A High-Tech Pill to End Drug Injections

Engineers have developed a tiny robotic capsule that injects insulin once it lands in the stomach.

Comments: 68

  1. Making holes in our barriers to the outside is problematic. The integrity of our skin keeps our sterile insides protected from infection. The gastro intestinal tract can be thought of in a similar light. We have this long complicated tube which the sources of nutrition, fluids, electrolytes with all sorts microbes riding along with them as it passes through the body. The GI tract selectively absorbs and rejects what it wants AND houses a complicates microbiome that further processes this passing stream with various organisms. In the GI tract these microbes are benign. Inside the body these microbes can reek havoc. Physically making a hole in this barrier doesn't strike me as a benign endeavor.

  2. @GTR I think you should consider that the people involved in this research are not quite as dumb about these things as you think they are.

  3. @Joy Thompson It takes a few 1000's to show something works and tens of 1000 to discover the complications. There are numerous examples of product withdrawals after FDA approvals. Registry's help to identify problems earlier but the industry tries to avoid them, especially on devices.

  4. @GTR. Isn't the complicated microbiome you speak of, caudal to the stomach?? The empty stomach is by and large, a pretty aseptic environment, I would suggest. And your concern would most certainly be included in an important safety-related endpoint in the clinical trials.

  5. 80% of overweight or obese people with type 2 diabetes would be asymptomatic if they simply lost weight. Before any public money is spent on high-tech treatments for the obese or overweight with type 2 diabetes, they should be at a healthy weight.

  6. @Moishe Pipik Yeah, like telling new mothers that they can beat post partum depression with vitamins and exercise (false); or telling addicts to just get some self control (opioids rearrange neural receptors, so they actually lose self control). Perhaps a bit of empathy and A LOT less patronizing would benefit some folks ....

  7. @Moishe Pipik Perhaps you should educate yourself on the existence of people with Type I Diabetes.

  8. @Moishe Pipik And 0% of type 1 diabetics would be asymptomatic, who rely on insulin injections daily to survive.

  9. Soma? As in "Brave New World"? That even made it into the crossword puzzle recently.

  10. What would the consequences be of having millions or billions of these devices excreted into the environment?

  11. Probably no worse than all the used syringes and needles currently "excreted" into the environment. I wonder how dosage would be controlled. With injections you can control the amount of insulin very finely. Sounds like a big challenge for this delivery method, which would seem not to allow the patient to make the dosage decisions which are part and parcel of daily type 1 diabetes management. Will it go the way of inhaled insulin?

  12. @RC That was my immediate thought as well :(. Tells me quite a lot about the unsolved inefficiency's that continue to plague the high tech insulin delivery research system. The throwaway insulin pumps are bad enough.

  13. Remember you’re also cutting down on the much larger plastic syringes and packaging for full size giving kits though.

  14. How will all those insulin dumps effect the gut bacteria which is critical to our immune system? Research on gut bacteria should be undertaken as well.

  15. However beneficial the resident gut biotics don’t really figure in the hypoglycemia, ischaemia, retinopathy, hypertension leading to strokes and coronary syndromes which diabetes does. I doubt if there should be any more significant change injecting insulin to gastric mucosa wrt anywhere else.

  16. My insurance probably won’t cover this. Even today’s injection pens are so expensive I have a $300 per 90 days copay. I can reduce that by going back to my father’s insulin and using a vial and syringes. You try managing your diabetes with three injectables with that copay on a Social Security disability income.

  17. Use a needle and a bottle of insulin. You are wasting money on a wasteful device.

  18. Interesting concept that is probably more than three years away due to the need for clinical trials/reliable bioavailability studies. However, already on the market is an inhaled insulin called Afrezza, for those who would like to avoid injections.

  19. My gut response is, "Injections in the stomach: what could go wrong?" I'd await years of real-world usage data before I'd prescribe this for my patients. It's fascinating technology, but I wouldn't be an early adopter. Additionally, lifestyle measures are highly effective for diabetes, and are the first line of prevention and treatment for type II diabetes. (See: Diabetes Prevention Program by the CDC.) Unfortunately, we commit comparatively few resources toward educating physicians and patients of their benefits and implementation.

  20. This may seem to be a wonderful invention but there is a darker side. If the device works well and has a reasonable price, it will cause many people who produce the traditional insulin and needles to lose their jobs. It may also cause a good percentage of seniors who receive pensions, Medicare, Medicaid, and social security to live longer and cost those systems more money.

  21. @Richard Winchester by that logic computers should never have been invented. Nor insulin itself.

  22. Sooooo...what happens if the thing lands on that poorly-chewed piece of pasta that I had for dinner? Won't it just inject the pasta with insulin? According to the article: "The sugar disc shatters five minutes later, releasing the post. It pokes through the stomach wall, delivering insulin to the bloodstream."

