Good for Diabetics– No More Needles?

For people with diabetes, self-injections and pinpricks are part of a daily routine designed to regulate and monitor blood sugar levels. You can say goodbye to the needles.

Blood glucose is typically measured by pricking the finger with a small, but very sharp lancet several times each day to obtain blood samples. A small drop of blood is applied to a test strip, which is then inserted into a glucose meter that determines blood glucose levels. Monitoring blood glucose levels may seem like a simple procedure, but it is never a pleasant experience.

Fortunately, science and technology have come to the rescue with a new and improved method of glucose monitoring. Developed by Cygnus under the trademark name “GlucoWatch”, this bit of technology may allow people with diabetes to check glucose levels more frequently without as much discomfort as the finger-stick method. Worn around the wrist, the GlucoWatch is designed to measure glucose using a disposable Autosensor. The sensor measures glucose via contact with the skin after receiving a small electric current. Within the sensor is an enzyme, which releases hydrogen peroxide when it reacts with collected glucose. Hydrogen peroxide generates an electronic signal, which is then interpreted as a blood glucose value based upon previous calibration with the pinprick method. The Autosensors are good for 12 hours after calibration, and can detect up to three glucose readings per hour. Cygnus expects to launch the GlucoWatch in early 2001 pending FDA approval. Although the GlucoWatch is not meant to replace the traditional method of glucose monitoring, it may reduce the number of times diabetics need to draw blood samples.

Unfortunately, needle-sticks do not end there for people with diabetes. Insulin is given via injection to people with Type I diabetes because their pancreas does not produce enough (or none at all!) to facilitate glucose’s entry into cells. Even those with Type II diabetes may eventually require insulin injections as the disease progresses. Diabetics may require multiple injections throughout the day. I cannot think of even one person who enjoys being given a shot, much less two or three each day.

Are injections the only way to administer insulin? Isn’t there some sort of an insulin pill for people with diabetes? The problem is that insulin needs to arrive intact in the bloodstream in order to be effective. Insulin cannot be taken by mouth unless it is protected from digestion because it is a protein. Similar to a hamburger, proteolytic enzymes, rendering it useless, would break down a simple insulin pill.

However, scientists have come up with some interesting ways to get around this problem. Several different modes of drug delivery are currently under investigation, one of which is an “insulin inhaler”. Together with Pfizer, Inhale Therapeutic Systems has developed an insulin delivery system (similar to an inhaler) that allows dry insulin to be absorbed by alveoli in the lungs. Alveoli are small air sacs covered by a very thin layer of cells and surrounded by blood capillaries. Aerosolized insulin is easily absorbed by alveoli, whose total surface area is over 100 square meters in the adult.

According to findings presented at a conference of the European Association for the Study of Diabetes held in Jerusalem, researchers at the University of Vermont College of Medicine reported that inhaled insulin was as effective as injected insulin in their two-year study. Study participants did not appear to suffer any lung damage. Inhale Therapeutic Systems’ inhaleable insulin is currently in Phase III clinical trials.

With the advent of insulin inhalers and non-invasive blood glucose monitors, quality of life for people with diabetes may well be improved. If you or someone you know has diabetes, ask your doctor for more information about the latest options in diabetes care.

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