Insulin administration: Researchers in Texas work toward making a pill for diabetics

For many diabetics who inject insulin several times a day to survive, swapping needles for pills is a long-held fantasy.

PHOTO BY LAURA SKELDING / COX NEWS SERVICE University of Texas professor Nicholas Peppas led the discovery of a gel-like material that allows insulin to enter the bloodstream via a pill. At right are graduate research fellows Diana Snelling and Daniel Carr. But an insulin pill could be edging closer to the real world. New research at the University of Texas shows that a way to deliver an insulin pill to the bloodstream has worked in the lab, clearing the way for tests on animals and, ultimately, humans.

Nicholas Peppas, a professor of chemical engineering, biomedical engineering and pharmaceutics, has spearheaded the discovery of a gel-like material that protects the insulin as it enters the harsh, acidic stomach - the place where most pills break down.

The insulin loaded into Peppas' gel stays intact on its way to the small intestine so it can be absorbed into the bloodstream, according to a paper Peppas and two UT researchers published recently in Biomacromolecules, an American Chemical Society journal.

"We are talking to companies right now and are close to closing a deal with a company that would do the animal studies," Peppas said recently. He declined to name the companies because no contracts have been signed.

After an article about the work appeared in an Australian magazine in May, Peppas said patients in Australia started calling to find out when the pill would be available.

Drug development takes a long time, Pep- pas said, adding that his work with Kristy Wood and Gregory Stone, UT doctoral students who graduated last year, is about halfway there. If everything goes well, Peppas said, the pill could be on the market in seven years. Other researchers around the world also are competing to develop the first insulin pill.

Peppas envisions the drug being used initially by adults with type 1 diabetes, which occurs when the body can't make insulin, a hormone that converts sugar, starches and other food to energy. Eventually, the pill could be used on any diabetic who injects insulin, he said.

"I like this idea a lot," said Dr. Tom Blevins, an Austin, Texas, endocrinologist. "It's a fascinating technology.

"As a clinician, I love to see people making drug delivery more easy for people with diabetes. It's tough enough for them."

Producing a pill is a challenge, he said, because tiny changes in dosing, regulated easily by injection, are needed to keep blood sugar levels from teeter-tottering dangerously throughout the day.

Dr. Craig Spellman, a Texas Tech University official who leads the Texas Diabetes Council's Health Care Professionals Advisory Committee, said the research sounds interesting but agrees that a lot of work remains.

Alternatives to injections have proved elusive. Inhalable insulin was not the boon that drug manufacturers thought it would be, and some patients had negative reactions, said Spellman, associate dean of research and professor of medicine at the Department of Internal Medicine at Tech's Permian Basin school at Odessa, Texas. Most companies have discontinued investing in that work.

Spellman's research is aimed at regenerating cells in the pancreas so they can work again to produce insulin. "That's the holy grail," he said.

Diabetes is a growing problem in the United States. Data from the Texas Behavioral Risk Factor Surveillance System shows that 7.9 percent of Texas adults had diabetes in 2005, compared with 7.3 percent of adults nationally. A year later, 8 percent of Texas adults were diabetics, compared with 7.5 percent of U.S. adults. Blacks and Hispanics had the highest rates.

"Anything that can offer an alternative to patients who have to take insulin so they wouldn't have to inject it, we support it," said Carole Lieber, a spokeswoman for the American Diabetes Association's Houston office. "People just don't like shots."