Type 2 Diabetes (T2D) is a metabolic disorder that causes glucose to accumulate in the blood becuase of two main factors: cells become insulin resistant and the pancrease becomes unable to keep up with the necessary production of insulin.
If detected at an early stage, this chronic disease can be treated first by doing more exercise and changing the diet. However, if these two activities do not improve the patient's situation, then oral and injectable medications will be necessary.
Some of them are metformin, which blocks the production of glucose by the liver and decreases cell's resistance to insulin. After metformin most doctors will prescribe sulfonylureas, which will increase the production of insulin by the pancreas. Other medications include DPP-IV inhibitors, TZD, GLP-1 analogues and insulin.
Insulin is the most common injectable medicatin to treat diabetes and nowadays, there are many options to get this hormone into the body. Some of them include needle and syringe, insulin pumps, insulin pens, inhalers and even jet injectors. The downside with some of these is that they can be expensive and intrusive and in developing countries, the cost and complexity of such drug-delivery mechanisms can put them out of reach.
Medication adherence is defined by the World Health Organization as "the degree to which the person’s behavior corresponds with the agreed recommendations from a health care provider." Compliance implies patient obedience to the physician’s authority, whereas adherence means that the patient and physician collaborate to improve the patient’s health by integrating the physician’s medical opinion and the patient’s preferences for care.
There are several types of non-adherence. In the primary one, the prescription is provided but the medication is never filled or initiated. In the second one, non persistence, patients decide to stop taking a medication after starting it, without being advised by a health professional to do so. This usually happens because of resource limitations. A third type of non adherence is known as non conforming, in which medication are not taken as prescribed. This includes skipping doses, taking medications at incorrect times or at incorrect doses or even taking more than prescribed.
Of important notice, extensive review of the literature reveal that in developed countries adherence to therapies averages 50%. Approximately half of this non-adherence is intentional, while the remainder occurs because patients are either unaware that they are not taking medications as prescribed or the regimen is too complex.
Regarding chronic diseases like diabetes, studies reveal that patients with chronic illnesses take only ~50% of medications prescribed for those conditions. Some of the consequences of this are disease progression, reduced functional abilities and increased use of medical resources. In fact, a study conducted by Anon showed that the risk of hospitalization was more than double in patients with diabetes mellitus and other diseases who were non adherent to prescribed therapies.
The problem is now clear: half of the patients are not adhering to their treatments because sometimes it can get too complicated to remember the right doses, at the right time. Since this can lead to fatal events, the awareness of the problem has increased over the last years and some people have come up with some solutions.
The problem is even thoguh insulin delivery technology has been advancing, most of the new devices are really uncomfortable and need to be there all day, making the experience even worse. Not to mention that some of them are really expensive and cannot be afforded by many patients in developing countries.
Becuase of the previously stated problems, an insulin pill has always been the holy grail that scientists and patients have been looking for during years. And this hadn't been possible until very recently, when a company based in Israel came up with an innovative solution.