  23. @W the article says the pill would have to be taken when the stomach is empty

  24. @W- As a Type 2, one of the chief difficulties is regulating digestion. Anyone currently on one of the various exenatides can attest to food taking hours and hours to be digested - it's kind of the point to those medications. How on earth would one be certain of the stomach's 'emptiness'?

  25. Too bad Soma already is the FDA approved brand name of carisoprodol (muscle relaxant). They probably are going to have to change the name.

  26. It seems like the potential downsides are greater than te potential benefit. What if one of these little machines malfunctions and fails to deliver its payload? The patient would never know. That could be a serious problem. And how about the damage of a lifetime of tiny perforations to your small intestine?

  27. This is a wildly misleading article. First of all, it's a cheeky point, but these pills aren't an end to injections, it's just rerouting them to your stomach wall. The article raises more questions than it answers, which would be plainly obvious to anyone with a passing knowledge of type 1 diabetes. This is innovative technology, it's cool, but it's impractical in the face of how actual diabetes management functions. It doesn't appear to be more effective, safe, or convenient than injections. Considerations: 1) how would the patient control dosing? each meal or correction is going to require a different number of units. 2) how does the patient know the drug has been administered? timing insulin doses in relation to meals is a huge part of diabetes management -- if the pod releases insulin within 10 minutes, how long after that administration does it kick in? 3) what's the efficacy of the different form of insulin (powdered?) versus traditional insulin? 4) what if the pod attaches to an obstruction, not the stomach wall? what if it misfires or malfunctions? 5) is it safe to poke holes in your stomach wall? will it interfere with gut bacteria? 6) efficacy and timeliness -- is it more/less effective to administer insulin this way? does it take more/less time to work?

  28. It says it will still be three years before human testing begins.

  29. @Lane And the researchers are not thinking about all the questions you pose?

  30. Soma is originally a ritual hallucinogenic drink described in the ancient Hindu Rig Veda text. Some researchers think it might have been made from deadly amanita mushrooms. An odd choice of name for this device!

  31. How long before the average"Joe and Jane Doe" would able to afford this technology? Long after the surgery required to remove these buggers from the GI tracts of the wealthy consumers. I pass. I'll go the subcutaneous route. The idea of swallowing (or inhaling ) a powerful hormone like that gives me the willies! :-(

  32. Stomach walls are lined with a thick layer of mucous that protects the wall surface from the strong degradation. If you poke over time several micro holes in the lining, you are certainly going to create ulcers that will be a real nuisance.

  33. The article doesn't seem to touch on why injections are such a problem. Given the absurdly high cost of medical care and prescription drugs in the US, it's quite the oversight to talk about 'the injection problem' without explaining to the reader exactly what this 'problem' actually is. Aside from the fact that it's high tech and cool, what value is being added above that of the needle/syringe that is going to justify an undoubtedly sky high price to the consumer? Maybe the justification is there, but the NYT really missed the boat by not making the answer clear.

  34. "Eventually, the device is excreted; patients should not even notice it." But most certainly the environment will!

  35. My thoughts exactly.

  36. I would argue that the environmental waste generated by that small thing is much less than a conventional syringe and needle and the wrappers they come in. Not to mention the alcohol pad(s) and wrapper(s) to sterilize the insulin bottle and injection site.

  37. @Jen - but those aren't going into a water treatment system those are going into a solid waste landfill these little gadgets go into the water treatment system, and eventually end up either in the sludge (frequently treated as fertilizer, not solid waste) or back into natural water

  38. And naturally in the tradition of US Wealth Care, only the moneyed will be able to afford this.

  39. I’m a bit taken aback at the swift writing off of this idea so many readers are having. It’s a new technology, one that addresses something that is a huge component of diabetes - whether you are type 1 or 2. Were so quick to dismiss it because if environmental reasons, the name of the thing (although I’ll grant you Soma is odd, see the book, ‘Brave New World’) and dismiss it for potential high costs. Isn’t it something to celebrate that these scientists are trying, creating, and experimenting to ease some of the burdens of being a diabetic? Having taken mutiple injections for 33 years now, although I’m on a pump so the number of shots has decreased, I certainly am curious to see where this goes. Maybe it leads to other advancements in terms of managing the disease.

  40. I understand your point of view, but as a type 1 diabetic I live with managing my blood sugar and it's effects every second, every minute, every hour of every day. Don't get me wrong, I am beyond thankful for the discovery of insulin and research that has allowed me to survive. But, the money now needs to be applied to a cure, not to another tool so that drug companies and biomedical engineering firms will avoid the real issue. We need a cure for type 1 diabetes , please, no more band-aids.

  41. People who must inject biologics to treat autoimmune diseases like rheumatoid arthritis would benefit from the ability to take them in pill form. Biologics aren't convenient- they have to be injected, and must be kept refrigerated, which makes it a challenge to travel with them, especially to places without refrigeration. It was definitely a challenge for me on a two week raft trip down the Grand Canyon. Sounds like this device requires the medication to be dried. Can biologics, which are large complex molecules like monoclonal antibodies, be made in powdered form? I also worry about consequences a missed dose of medication if of one of these devices fails to work. Guess we'll be "stuck" for the forseeable future.

