New Treatment Methods

Since the introduction of intramuscular injections as a treatment method of administrating Insulin into the body, research has been focused on other methodsto take insulin into the body in a quick and more efficient manner. One of the more recent devlopments, now available on the NHS is an Insulin Pump and Inhaled Insulin. Other research ideas, that are still within clinic trial stages in development include more adavanced Insulin inhalers, patches and tablets.

Insulin Pump  

Insulin pumps are a relatively new form of treatment that, similar to injections, deliver insulin into the body via piercing the skin with a needle. They were first introduced in the 1970's and have become more popular over the years. Currently around 1 in every 1000 patients uses an Insulin pump. They are even more predominant in children as they eliminate the need for them to inject themselves if they are at a young age or in a school environment. They work by attaching a needle or cannula into the skin which is held in place and linked via a thin tube to a storage meter which holds insulin, similar to an injection in a file. The pump releases insulin into the body both in a long lasting effect as well as a short acting effect for when food has been eaten. The insulin delivered is a short acting type of insulin but it is released regularly in small doses by the pump so that it has a long lasting effect.

Inhaled Insulin
Inhaled Insulin became available in 2006 and was the first alternative method of delivering Insulin into the body without the need for injections. Exubera was the clinical name given to the first inhaled insulin, a fast-acting, dry powder preparation of human insulin that is inhaled into the lungs via the mouth. However, due to it being only a short - acting insulin, such treatment did not take away the need for a background long lasting insulin to stablisise glucose levels throughout the day.  Patients would therefore still need to use injections. After its first introduction, Exubera was not as effective in the market for this kind of drug and was removed from treatments available to diabetic patients no long afte rbeing released. there are currently around 600 patients in the UK who still use Exubera but the inhaler is no longer available as a new treatment option.

There is currently several companies who are still in the process of trying to produce more efficient inhalers that are portable and therefore can be carried around by the patient. AERx Diabetes Management System is currently in phase III of its clinical trial, supported by Novo Nordisk and Aradigm Corporation. AERx is an electronic inhaler that releases a dose of liquid insulin deep into the lungs. Whilst trials are underway (not yet in the UK), the only disadvantage that has been highlighted is the need for specific breathing rates and depths to ensure the insulin diffuses are the correct speed to avoid any complications. The rate and depth of breathign must therefore be monitoring when the inhaler is taken.

The other insulin inhaler that is currently within development is being funded by the Generex Biotechnology Corporation and is known as Oral-lyn. The Insulin inhaler is similar to AERx in the way it is delivered but instead of working at the level of the lungs, the liquid is absorbed rapidly into the blood stream through the cheeks. The trials for Oral-lyn are still underway in Italy but it has been approved for marketing in Ecuador and also in Canada in the near future.

Insulin Patches

Insulin patches have been involved in new treatment research for quite some time with several companies looking into finding a way for Insulin to enter the body via a patch that can be placed on the skin. However, not much success has been made due to the complications with the Insulin molecule’s structure and finding a way for it to pass through the skin barrier. There are currently two patches going through early trial stages involving a long lasting insulin aimed at both Type I and Type II diabetic patients. This is being funded by Altea Therapeutics. There is also research by Starbridge Systems underway about a plaster like pump that can release Insulin for a duration of 3 days before it needs replacing.

Tablets

Tablets are one of the easiest methods of administarting medicine used today. However, due to its hexameric structure, Insulin is unable to enter the body orally as it is broekn down by the digestive enzymes in our GI tract. research is still ongoing to try and discover a way of protecting the Insulin from the acid and enzyme destruction and Scientists in India are currently looking into coating the Insulin to form a jelly pill that will only break down when it is within the more alkaline region of the large intestine.

Transplants

There are also other new developements in treating Type I diabetes that include more evasive methods such as transplants of both the pancreas as a whole organ or transplantation of the specialised islet cells responsible for the release of Insulin. As of february this year, islet cell transplantation has become available on the NHS but only to those patients who are hypoglycaemia insensitive and have very poor control over their diabetes. Due to the costly equipment required to carry out such operations, they are only being used as a last resort treatment. However, in clinical trials previously carried out, results showed a potential cure using islet cell transplantation due to restored Insulin production by the new transplanted cell.  The other option in transplantation operations is in regards to stem cell biology where research is currently underway with hope to using stem cells to regenerate the islet cells and hopefully aim towards a cure for Diabetes using similar theories. There is a video below when a scientist is discussing the new advancements in stem cell research with regards to Diabetes.