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In North America, insulin-dependent diabetics are more commonplace than ever.  As of 2021, the CDC reports that nearly 12% of the entire United States population suffers from the health condition.  Traditionally associated with Type-1 diabetes, this rise in insulin dependence is largely due to a spike in earlier onset Type-2 cases closely linked with obesity, fueled by poor diets and sedentary lifestyles.   What is the result of this growing prevalence? Diabetes is now a top-10 killer among preventable deaths.  Aside from mortality rates, diabetes can be an especially difficult condition to live with on a daily basis.  For example, this can mean,

• blood sugar monitoring
• associated health ailments (increased risk of heart and kidney diseases, glaucoma, nerve damage, etc.)
• restrictions on motor vehicle licensing
• dietary restrictions

For the insulin-dependent diabetic, perhaps the most challenging hurdle is the need for daily injections.  Thankfully, scientists have been hard at work developing a workaround to this need, and have released a paper discussing a new approach that will allow for oral insulin delivery, negating the need for injections altogether.  Promisingly, this approach is already set to undergo human testing in 2025 and could potentially be available for use by 2027.

Oral Delivery to Replace Injections

Before taking a closer look at the approach discussed in the paper, it should be noted that not all diabetics suffer from the same condition.  While both Type-1 and Type-2 may be insulin-dependent, the reasons why vary.

Type-1 diabeties: This is an auto-immune disorder that typically first appears between the ages of 4-14 years and remains with the individual for life.  These individuals do not naturally produce insulin due to the body attacking production cells within the pancreas.

Type-2 diabetes: This typically onsets later in life and is the result of lifestyle choices such as poor diet and lack of physical activity.  Those suffering from Type-2 can over time lose the ability to make insulin as production cells within the pancreas, essentially, become overworked from constantly battling high-sugar levels.  The longer someone lives with diabetes, the greater the likelihood they will become insulin dependent.

In either case, insulin is a terrible medication to be reliant upon because when ingested, it breaks down before it can be distributed throughout the body and do its job – requiring daily injections instead.  To circumvent this need and greatly improve the quality of life for those reliant upon injections, the scientists behind the paper created a unique coating that will protect insulin within the stomach and only break down, exposing the insulin, once the medication reaches the liver and is exposed enzymes released in a high-sugar environment.

Beyond Quality of Life

Interestingly, the proposed approach does more than improve the quality of life for those who are insulin-dependent; it also stands to improve the efficacy of such treatments.  This is due to the ability to offer a more targeted approach.

When reliant on injections, it means that there is a set dose of active insulin being introduced to one’s system all at once.  Changing the approach means that the insulin will only be activated when sugar levels dictate a need for it and are ready for systemic release from the liver at a moment’s notice.  This is a much more targeted approach that could result in less insulin needed, quicker response times, a decreased chance of accidental hypoglycemia, and money saved for the end-user.

Diabetes Comes with a Cost

Promisingly, in the paper, it is stated that “…insulin conjugated to Ag₂S QDs with a CS/GS polymeric coating was simple to manufacture and reproducible at CSIRO”.  While only time will tell if this results in an affordable alternative for end users, one can hope.

As it stands, insulin is often a hot topic for ethical practices.  While insulin was originally an affordable medication, it has become quite cost-prohibitive due to a lack of generic alternatives on the market due to patents on slight modifications made to manufacturing processes.  A simple manufacturing process could go a long way to ensuring this step forward remains financially attainable for those that need it.

Due to the widespread prevalence of diabetes and the resulting increase in those who are insulin-dependent, the situation has even led to government intervention meant to cap the costs of the medication.

Top Potential Oral Insulin Manufacturers

While the benefits of oral delivery for insulin-dependent users are numerous, the companies that would be responsible for the manufacturing of such a medication would, no doubt, capitalize.  Even if profit margins on such medication are kept low, the sheer prevalence in usage across the population means that insulin, regardless of delivery method, could be quite lucrative.

*Figures provided below were accurate at the time of writing and are subject to change.  Any potential investor should verify metrics*

1.  Novo Nordisk

As a leading global healthcare company focusing strongly on diabetes care, Novo Nordisk has a long history of innovation in insulin therapies, resulting in it becoming a prominent player in the field.  With a well-established pipeline for diabetes care products and a reputation for advancing diabetic care, Novo Nordisk is well-positioned to develop and market new forms of insulin, including the potential for orally administered insulin.  Its commitment to diabetes research and development and its global reach could make Novo Nordisk a key competitor in the oral insulin market should it choose to pursue this path.

2. Pfizer, Inc.

Pfizer is a multinational pharmaceutical corporation known for its wide-ranging portfolio of medicines and vaccines.  The company has a history of successful drug development and commercialization across various therapeutic areas.  The company’s significant research capabilities, substantial financial resources, and global distribution networks position it well to venture into new territories like orally administered insulin.  Pfizer’s expertise in drug formulation and delivery systems and its strategic partnerships could facilitate a foray into this area, aligning with its commitment to address unmet medical needs.

3. Eli Lilly and Company

Eli Lilly is another pioneer in diabetes treatments, having been instrumental in developing and marketing insulin since the 1920s.  As a result, the company’s deep expertise in insulin therapy and commitment to diabetes care innovation make it a formidable player in the space.  Eli Lilly’s ongoing investment in research and development, particularly in novel diabetes treatments, positions it more favorably than most to explore and potentially lead in developing oral insulin solutions.  Its track record of innovation in insulin delivery and formulation suggests a strong potential for success in bringing an oral insulin product to market by 2027, provided further research on such a product is successful.

Final Thoughts

Insulin is a lifesaving medication that – despite being needed by a large chunk of the population – is a burden due to its delivery mechanism.  The development of a cost-effective alternative that removes the need for daily injections, all while providing a more targeted approach, has the potential to be a welcome step forward in the treatment of diabetes, benefitting not only those reliant on the medication but the companies responsible for servicing this need.