Our human being is facing a lot
crises. No, not the border crisis Trump just declared. 🤠Certainly not any manufactured crisis that someone is calling. 😲😲I’m talking about something health-related. If you are not aware of yet, one big
crisis we are witnessing is the diabetes crisis. Here is the alarming stats
from the government: According to the
Centers for Disease Control and Prevention (CDC), 30.3 million people—or 9.4 %
of the U.S. population—had diabetes in 2015, and in the same year, about 1.5
million new cases of diabetes were diagnosed among adults age 18 or older. The
CDC also estimates that 33.9% of U.S. adults had prediabetes. The economic
burden of diabetes is massive. The American Diabetes Association (ADA)
estimates that the cost of diagnosed diabetes in the U.S. hit $327 billion in
2017, with reduced productivity costing another $90 billion (Diabetes Care
2018;41:917-928).(You can see more details in this report: Facing
the Diabetes Crisis).
One of the most effective treatment
is insulin, a protein that we normally should produce to balance the glucose
levels but diabetic patients often lack, especially those with so-called type I
diabetes. Although there are many other effective antidiabetic medications that
have been invented in the past decades, insulin remains an unbeatable effective
core therapy for this terrible life long disease. For those not in the medical
field, the biggest drawback for insulin is the way how it must be used. It is a
painful injection every day the patient has to do. If it is just a short term
injection, it is not a big deal, right? But it is a life long routine patients
have to endure. For years, scientists have been trying to develop a new
formulation like a pill or inhalant that may relieve patients from the painful
treatment but all fail. Why so difficult you may ask? Well, it is all boggled
down to the nature of insulin, that is it is a protein. As a protein, it is a
big molecule that cannot be simply absorbed by our intestine. Instead it must
be digested and downgraded into small molecule pieces that can pass through the
intestinal wall and therefore it becomes useless after being absorbed into the
blood. For inhalation, actually there is an insulin inhalation product already
approved by the FDA but unfortunately it has been a widely disappointment in
terms of usage, primarily due to the fact that it is very difficult to control
the blood level from inhalation. The insulin blood level is very critical as it
can easily cause disaster if not well controlled such as dangerous hypoglycemia
with too much insulin. If I’m not mistaken, this is the major issue for the
inhalation insulin. So if there is any breakthrough that will allow easy intake
of insulin without relying on injection, that could be revolutionary given the
rampant crisis. I’m happy to say that we may see a glimpse of light now.
Scientists are developing an oral insulin delivery
system. See below what was
reported in Science with a genius idea that will basically still inject insulin
but within the stomach. If successful, patients may get stable doses of insulin
as the current skin injections but without pain.
The
pill is about the size of a blueberry and contains a small needle made of
insulin. Once it reaches the stomach, it adjusts its orientation to ensure
contact with stomach tissue before injecting the medicine. In tests in rats and
pigs, the drug successfully lowered blood sugar to levels similar to those seen
with insulin injections. The team reported the results in Science.
Interestingly, this
idea was inspired by tortoises actually. The key to success is to make sure the
tiny needle can always position in such a way to make the injection directly
into the stomach wall. Turtles are well known to able to turn around to
position properly regardless what happens, even in an upside down position. That’s
why scientists want to mimic for this new insulin delivery system. It looks
promising at least in the animal testing. Of course it is still a long way to
go before it can be finally proved effective in humans but I think the prospect
is bright!
If indeed it proves
to be successful, which company may benefit the most? Novo Nordisk (NVO), the company that sponsors the
development of this technology. If you are not yet aware, NVO is a pure player
for insulin development and actually I cannot think about any other well-established
pharma that is so successful for decades but solely based on one product,
insulin! That also speaks for the fact that how critical insulin is for this
life long disease as the need is always there and growing as the crisis is
deepening. NVO is a very well managed drug company and its business has been
booming for decades. More attractively to me is the fact that NVO is also a
great dividend growth stock. In the past two years though, NVO has apparently
run against its bottleneck and its growth has been slowing down significantly.
But I think it is temporary hiccup and great business can always find its way
to turn challenges around. I have good faith in NVO for its long term. This new
development of the innovative technology shows again how NVO is working hard to
overcome the obstacles it is facing. If successful, it will be a great stride
for it and greatly benefit the company while helping diabetic patients in a
revolutionary way. Even if not, it will also trying to innovate in other ways
to continue its mission to help fight for this human crisis.
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