Can I Take Insulin Orally?
In a word, no.
At this time, insulin cannot be taken as a pill. There are no pills on the market that are safe to take – according to Joslin Diabetes Center, “Insulin currently cannot be taken by mouth because the digestive juices in your stomach and intestine will break down the insulin before it has a chance to get into your bloodstream to do its job.”
However, there may be a future for oral insulin.
In September 2017, Biocon and JDRF, a global organization that researchers and advocates for type 1 diabetes, partnered to research a global study the oral insulin, Tregopil. According to The Hindu, “The fast-acting oral insulin could improve post-prandial glucose control with reduced side effects and greater adherence, thus holding a promise to transform T1D management.”
Tregopil has already had positive clinical data in 2016 in a Phase I study in the United States, and will also be studied in type 2 diabetes participants.
Inhaled Insulin, What Is It?
If you’re prescribed insulin but a bit leery, you could try inhaled insulin. In June 2014, the FDA approved Afrezza, which is an inhaler with pre-measured, rapid-acting insulin, so it is used before meals. At this time, there is only a rapid-acting insulin that is in the inhaled form – so if you have type 1 diabetes, you would still require an injection for a basal insulin (long-acting or intermediate-acting).
There are some contraindications to inhaled insulin – it should never be used as a treatment during diabetic ketoacidosis (DKA), and if you have COPD or asthma, it is probably not the insulin for you.
The Misconceptions of Insulin
Now that we’ve discussed what insulin is, let’s talk about what diabetes isn’t. I have heard a lot of different falsehoods about insulin in my diabetes education practice and there are a few I’d like to clear up.
Insulin Is Not a Sign of Failure
First of all, I’ve had plenty of patients come into my office and say, “I’m starting insulin today because I fell off the wagon. I failed at my diet and exercise routine, so this is really all my fault.”
Insulin is not a sign of failure. Diabetes is a progressive disease, and this is the perfect time to remind my patients of this.
Insulin Causes Amputations
The second misconception I often hear is that insulin causes amputations. If anything, insulin prevents amputations, but I can understand where my patients are coming from.
Often what is happening in patients who are requiring amputations is that their blood glucose levels are not under adequate control. When this happens, a sore or ulcer is not healing and ultimately, an amputation is required.
Another possibility is that these patients have waited too long to start insulin because they did not understand the importance of starting insulin when their blood glucose levels were running dangerously high.
Insulin Injections Hurt
And third, insulin injection hurts! Another falsehood.
I have educated patients as young as two years old, and as old as 90, to give insulin injections. There have been several people who state that the injections hurt – but the vast majority – even the two-year-old, find that the needles and syringes available to us now do not hurt.
And if it does, it is probably an issue with your insulin injection technique, meaning it is time to get back in touch with your diabetes educator for a refresher!
The Bottom Line…
Insulin… you may not love it, but you may need it to survive. Knowing what it is and why you need it is half the battle.