jayhasbigvballs t1_j0yqxs2 wrote on December 20, 2022 at 12:18 PM

Reply to comment by [deleted] in Molecule that mimics insulin opens new doors for a diabetes pill by rchaudhary

No because insulin is about timing. You take insulin in response to a meal. If you just pop a pill in the morning, there’s nothing to tell the mimetic to begin or stop acting.

elijah112358 t1_j0yttnk wrote on December 20, 2022 at 12:48 PM

many people are also able to control T2DM with only basal insulin (i.e. long acting insulin that isn’t bolused at meals)

jayhasbigvballs t1_j0zfb7f wrote on December 20, 2022 at 3:41 PM

Sure. But type two diabetes is progressive and almost all those patients will eventually fail because of the nature of their disease. What will make this drug useful is if it was the only thing required, aka a short acting insulin mimetic, which will actually regulate blood sugar in an impressive way. Most type 2s on long acting are also on other oral antidiabetic medications because long acting just doesn’t really lower blood sugar a whole bunch.

Source: I’m a type 1 diabetic, did my PhD in metabolic disease, and worked in research for a large pharmaceutical company in their diabetes portfolio.

LaserHD t1_j0zxnje wrote on December 20, 2022 at 5:40 PM

Thanks Dr. Jayhasbigballs

TummyDrums t1_j0zgs5x wrote on December 20, 2022 at 3:51 PM

bolus insulin (short acting) is about timing, but basal insulin (long acting) is a once a day thing (twice in some cases), where you always have some insulin circulating. All type 1's need this, and type 2's use it in some cases too.

jayhasbigvballs t1_j0zihvh wrote on December 20, 2022 at 4:02 PM

Not all type 1s need long-acting insulin. For example, those on pumps. Because the short acting is delivered throughout the day and night. Theoretically this drug could be designed to fulfill both roles, if they made it glucose sensitive.

TummyDrums t1_j0zxetd wrote on December 20, 2022 at 5:39 PM

While you're technically correct on the pump, the pump itself is manipulating the insulin delivery to mimic long acting insulin so that's only a semantic difference. Whether it's a constant drip from a pump or a constant release from injected basal insulin, all type 1s need a constant delivery of insulin.