Monday, 6 February 2012

What is wrong with this image?

Injected insulin during pregnancy

The BBC today published an article about the increased risk of birth defects in pregnant women with diabetes. With this story came the image above. ‘This is just wrong’, my first thought.
My thoughts are not geared towards the story nor is it towards the image but rather towards the harsh reminder of the impractical problem facing diabetics at large, which is the injection of insulin. Watch this.

Diabetes is a long term condition in which the body has unusually high levels of glucose in the blood either due to the pancreas producing too little or no insulin at all. Insulin is a hormone required to metabolise glucose by converting it into energy for the body to utilise in going about daily activities. Lack of this energy and the build-up of glucose escalate into a host of other conditions including blindness, heart disease, and damage to blood vessels and nerves which can lead to loss of limbs.  The condition affects about 346 million people worldwide according to figures by the World Health Organisation with more than 80% of diabetes related deaths occurring in low- and middle-income countries.

There are two types of diabetes;
  •       Type 1 also known as insulin dependent or insulin controlled is where the pancreas is unable to produce any insulin at all
  •       Type II also known as non- insulin- dependent or diet controlled is where the insulin produced by the pancreas is not sufficient or does not work properly.

Both types of diabetes as with any other illness require a healthy diet and active lifestyle. Type I diabetes although less prevailing is the more aggressive form and treated by daily injection of insulin. Some cases of type II diabetes may also require insulin injections.

This takes me back to the image - Daily injection to body parts such as the stomach, thighs and back of the arms where fatty tissue is abundant. It is most effective when injected into the stomach making it the first site of choice. Can you imagine the discomfort or inconvenience of having to inject yourself several times daily? Not very practical yes, but this is not because researchers and pharmaceutics are insensitive to the mode of administration but because insulin is a tricky substance to make for administration in any other form.

Basically, insulin is a protein and proteins are fussy, in that the lack of the right environment causes their degradation. Enzymes present in the mouth and stomach will be quick to break down this insulin once they come into contact rendering them ineffective. It is for this reason that getting the right formulation to enable oral administration has been challenging. Direct injection into the body tissue bypasses this problem.

As with the numerous scientific advancement’s, there is hope for the future. A buccal (mouth) spray called Oral-lyn has been developed by Generax and currently undergoing clinical trials. Information and details on progress of this trial so far can be found here (apologies for the technicalities to my non- scientific audience).

Here is a couple more life stories about living with diabetes.

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