Diabetes Surgery In A Pill

Great progress has been made by bariatric surgeons during the past decade in weight loss surgery that can also reverse type 2 diabetes in patients with both conditions, even so despite improvements to quality of life the number of patients pursuing this avenue remains relatively low.

Collaborative research was prompted to find a more appealing and less invasive way to effectively treat obesity and reverse type 2 diabetes, offering the same benefits as surgery with more appeal and application. Oral agents administered to model rats during preclinical studies have delivered a substance to temporarily coat the intestines to prevent nutrient contact with lining in proximal bowel and avoid post meal spikes in blood sugar.

Envision replicating surgery effects noninvasively just by simply taking a pill before a meal that transiently coats the gut.  A material has been developed by the researchers to meet the clinical need by finding a material with the correct properties to adhere to intestines and dissolve within a few hours. The chosen substance called sucralfate is FDA approved in treatment of gastrointestinal ulcers, it was further engineered into a novel material to coat intestine lining without requiring gastric acid activation, and is now called Luminal Coating of the Intestine.  LuCI can be made into dry powder form to be encapsulated into a pill, essentially providing surgery in a pill.

Bioengineering approaches were used to formulate a pill with good adhesion properties which dissipate within hours. Once LuCI was in model animals intestines it was found that it coated the gut with a thin layer acting as a barrier to alter nutrient contact which lowers blood glucose responses after consuming a meal. Typically after consuming a meal blood sugar levels will rise and can remain elevated over time, one hour after LuCI was administered the response to glucose was lowered 47%, which was found to be a temporary response as after 3 hours effects disappeared.

Long term use and short term effects of LuCI are now being investigated by the researchers, who plan to advance some pilot studies showing LuCI can be used for delivery of drugs including proteins to the GI Tract.

Gastric bypass is well studied with benefits being well documented including positive effects for blood pressure, sleep apnea, certain forms of cancer, and fast weight independent improvement in diabetes; having a transient coating to mimic these effects without surgery could be a huge asset for patients and care workers alike.