None — Diabetes
Normally, when we eat, cells in the pancreas release insulin, a hormone that enables glucose in the blood to enter cells and be used as a source of fuel. Diabetes is a disease that affects the body's ability to use glucose. There are two main types. In type 1, the pancreas doesn't produce insulin because of an immune system attack on the insulin-producing cells. In type 2 diabetes the pancreas either doesn't make a sufficient amount of insulin or the body is no longer able to effectively use the hormone to get fuel into the cells.
According to the American Diabetes Association, about 23.6 million Americans have diabetes. Roughly 1.6 million new cases are diagnosed annually. Type 2 is the most common form of the disease, accounting for 90 to 95 percent of all cases.
Over time, excess glucose in the blood can damage blood vessels and organs. People with diabetes are at high risk for a number of complications, like heart disease, stroke, kidney disease, nerve damage, infections that don't heal and amputation. The CDC estimates, in 2007, the economic cost of diabetes was $174 billion.
Insulin for Diabetes
There is no cure for diabetes. People with type 1 diabetes don't make insulin and need regular injections of the hormone to stay alive. Patients with type 2 can often control the disease through diet, exercise, lifestyle modifications and medications. However, some of those with type 2 will eventually need insulin treatment to control glucose levels. The CDC estimates that nearly 1/3 of people with diabetes use insulin.
There are several different forms of insulin. Regular-acting insulin enters the bloodstream within 30 minutes and is effective for about 3 to 6 hours. Rapid-acting insulin gets into the blood very quickly, typically in about 5 minutes and is good for about 2 to 4 hours. Intermediate-acting insulin enters the bloodstream in 2 to 4 hours and is effective for 12 to 18 hours. Long-acting insulin takes about 6 to 10 hours to get into the bloodstream and lasts the longest, usually 20 to 24 hours.
Insulin Spray
Insulin can't be given in a pill form because the digestive tract breaks it down before it can enter the bloodstream. Therefore, people who need insulin must take regular injections of the hormone. Some people have a hard time accepting the injections, leading to poor compliance and a greater risk for complications from diabetes.
Researchers are now testing a new way to deliver insulin, by using a mouth spray. The new form of insulin is called Oral-lyn™ and it's delivered through a RapidMist™ device. The RapidMist is similar to an inhaler. But instead of breathing the drug into the lungs, patients hold it inside their mouth, where it is absorbed through the cheek lining. Dennis Gage, M.D., Endocrinologist with Beth Israel Medical Center in New York City, says this lining has a lot of blood vessels, enabling the drug to be quickly absorbed into the bloodstream.
Usage is simple. Gage explains the patient exhales, sprays and holds the drug inside the mouth for about three seconds. A single spray delivers one unit of insulin to the cheek lining. The dosage of insulin can be adjusted by increasing the number of sprays. Thus, if the patient uses more insulin, he/she simply repeats the process until the required dose is achieved.
Oral-lyn™ is a fast-acting type of insulin that's currently being tested for use before meals. Gage expects that many patients will find the oral spray form of insulin easier and more acceptable to use than injectable forms. However, some people, especially those with type 1 diabetes, will still need injections of longer-acting insulin to control their glucose levels.
There are two clinical trials currently being conducted for Oral-lyn™. For information on the Phase III trial for patients with type I diabetes, click here, then type in the trial identification number: NCT00668850. Information on the trial for patients with type 1 and type 2 diabetes can be found on the same site using the trial identification number, NCT00948493.
For information on Oral-lyn™, click here.
For general information on diabetes or insulin treatment:
American Diabetes Association Centers for Disease Control and Prevention National Institute of Diabetes and Digestive and Kidney Diseases