People with diabetes may soon be able to take a pill to control the disease instead of needing several daily insulin injections.

A British company will report at a conference in the US today that it has developed a form of insulin that can be taken by mouth, which it believes will provide better control of symptoms.

Oral insulin has been a dream for many years, and several companies have tried to develop it. The problem is that insulin is a protein and the stomach is perfectly adapted to digest proteins, breaking them up into smaller fragments.

Diabetology, a small research and development company, has spent many years trying to get around the problem. It has apparently achieved success by enclosing the insulin in a capsule that resists stomach acids and passes intact into the small intestine.

There it dissolves, releasing a mixture of insulin and other materials that enhance the ab-sorbtion of the insulin through the intestinal wall.

The insulin is then transported to the liver, where it creates a store that can be drawn on by the body.

This more closely approximates the behaviour of the pancreas, the source of insulin in healthy people, releasing insulin as it is needed.

The capsule form is also much more easily administered to young children, who can struggle with needles and the more recent innovation of inhaled insulin. The results to be presented today at the American Diabetes Association meeting in Chicago come from a small trial of 16 patients with type 2 diabetes – the commoner type that usually develops in middle age – carried out at Cardiff University by a team led by Professor David Owens.

They are expected to show that the oral dose taken twice daily before breakfast and before dinner, controlled glucose levels successfully in the patients treated.

The results will be presented by Dr Steve Luzio, also from Cardiff.

Drugs already exist that can lower glucose levels, but they have side-effects. As type 2 diabetes develops, patients eventually have to move on to injected insulin, a transition many are very reluctant to make.

As a result, control of the disease suffers and the long-term risks are increased.

Glen Travers, the executive chairman of Diabetology, said that he hoped the product would remove this inhibition and enable better control of the disease to be achieved, without the increased risk of heart attack that has been linked to the widely used diabetes drug rosiglitazone.

The details of Dr Luzio’s presentation cannot be released until he has made it, but are expected to show that oral doses achieved the desired changes in glucose metabolism, showed a rise in insulin levels in the body that lasted a long time, and revealed no safety concerns.

Additionally, it does not lead to short-term “spikes” of high insulin in the circulation – unlike insulin injections – potentially reducing the risk of side-effects.

A growing problem

— An estimated 2.35 million people in England suffer from diabetes

— By 2010 it is predicted there will be 2.5 million, 9 per cent of which will be due to an increase in obesity

— The life expectancy of someone with Type 1 diabetes is reduced by at least 15 years

— In Type 2 diabetes, which is preventable in two thirds of people who have it, life expectancy is reduced by up to ten years

— It is estimated that about 90 per cent of people with diabetes have Type 1

— People from minority ethnic communities have up to a six times higher than average risk of developing the condition

— About 5 per cent of the total NHS spend is used for the care of people with diabetes

Source: Department of Health

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