I have a 59 year old brother who is diabetic, taking insulin injections. We are looking for any information about insulin taken orally. We were told recently of oral insulin and want to learn more.
The hope of being able to discontinue insulin injections and substitute insulin by mouth is a very understandable one; but sadly unachievable. It has of course been tried, using insulin in capsules that release it beyond the reach of protein-digesting enzymes or in company of compounds that inhibit these enzymes. The problem is that, although the insulin is absorbed, very much larger doses are required and the degree of absorption is too erratic to guarantee the precision of control that is now thought advisable.
What you have probably heard about is the use of nasal or oral insulin to 'vaccinate' first degree relatives of new onset cases who have antibodies indicating a high probability that they will get clinical diabetes within a few years. These studies have only just begun so that there is no evidence as yet that they will.
[Editor's comment: I also would wonder from your description whether your brother might be a Type 2 patient. If so, there's the possibility of him using the diabetes pills (which are not oral insulin), either together with insulin shots, or instead of insulin injections. There are many new types of pills, and a combination of one or two might decrease his need for shots. He should discuss this possibility with a knowledgeable endocrinologist. WWQ]
Original posting 16 Nov 96
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