Ellen Campbell -Grizzle
INTENSE RESEARCH into new ways to deliver insulin for the treatment of diabetes mellitus is bearing good fruit.
For many diabetics, insulin shots are a fact of life. The drug is necessary to control their blood sugar, decrease the risk of complications and improve quality of life. Insulin is critical to the normal functioning of cells in your body. It acts like a key to open the door to the cells and let food (glucose) in.
Without insulin, cells are denied energy. No matter how much you eat or drink, your cells remain hungry and continuously signal your body for more food. Your body sends signals that it is thirsty, you drink a lot, and then the body uses the drink to get rid of extra glucose. This explains why people with diabetes feel hungry and thirsty all the time. They are eating and drinking but the cells of the body are starving.
MEANS OF SURVIVAL
Insulin shots are, therefore, a means of survival for many diabetics. However, many do not like injections. Today, there are alternative devices that offer promise and treatment advantages. Recently, advisors to the United States Food and Drug Administration (FDA) recommended approval of Exubera, an inhaled form of insulin. The device could be used to manage blood sugar levels for people who take short-acting insulin injections before meals. The FDA is not recommending the product to replace longer-acting insulin injections. Exubera is not recommended for smokers. ORA-LYN, an oral insulin spray formulation, was recently licensed in Ecuador. The inhaled insulin delivery system provides insulin as a spray or dry powder inhaled through the mouth, directly into the lungs where it passes into the bloodstream.
Other devices for taking insulin exist or are in development. Some diabetics are already using:
Insulin pens - these carry a short, fine needle at the tip of a device that looks like a pen. The insulin is stored in an inner cartridge. Users turn a dial to select the desired dose of insulin and press a plunger to deliver the drug just under the skin.
Insulin jet injectors - these send a fine spray of insulin through the skin in a high pressure air mechanism instead of needles.
Subcutaneous infusion sets deliver insulin through a catheter.
External insulin pumps are about the size of a deck of cards. Users programme the pump to deliver a steady trickle of insulin daily or several units at a time related to meals or as necessary.
In the insulin pipeline are:
Implantable insulin pumps that are surgically implanted under the skin of the abdomen.
The insulin patch to be placed on the skin and provide a continuous low dose of the drug
Insulin pills - researchers are working on ways to get insulin into the blood before it is changed by the digestive system.
A spray that delivers liquid insulin into the mouth. It would then be absorbed through the throat and inside of the cheeks.
As research unfolds, it is possible that an artificial pancreas will imitate the action of the pancreas by sensing blood glucose levels and secreting insulin in response. Other innovations may not make it through the rigorous human testing trials because of long-term adverse effects. However, insulin as we know it continues to benefit millions of diabetics around the world.
Remember, if insulin is a part of your therapy, take your treatment daily as directed, monitor your blood glucose regularly, stick to a healthy diet and exercise in accordance with your wellness plan.
Ellen Campbell-Grizzle, president, Caribbean Association of Pharmacists; director, Information & Research, National Council on Drug Abuse; email: yourhealth@gleanerjm.com.
