Why can't I take insulin by mouth?
The reason you can't swallow insulin and have it work is because there are enzymes and acid in your stomach that just break it down. So it doesn't get into your circulation and it won't work. It's a fragile peptide hormone that comes out inside your bloodstream and isn't meant to be swallowed. Now, they're working on different ways of giving insulin. There's inhaled insulin which is actually on the market in the United States which allows you to take puffs of insulin into your lungs. The problem with that is that it's still insulin so I have patients who think inhaled insulin is gonna be easy but in essense you still have to check your blood sugar and adjust the balance between food and insulin. And my biggest concern about it is that, although it does work to lower blood sugar levels, we don't know what the long term risk to inhaling all that insulin into your lungs is. So they're doing follow up studies now to see people over time to make sure that's safe. But if I have somebody who absolutely won't give a shot, they may take inhaled insulin and it can work for them. Now the caveat is is that many of the people with inhaled insulin have to give one shot a day so it may not be shot free. There's other ways that they're looking at giving insulin which involve spraying things into the back of your mouth or putting it on the inside of your gums but all of these ways are difficult because you really need to make sure that people get the same amount each time you give the dose because if you don't, their blood sugars can go too high or too low. So the delivery of insulin, other than through injections or through a pump has been really difficult to figure out.
