Sunday, February 10, 2019

Would this "Make Diabetics Happy"?

A new invention that put little syringes loaded with insulin into capsules has riveted the popular press.

Here is one story that shows how the things work. And this story says they'll "make diabetics happy." Even the New York Times did a story on it.

As usual, the people designing new drugs and gizmos don't really understand diabetes. The biggest problem facing people with diabetes is not "painful insulin injections." It's figuring out what you can eat and, if you take insulin, how to match the insulin you inject to the food you eat.

One can also inhale insulin. But one problem with that, in addition to the problem of lung damage although the supporters of inhaled insulin say the risk is minimal, is that the amounts you  can inhale are limited. With a pen or a syringe, you can inject any amount you want, not just 4 or 8 or 12 units (the choices available with the inhaled insulin Afrezza). Would these little encapsulated syringes offer a similar benefit? I doubt it.

Another problem is that although the inventors say these things work in pigs, that's only when they have empty stomachs. One might have an empty stomach first thing in the morning, but probably not before meals, so the injections couldn't be used for bolus (premeal) insulins.

If inventors want to "make diabetics happy" they should listen to people with diabetes and see what they really want. There are probably a few people who would love to use tiny syringes in capsules, but I suspect not a lot. Inhaled insulin hasn't caught on, and I suspect encapsulated syringes would have a similar fate in the marketplace even if the cost was low.

Sure, it's fun for the scientists and engineers to come up with gizmos like this, but let's hope they come up with more useful gadgets. Continuous glucose monitors became popular when they became more affordable than some of the older CGMs. Patients are reporting major reductions in their hemoglobin A1c when they use the CGMs and find out what makes their blood glucose go up.

So I'd be happy if the engineers developed cheap CGMs that everyone could use.


1 comment:

  1. Amen on the cheap (and noninvasive) CGMs.

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