Aim: This randomised, twelve-week open-label study compared the pharmacodynamic properties of different dose of regular human insulin administered in capsule form twice daily.

Methods: 100 persons (48 male, 52 female) with type 2 diabetes on metformin completed the study according to protocol. Mean (SD) age 48.5 (6.7) years, BMI 25.7 (2.8) kg/m², HbA1c 8.10 (0.65) %. Subjects randomised on admission were assigned to one of three groups receiving 75iu BD of formulated regular insulin or 150iu insulin BD, or 300iu BD in enteric-coated capsules. Primary and secondary endpoints were change from baseline in HbA1c and FPG respectively. A total of 100 subjects from 15 different centres completed the study within protocol.

Results: The study met its primary clinical endpoint of a decrease in HbA1c ≥ 0.5% in the dose group receiving 150 IU BD. In a subset of this population, with starting HbA1c values between 9 and 9.5%, an average decrease of 1.575% was seen. In the total population, least square mean decreases in HbA1c for groups 75iu BD and 300iu BD were -0.11% and -0.42% respectively. Mean change in FPG in the 150iu BD dose group was -18.8mg/dL and -14.8 and -2.7mg/dL for groups 75iu BD and 300iu BD respectively. A decrease of 20% for triglycerides (-40 mg/dL) was seen in the 150iu BD dose group. No significant increases in body weight were observed, and significant decreases in systolic blood pressure were seen in all groups. No serious treatment-related adverse events were recorded, and no incidence of hypoglycaemia was reported throughout the whole twelve-week study period.

Conclusions: Capsulin oral insulin administered twice per day at a dose of 150iu per capsule is safe, with no confirmed treatment-linked hypoglycaemic events, and results in significant decreases from baseline in HbA1c, Fasting Plasma Glucose and triglycerides. This article is protected by copyright. All rights reserved.