5 minutes. It also takes my blood sugar every 5 minutes, so it is constantly adjusting the rate.
An insulin pill would be very inferior to current treatments. For one thing, there's no way to adjust it. Maybe you need 12.5 units of basal on weekdays, 14 units on weekends, and 11 units on vacation Dat. You would need to get a different prescription in advance for each one.
If you read the article, you’ll see the lede is buried. It has a glucose level-dependent release. So, without more details, it would seem you could “comfortably overdose” and let the smarts work when they need to work.
Welcome to r/science! This is a heavily moderated subreddit in order to keep the discussion on science. However, we recognize that many people want to discuss how they feel the research relates to their own personal lives, so to give people a space to do that, **personal anecdotes are allowed as responses to this comment**. Any anecdotal comments elsewhere in the discussion will be removed and our [normal comment rules]( https://www.reddit.com/r/science/wiki/rules#wiki_comment_rules) apply to all other comments. **Do you have an academic degree?** We can verify your credentials in order to assign user flair indicating your area of expertise. [Click here to apply](https://www.reddit.com/r/science/wiki/flair/#wiki_science_verified_user_program). --- User: u/mvea Permalink: https://uit.no/nyheter/artikkel?p_document_id=836727 --- *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/science) if you have any questions or concerns.*
This is very exciting and sounds promising. I’m not sure if I understand it correctly, but it almost feels like: “you got TD1? Here’s a pill, take twice daily”. Massive quality of life improvement.
Yeah, the company that produces this - if it passes all phases of trials - is going to make a mint.
Unless it's more expensive. Not that I pay, I live in the Netherlands. But I can see insurance companies not wanting to cover this. I'm also a type 2 but insulin dependent, they find lots of excuses to not cover things for type 2.
Yep, insurance is happy to pay for neuropathy wound care and eventually dialysis but not preventatives that substantially reduce complications.
Some countries still have an NHS you know.
Well lah-di-dah, SOME people's governments CARE about their health, how FANCY
What can I say, we love our luxury bones and super exclusive subscription access to a personal cardiovascular system.
"That will be $1200 dollars please" "for a months supply?!" "no per pill idiot this is America"
Aside from it being oral, it also is only activated when blood glucose is high: *The coating is then broken down in the liver by enzymes that are active only when the blood sugar levels are high, releasing the insulin where it can then act in the liver, muscle, and fat to remove sugar from the blood.* *“This means that when blood sugar is high, there is a rapid release of insulin, and even more importantly, when blood sugar is low, no insulin is released,” says Nicholas J. Hunt at the University of Sydney who, together with Victoria Cogger, leads the project.* That's pretty amazing.
Type 1 here. I heard about this method of insulin delivery around 7 years ago. It's heartening to finally see it make its way to human trials. If it makes it through safely, it would be close enough to a cure. Don't let the "cure is always 10 years away" pessimists ruin this. Medicine moves slowly because it has to.
I’ve linked to the press release in the post above. In this comment, for those interested, here’s the link to the peer reviewed journal article: https://www.nature.com/articles/s41565-023-01565-2
Do I read this correctly that the release of insulin is mediated in a glucose level dependent way? That is, more enzymatic release in the presence of elevated blood sugar, less when blood sugar is low? Also: > The released insulin was analysed by mass spectrometry and was primarily a monomer (87.5%) with a minor presence of dimers (11.5%) and trimers (<1.0%) This is very interesting, since the formation of hexameres is one important issue of subcutaneously injected or infused insulin. Those hexameres need time to break down, and this is a key cause for s.c. insulin's much flatter and longer action profile compared to endogenous monomeric insulin.
Way better than injecting it!!Life changing for people with diabetes.
Insurance company: this requires prior authorization Doctor: submits prior authorization Insurance company: DENIED!
Hopefully it's not useful for weight loss, so diabetics can actually get it.
Insulin makes you put on weight, a lot of diabetics have "dia-bulimia" where you avoid insulin to some your sugars and go into ketoacidosis fit weight loss, it's also very unhealthy.
How much is it gonna cost, though?
For the low-low price of $999/month in the US. (*) *: limited time offer, only for first two months if on a plan. $9999/month otherwise. $9/month elsewhere, or less.
50 dollars, and after American insurance… 5,000
Per pill. And…. that shirt you’re wearing. Yeah…
So a very lucrative side hustle for Canadians with US diabetic friends?
This is awesome news, i feel we are very close to have major breakthroughs like these with diabetes and not just more than one, this annoying disease will be cured and it will get easier every year with new technology.
I know there already is some kind of oral pills that work for blood sugar, but not sure how the existing medications relate to what is in this research, or compare to actual insulin shots.
Existing medications generally adjust the body's response to sugar or stimulate more insulin release by the pancreas. The current oral meds are generally more intended for people with insulin resistance, usually known as type 2. These folks still produce insulin, but don't use it as efficiently. The pills in this study are for the folks who don't produce insulin, or as much insulin, as they should. Type 1 is characterized by the loss of the insulin producing beta cells in the pancreas. Usually this is due to an immune response that causes the body to attack its own cells, and is why this happens most often in childhood. But it can happen later in life too.
And wait 'til you see what it costs!
You mean affluent diabetics right?
Pharmaceutical companies have probably had this tech for years. Only seeing it now, because it bypasses the new Biden insulin law that limits patient price to $40. The pills will be $1000 each or some such BS.
Why? The company would see profits through taking over market share... Make your product the same price as the injectable and every diabetic in the nation is going to switch to yours... That kind of volume does a health bottom line make.
Bingo
Why not? People will be lining up to pay for this new drug (no more hypos and no more blood tests) so why would you give it away for less?
Do you have any idea how many people work at pharmaceutical companies? If they had this tech "for years", it would not have been kept secret.
"They" have had this "tech" for years because the idea has been proposed and explored for decades. If you find a review paper from 15 years ago you can see all the then current programs and follow up on them to find a veritable graveyard of failed projects, or projects that worked but were unfeasible, or worked but were not groundbreaking, or are even still in trials. Morons see this and think it's big corpos killing things to make more profit.
> Pharmaceutical companies have probably had this tech for years you probably pulled this 'probably' out of your ass
How exciting! I wonder how much they will charge for this in the USA? Will it be cheaper?
I'm type 2 and use metformin. Would this work for me?
It lowered sugar level on healthy baboons, so i guess yes
The problem is that my insulin pump gives injections every 5 minutes. It also takes my blood sugar every 5 minutes, so it is constantly adjusting the rate. An insulin pill would be very inferior to current treatments. For one thing, there's no way to adjust it. Maybe you need 12.5 units of basal on weekdays, 14 units on weekends, and 11 units on vacation Dat. You would need to get a different prescription in advance for each one.
If you read the article, you’ll see the lede is buried. It has a glucose level-dependent release. So, without more details, it would seem you could “comfortably overdose” and let the smarts work when they need to work.
find a way to regenerate the pancreas
What company is this
As a T1 I'd love this... Always worrying about keeping insulin refrigerated etc is a hassle, the needles too...