Researchers develop oral insulin for the treatment of diabetes.

By Thais Szegö, from Agência Einstein - Researchers at the University of Sydney in Australia are developing an oral insulin that could revolutionize the treatment of diabetes patients who currently need to use injectable insulin to control their blood glucose levels.

Oral insulin has already been used in diabetic rats and mice, as well as healthy baboons, showing excellent results (published in...). scientific journal Nature)The expectation is to test the new insulin on humans starting next year. According to experts consulted by Agência Einstein, the effects obtained with animals indicate that the new form of insulin use has an advantage over the injectable form because it delivers the hormone directly to the liver, where it can be absorbed or enter the bloodstream.

Diabetes is a chronic disease characterized by the inefficient production of, or resistance to the action of, insulin, the hormone produced by the pancreas that controls the amount of glucose in the blood to provide energy to the human body. According to data from the Vigitel Brasil 2023 survey (Surveillance of Risk and Protective Factors for Chronic Diseases by Telephone Survey), 10,2% of the Brazilian population has diabetes.

Until now, the use of insulin orally was not a possibility, since the substance is a protein, which means it undergoes digestion in the stomach and cannot reach the liver intact, where it should act. "Therefore, researchers have developed nanoparticles that can resist this process and are absorbed properly," explains endocrinologist Simão Lottenberg, from the Albert Einstein Israelite Hospital.

In the case of injections, a large portion of the insulin ends up in the muscles and adipose tissue. Besides making the substance's action more effective, this factor can help prevent hypoglycemia, which is characterized by a low amount of sugar in the blood, a well-known side effect for those who use the injectable version. This is because, when it reaches the liver, insulin is broken down by enzymes and is only used by the body when blood glucose levels are high – nothing happens if they are normal. “Since the hormone applied by the needle impregnates the adipose tissue, part of it is released even when glucose is normal, which can trigger hypoglycemia, making the oral alternative much safer,” says endocrinologist Deborah Beranger, from Rio de Janeiro.

“This reduces the risk of hypoglycemia, that is, a drop in blood sugar, because the release occurs in a controlled manner, according to the patient's needs, unlike what happens with injections, which cause the insulin to be released all at once,” explains the doctor.

Oral insulin makes treatment easier.

Another advantage of using oral insulin is that it will likely ensure greater adherence to treatment, as patients will not need to inject themselves. According to doctors, many patients avoid injecting the substance when they are away from home for fear of suffering an episode of hypoglycemia, which can cause mental confusion, dizziness, palpitations, tremors and, in more serious cases, trigger seizures, loss of consciousness and even life-threatening situations. "Not to mention that the need to constantly monitor blood glucose with a finger prick would be reduced," says the doctor.

“Although current insulins are much easier to manage than in the past, oral administration could indeed lead to greater adherence,” agrees Lottenberg. However, the doctors interviewed by Agência Einstein say that the only bad news is that there is still a long way to go before oral insulin is accessible to diabetics.