  42. @Edie Clark They can, we prepare them for cancer patients from powder. Perhaps not the most exotic ones, but the usual stuff comes as powder (sometimes with special solvents). But a lot of them still need to be refrigerated for optimum shelf life.

  43. When will the public and medical establishment understand that injections are the easiest part of managing diabetes? Controlling blood sugar through diet, exercise, continuous glucose monitoring, blood tests, and frequent doctor visits are exhausting. Diabetes is not just about injecting insulin. If only it were that easy! Research money should be spent on finding a cure, not on avoiding a shot. I’ve had Type1 for 51 years.

  44. I hope a massive variety of different points of view contemplate the possible unintended consequences of this rather frighting scientific development.

  45. What a waste of brains and money. While diabetes is a large, profitable and growing market, any diabetic or endo can tell you that this is a solution to a problem that does not exist. The abject failure of inhaled insulin tells you enough. Any patient prompted to participate in a clinical trial should change doctor.

  46. No more injections! Lucky kids of the future have no idea how good their going to have it

  47. As a type 1 diabetic, injecting myself is not a problem - the problem is the cost of insulin. When will drug companies quit profiting from price gouging? Make it possible for us to buy our humalog and lantus in order to live.

  48. Is Elizabeth Holmes in on this invention too?

  49. @Just paying attention Sure, making the 'Nano pill' :0

  50. This is a fantastic development and the technology is amazing. The future is so exciting. And I mean every word of that. But are those little delivery peas biodegradable? What will a million of theses peas mean to our environment in the long term? Footnote #107: These delivery pods need to be made so that they dissolve so our next generation isn’t cleaning them up after we are gone.

  51. If you know anyone with T1D, you’ll mostly hear injections are not an issue, and those with pumps in particular are satisfied with delivery methods, not so much pricing of insulin, and they are looking forward to the ready availability of closed-loop systems (so-called aritifical pancreases) that are far more likely to assist these patients. So while this is an intriguing story, one wonders if it will provide any advantage over current, and reliable, delivery methods. In particular, non-digestible items may become lodged in the gut, and if there is a malfunction it is easy to manage a pump, not so much a needle in the gut. Bottom line, this is a fun story of a novel idea, more perspective is needed, and the pathway to this technology being useful and a product is about as far away as teleportation.

  52. It occurs to me, also, that this new method/product would not eliminate the need for injections in at least one type of patient - those with diverticulitis. they cannot eat small particulate type foods such as seeds and peanuts because even after chewing they get caught in the gut and in polyps that might have also developed.

  53. @Smokey--As well as those who will not, or can't, swallow pills. I recently had an infected cat bite, and the antibiotics I needed came in such big pills that I got them stuck in my throat several times, for up to half an hour. (My throat is not normal size due to cancer treatment.) It's unusual to develop a sore throat while on antibiotics.

  54. And what do you do with the capsule after you poop it? Is it biodegradable?

  55. @Luis Londono I was about to ask the same question. Hopefully it doesn't contribute to the problem of plastic pollution in waterways.

  56. Insulin injections already enable genetically deficient individuals to survive. This would expand that serious threat to the long term viability of the human race.

  57. @No-- I find this comment scary!

  58. If you thought prescription drugs were expensive now... just wait for this technology to come on the market. Every cheap generic will get rebranded and we’ll all have to pay for the new method’s development costs.

  59. So what is wrong with injections? Were it me, I'd rather have an injection than little "robots" or whatever the devices would be called, in my stomach. Maybe I'm not in the majority? And insulin is expensive now. What happens when we need to pay for these little guys as well? And what about the solid waste problem? And what on earth made them settle on a sugar disk for diabetics?

  60. I️ also wonder what the impact of this tech would be on the environment/sewage system.

  61. Drugs and methods to deliver them is a playground for academics. Government agencies that fund these research projects need to have guidelines on how the taxpayers money is being spent.

  62. Or just reverse your diabetes with a keto diet.

  63. Can’t reverse Type I diabetes w any keto diet. That’s for the Type II’s to debate...and I’ll take my CGM and insulin pump any day over swallowing a pill. Too many variables could result in my having to self administer insulin injection to correct for an unanticipated metabolism change in my acidic stomach.

  64. @Zab Fitz I agree with you completely! I can't believe they are even spending money on this type of research.

  65. Total waste of money. Find a cure for Type 1 diabetes. Injections were never an issue. Just do it!

  66. I am in agreement with many of the previous comments. I have been a Type I diabetic for 30 years-- injecting myself has been the least of my worries. My main worry is the increasing cost of insulin. Those who don't have insurance or don't want a pump should be able to find lost-cost means of keeping themselves alive. Syringes, vials of insulin, exercise, and a healthy, low-carb diet are really all we need to stay alive and healthy. I am furious and despairing that money is being spent on such ridiculous research.