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JAMA:口服胰岛素胶囊或可有效控制糖尿病

来源:生物谷 2015-07-06 11:12

2015年7月6日 讯 /生物谷BIOON/ --近一个世纪以来,胰岛素被认为是挽救糖尿病人的重要疗法,而如今来自国外的研究人员验证了一项棘手的问题,即如果药片包含有给病人注射的相同药物,那么其是否可以用来帮助抑制糖尿病的发生,相关研究成果刊登于国际杂志Journal of the American Medical Association上。

文章中研究者确定了这种新型策略是否可以帮助治疗1型糖尿病,一旦证实有效,那么这种疗法或许可以有效普及到1型糖尿病患者的治疗中。1型糖尿病常常高发于儿童中,研究者对400名儿童和成年人进行研究,调查了这种实验性的胰岛素胶囊是否可以有效抑制或减缓1型糖尿病的发病。

研究结果表明,服用胰岛素胶囊的儿童主要表现出了免疫系统的改变,而这一改变或可帮助有效抑制糖尿病的发生。目前研究者进行的大型研究非常严格,他们随即让参与者服用实验性的胰岛素胶囊或安慰剂,研究者Louis Philipson说道,这种胰岛素胶囊是否可以有效减缓或抑制胰岛素的发生呢?如果其被证实可以,那么这将是糖尿病疗法领域的又一大突破。

大约有125万人患1型糖尿病,而2型糖尿病更为常见,其在美国影响着大约3000万人的健康,而在全世界大约有超过3亿名个体患糖尿病,糖尿病患者机体除了血糖控制较差之外,该病还会对肾脏、心脏以及眼部产生损伤。在1型糖尿病中,胰腺会阻断胰岛素的产生,而当前治疗1型糖尿病的疗法就是通过注射或小型泵来终身替代胰岛素;而对于2型糖尿病而言,机体往往不能够恰当地使用胰岛素,然而患者通过健康的饮食和锻炼就可以减缓疾病的发生或进展。

研究者Wendy Brickman解释道,通过口服胰岛素就可以使其像食物一样被消化,通过哄骗机体损伤的免疫系统使其不攻击产胰岛素的细胞;胰岛素胶囊/药片目前已经被研究作为糖尿病的疗法了,但研究者所面临的挑战是寻找一种策略来使得药物在进入血液后在消化的过程中不被降解;目前研究者希望通过后期的研究来有效改善这种新型胰岛素胶囊的运输,进而使其可以更好地帮助糖尿病患者控制血糖。(生物谷Bioon.com)

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Could insulin pills prevent diabetes? Big study seeks answer

For nearly a century, insulin has been a life-saving diabetes treatment. Now scientists are testing a tantalizing question: What if pills containing the same medicine patients inject every day could also prevent the disease?

Thirteen-year-old Hayden Murphy of Plainfield, Illinois, is helping researchers determine if the strategy works for Type 1 diabetes, the kind that is usually diagnosed in childhood. If it does, he might be able to avoid the lifetime burdens facing his 5-year-old brother, Weston. They includes countless finger pricks and blood sugar checks, and avoiding playing too hard or eating too little, which both can cause dangerous blood sugar fluctuations.

Hayden Murphy is among more than 400 children and adults participating in U.S. government-funded international research investigating whether experimental insulin capsules can prevent or at least delay Type 1 diabetes. Hospitals in the United States and eight other countries are involved and recruitment is ongoing. To enroll, participants must first get bad news: results of a blood test showing their chances for developing the disease are high.

"When I got the news, I was devastated," Hayden said. He knows it means his life could change in an instant.

"He has the daily reminders. He sees what his brother goes through," said the boys' mom, Myra Murphy.

So now Hayden Murphy swallows a small white capsule daily and has his blood checked periodically for signs of diabetes.

"I hope it doesn't come to me, and I really didn't want it to come to him," Hayden said.

A small, preliminary study by different researchers, published recently in the Journal of the American Medical Association, suggests the approach might work. Children who took insulin pills showed immune system changes that the researchers said might help prevent diabetes. The study was too small and didn't last long enough to know for sure.

The ongoing larger study is more rigorous, randomly assigning participants to get experimental insulin capsules or dummy pills, and should provide a clearer answer.

"Does it prevent indefinitely? Does it slow it down, does it delay diabetes? That also would be a pretty big win," said Dr. Louis Philipson, a University of Chicago diabetes specialist involved in the study.

About 1.25 million Americans have Type 1 diabetes. Type 2 disease is more common, affecting nearly 30 million nationwide and most of the more than 300 million worldwide with diabetes. Besides short-term complications from poorly controlled blood sugar, both types raise long-term risks for damage to the kidneys, heart and eyes......

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