When it comes to maintaining a healthy body, medical experts have long maintained that there is no “magic bullet” that can replace a good diet and exercise, regardless of what shady supplement infomercials, Dr Oz, or Gwyneth Paltrow’s Goop are currently claiming.
For the hundreds of millions of people struggling with type 2 diabetes worldwide, lowering their blood sugar enough to relieve disease symptoms thus requires a consistent and strict regimen of lifestyle modifications and various medications. When these interventions are not enough, patients can undergo gastric bypass surgery – an operation that reduces caloric intake by reducing the size of the stomach and connecting it to the lower small intestine, bypassing the upper intestine. This digestive reshuffling is known to be very effective at relieving type 2 diabetes through mechanisms independent of weight loss.
Yet because this procedure makes significant permanent changes to the digestive tract and is not without its own risks, very few patients go through with it.
Hoping to find a non-invasive alternative, researchers from Brigham and Women’s Hospital and Harvard Medical School began investigating whether any safe-for-consumption materials could block absorption of glucose by temporarily coating the inside of the small intestine. Following several years of tinkering, the team has developed an experimental product that seems, given the promising findings from a study conducted in rats, to come pretty darn close to a magical solution.
“What we've developed here is essentially, 'surgery in a pill,'" stated Dr Yuhan Lee, first author of the paper published in Nature Materials. “We've used a bioengineering approach to formulate a pill that has good adhesion properties and can attach nicely to the gut in a preclinical model. And after a couple of hours, its effects dissipate."
The pill is composed of a dry powder, called LuCI, that turns into a sticky paste when exposed to the wet, low pH environment of the gastric mucosa – the mucous-excreting cell layer that lines the digestive tract. LuCl is a modified formulation of sucralfate, a drug compound widely used to treat acid reflux and ulcers.
When orally administered to rats, the LuCl pill dissolved into a viscous coating that remained stable on the intestinal mucosa for five hours and cleared fully within 24 hours without any apparent ill effects, such as diarrhea or unintended weight loss. Next, Dr Lee and his colleagues tested whether the apparent physical barrier was truly capable of blocking nutrient absorption by testing the blood glucose response in mice who had eaten after being dosed with a LuCl pill.
The results indicated that the LuCI coating successfully blocks a significant portion of sugar from being digested when taken one hour prior to a meal. But rats who ate three hours after administration had much higher glucose responses – an exciting sign that the pill can be used to reduce blood sugar spikes during strategic time windows without interfering with sugar absorption when a person truly needs to take in energy.
"We envision a pill that a patient can take before a meal that transiently coats the gut to replicate the effects of surgery," said co-senior author Dr Jeff Karp.