Insulin in the intestine
The capsules swallowed by pigs recharged the insulin pump
Anastasia Kuznetsova-Fantoni, N+1
Italian scientists have created an insulin pump implanted in the abdomen, which is refueled with insulin not from the outside, but from the lumen of the intestine – with the help of swallowed capsules. This method will avoid infection of the catheter from the external environment while filling the tank with the drug. The device restored normal blood glucose levels to pigs without a pancreas. A study describing the principle of operation of the device was published in Science Robotics (Iacovacci et al., A fully implantable device for intraperitoneal drug delivery refilled by edible capsules).
The introduction of insulin into the abdominal cavity is a promising method of treating type I diabetes, as it allows it to be delivered directly to the liver – the primary point of application of insulin. However, this method is not used much, since in this case it is necessary to connect the abdominal cavity with an external reservoir using a catheter, and this can lead to infection, leaks and blockage of the catheter.
Italian scientists led by Arianna Menciassi from St. Anne's High School have developed a technology that avoids these risks. They have created a device the size of a small mobile phone, which is implanted in the patient's abdomen above the small intestine and releases insulin into the abdominal cavity. Its difference from conventional implantable insulin pumps is that it is filled with insulin not from an external source, but from the intestinal cavity. To do this, the patient must swallow an insulin capsule surrounded by a ferromagnetic ring. When it reaches the area of the small intestine over which the device is located, the device attracts it to itself and turns it to the desired position by the influence of a magnetic field. The implant then pierces the capsule with a needle and draws insulin into its reservoir. The empty capsule is then excreted from the body naturally. The magnetic field can be turned off from an external controller, and the device is powered by wireless charging.
In the figure from the article in Science Robotics, the movement of the capsule through the intestine is shown by the example of a human VM.
The researchers implanted the device into three pigs with their pancreas removed. When the animals swallowed the capsules, it took the latter four days to reach the device. The capsules successfully docked to the device, and its tanks were filled with medicine. A glucose sensor installed in the neck area of pigs confirmed that the device allows animals to maintain normal blood glucose levels.
The device compares favorably with standard insulin pumps in that it is not connected to the skin surface through a catheter, and this significantly reduces the risk of infection and blockage of the catheter. In addition to diabetes therapy, the new device can also be used to treat other diseases, such as chemotherapy for cancer.
Blood glucose control using an insulin pump is more effective than standard insulin therapy – this has been confirmed by British and Swiss scientists. They installed an artificial pancreas in patients with type 2 diabetes on hemodialysis. The device made it possible to keep blood glucose levels in the target range 15 percent longer than standard insulin therapy.
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