AWESOME: A diabetes breakthrough from India

[gubbi]

Jana,

There is no benefit of insulin for those whose sugar level is normal, infact, it can be downright dangerous, as it will certainly lead to hypoglycemia, which is a medical emergency and a life-threatening situation. All non-diabetics should stay away from insulin, as the insulin produced by their beta cells in the islet of langerhans of the pancreas is adequate.

regards,

I guess she was asking about those individuals who are diagnosed with IDDM but whose glucose levels are controlled or managed through exercise and controlled diet. In any case, unless prescribed, it is, as is always the case with drugs, dangerous to take Insulin.

 

[indushek]

For the Diabetes capital of the world, this still isnt enough!

There have been numerous attempts to make an Insulin formulation (medicine packed in the form of tablet or capsule etc) which can be taken orally. The problem is that to be effective, Insulin should be absorbed in the stomach or the small intestine and get into the blood. Insulin is a protein molecule. And once it gets into the stomach, there are enzymes in the stomach (Pepsin) which breaks down the protein molecules into smaller components (amino acids) for better absorption.
You want the intact Insulin molecule to reach blood, not broken down pieces.
Hence Insulin cannot be given by mouth in the form of tablet or capsule or liquid.

I have no idea for now. But there is a possibility that such attempts are being made. It makes sense to mix drugs (unless there are contraindications or corss reactivities or reactions between different drugs) which are given for related disorders into one dose.
From the list it seems that all those first 3 drugs are used for Heart conditions (aspirin - anticoagulant in small doses; statins - lower blood cholesterol; and clopidogrel -antiplatelet, again anticoagulant.) However addition of the last one -sulfonylurea (anti-diabetic) into the above mixture doesnt seem to make sense at first glance.
I will let you know, if I find any info on that.

I am a Management student and have no idea about Medicine field, but from the discussion in this thread it seems that we Indians are doing some complex research work So on a global scale from ur knowledge where do u put our efforts??

 

[gubbi]

A poly-capsule would be of great benefit to the diabetic patients.

regards,

Yes, but the pros SHOULD outweigh the cons. Its tricky science. Creating such a formulation is not exactly easy. For one, each of those components should be adequately absorbed and should reach therapeutic levels in the blood. What if even one crosses the required threshold to reach toxic levels? Sometimes such therapeutic windows are very small. And thats why scientists are still struggling with such formulations.

 

[chachachoudhary]

Awesome news.

Sustained released or Depo formulations are destined to gain more and more importance in the coming decades. We are heading towards formulating "smart" drugs.

SIA II breakthrough is certainly going to help millions.

What I wonder is can there be a "smart" compacting of insulin molecules with a trigger mechanism i.e. the release will be controlled by some sort of a glycemic sensor. We can then actually place a small insulin implant inside the body in the intramuscular or subcu form. A futuristic idea though.

 

[Wounded Healer]

Yes, but the pros SHOULD outweigh the cons. Its tricky science. Creating such a formulation is not exactly easy. For one, each of those components should be adequately absorbed and should reach therapeutic levels in the blood. What if even one crosses the required threshold to reach toxic levels? Sometimes such therapeutic windows are very small. And thats why scientists are still struggling with such formulations.

Lolz, thats where people like you come in. You do all the tough work and research, and I , well am just a pill-pusher.

regards,

 

[gubbi]

So on a global scale from ur knowledge where do u put our efforts??

There is indeed a lot of research activity going on in India in the medical field. There has been a tremendous increase in R&D investment by big pharma companies. CSIR/DBT/DST etc have been giving out larger and larger grants for such research.
But to answer your question, to be honest, I dont know.

 

[gubbi]

Sustained released or Depo formulations are destined to gain more and more importance in the coming decades. We are heading towards formulating "smart" drugs.

Not exactly a new science.

What I wonder is can there be a "smart" compacting of insulin molecules with a trigger mechanism i.e. the release will be controlled by some sort of a glycemic sensor. We can then actually place a small insulin implant inside the body in the intramuscular or subcu form. A futuristic idea though.

I like that. Excellent idea. Since this Insulin formulation is a recent development, I do hope in future some one can come up with a formulation attached to such a sensor.
I think it a work in progress.

 

[Wounded Healer]

Hey Gubbi, a bit off-topic but i want your opinion.

What do you think about the GLP-1 Analogues and the DPP-4 inhibitors?

I have personally started patients on GLP-1 analogues and the result has been very good, but its main problem is that you have to inject it twice a day. Still waiting for the long-acting version to be launched here in Pakistan.

Dont know much about DPP-4 inhibitors result. It has just recently been launched in Pakistan. Whats your take on these two new drugs?

regards,

 

[chachachoudhary]

Not exactly a new science.


I like that. Excellent idea. Since this Insulin formulation is a recent development, I do hope in future some one can come up with a formulation attached to such a sensor.
I think it a work in progress.

Sustained release is not a new science, I agree, but technology to release them based on a criteria instead of intermittent and/or continuous release is new one.

We already have insulin pump with continuous glucose monitoring, but it is not anywhere near being "smart"

We need nanotech for this.

 

[gubbi]

Hey Gubbi, a bit off-topic but i want your opinion.

What do you think about the GLP-1 Analogues and the DPP-4 inhibitors?

I have personally started patients on GLP-1 analogues and the result has been very good, but its main problem is that you have to inject it twice a day. Still waiting for the long-acting version to be launched here in Pakistan.

Dont know much about DPP-4 inhibitors result. It has just recently been launched in Pakistan. Whats your take on these two new drugs?

regards,

What are the advantages of these drugs?
So basically GLP-1 analogs increase secretion of Insulin from the beta-cells, inhibit glucagon release, while DPP-4 inhibitors increase GLP-1 levels by inhibiting their degradation.

In IDDM, you have a scarcity of blood insulin levels - due to faulty beta-cell function, while in NIDDM you have insulin resistance (GLUT receptor downregulation).

IMHO, I dont see any advantages. What advantages would a sustained release formulation of GLP-1 have over sustained release Insulin formulation? Patient compliance is one of the importance factors when considering a choice of formulation.