Oral Insulin for Type 1 Diabetes - Problems and Possibilities

People with type 1 diabetes - the insulin-dependent version - must take insulin in order to keep their blood sugar down. Currently the most dependable way to do that is with insulin injections. However, recent research indicates that a more convenient way to take insulin may not be far off.

What is insulin?
Insulin is a protein hormone produced by the pancreas. It's released in response to an increase in blood sugar after a person eats carbohydrates - foods like starches and sugars.

People who have type 1 diabetes produce either too little insulin or, in some cases, no insulin at all. Therefore, they have to get it from an outside source. Insulin's been available since the 1920s, and scientific research has been able to develop a form that is relatively pure, which makes it stronger and more reliable. Still, the best way to take insulin is via injection.

The problems with insulin injections
Insulin is injected subcutaneously - under the skin. This isn't a very deep injection; the needles used are short and thin. But it's still an injection. There can be pain in that area, and some people develop itching or other allergic reactions there.

Also, because there's no cure for diabetes, the diabetic must take insulin every day - sometimes more than once a day. It would be really harmful to inject insulin, or any drug, into the same place this frequently, so the injection sites must be "rotated." But over a lifetime of injections, obviously the same sites will be used many times. These sites can develop lipodystrophy, a condition which causes a kind of puckering of the skin and other tissue in that area. It may not be very noticeable, but it does affect how insulin is absorbed from that site. So the site either needs higher doses of insulin - which can be dangerous - or it can no longer be used for injections.

Injections also require the use of sterile technique. This can be taught and is fairly easily learned by some people, but others can't do it, so their injections must be given by someone else - a family member or caregiver, perhaps.