Oral Insulin: A New Hope for Diabetes Care in Africa?
By Chinonso Cynthia Ukah. BNSc, RN, RM, RPHN. Freelance Health Writer. Medically reviewed by: A. Odutola, MB BS, PhD, FRCSEd.
Novembwr 22, 2025
A lady putting an oral pill in her mouth with an insulin syringe and tablet in the background. Image generated with AI, Chat GPT.
Diabetes mellitus is a chronic condition where the body cannot properly regulate its blood sugar levels, either because the pancreas, an organ in the body which produces insulin does not produce enough (Type 1) or because the body cannot respond to the effect of the insulin produced by the pancreas (Type 2). This keeps blood sugar at high levels making insulin injections especially necessary for people living with type 1 diabetes.
Before insulin injections were discovered, the treatment of diabetes revolved around ineffective practices like prescribing opium for pain relief, extremely overfeeding the patient, and recommending various outdated nutritional diets. [1]
Everything changed in 1922, when a 14-year-old boy named Leonard Thompson became the first person to be successfully treated with injectable (exogenous) insulin. For over a century since then, insulin shots have saved millions of lives, becoming the gold standard treatment for people with Type 1 diabetes and many with advanced Type 2 diabetes. [2]
Despite the role of insulin injections in diabetes, scientists have never stopped looking for ways to make insulin into a pill that can be swallowed rather than injected. This is because for millions of people across the world living with diabetes, the daily routine of insulin injections and pumps represents both a life-saving treatment and a significant burden. [3]
The need for multiple injections each day, refrigeration, fear of needles, electricity for insulin pumps and the social challenges of managing diabetes in people requiring insulin especially in Africa have made the current insulin therapy particularly challenging, creating the need for alternatives such as oral insulin.
This blog will highlight the progress scientists are making in producing oral insulin.
Insulin is a protein hormone (chemical) produced by an organ in the body called the pancreas. The pancreas is located behind the stomach (see fig. 1) and responds when you eat by releasing the right amount of insulin needed for the cells of the body to absorb glucose, the end product of digestion. In healthy individuals, this process happens automatically, keeping blood sugar levels stable throughout the day.
Fig. 1: Shows the pancreas lying behind the stomach (A) with its detailed anatomy with the stomach removed (B). Click on image to enlarge.
There are two main categories of insulin based on their source:
Endogenous Insulin: is the natural insulin produced by your pancreas. This is the body's own insulin that works perfectly in healthy individuals to regulate blood sugar levels throughout the day and night.
Exogenous Insulin: also known as synthetic insulin, is an insulin that comes from outside the body. It is designed to replace or supplement the insulin that the pancreas cannot produce adequately. There are different types of exogenous insulins as seen in Table 1.
Table 1: Types of exogenous Insulin. Click on image to enlarge.
Oral insulin is a specially formulated insulin preparation that is meant to be taken by mouth. Unlike the traditional injectable insulin that goes directly into the bloodstream when injected in the arm, thigh or stomach (subcutaneous tissues), oral insulin travels through the digestive system to reach the blood before it can regulate blood glucose levels.
At every point in the digestive tract, whether in the mouth, stomach, intestine and liver, insulin taken by mouth is subject to different breakdown processes before it can be absorbed into the bloodstream to have its effect. This results in little or no insulin being available to the bloodstream and poses a challenge in search of a solution.
Scientists are working to find ways to prevent the breakdown of oral insulin as it travels through the digestive system. Some of the ways have been shown to work well in diabetic animals and mice, but not yet in humans. Current developments in oral insulin focus on delivery systems that are beyond the scope of this blog to describe in detail. [4]
Oral insulin offers several actual and potential benefits over insulin injections. Some of these benefits are:
1. Faithful stay with treatment: Because taking oral insulin is simpler and less painful, people are more likely to take it consistently, which is key for good diabetes control.
2. It is more natural and dependable: Unlike injected insulin that goes straight into the bloodstream, oral insulin first passes through the liver, just like the insulin that the pancreas naturally produces. This may help regulate blood sugar in a more dependable and constant way.
3. Makes daily needle injection unnecessary: Oral insulin removes the pain, anxiety, inconvenience and extra costs that come with injections, making diabetes treatment far less stressful.
4. Improves quality of life: A tablet or capsule is easier to carry, swallow, and manage than syringes or pens. You can easily blend it into your routine without drawing attention.
5. Reduces injection-related problems: Oral insulin avoids issues such as skin irritation, infections, weight gain or changes in fat tissue at injection sites.
6. May solve storage issues: Some oral insulin types are stable at room temperature, reducing the need for refrigeration. Refrigeration is a major challenge in many parts of the world.
For millions of Africans living with diabetes, oral insulin could be life-changing.
In many parts of the continent, people struggle with the high cost of insulin, limited availability, poor storage conditions due to unreliable electricity, and the stigma of daily injections. Tablets or capsules that don’t require refrigeration could remove some of these barriers to care.
If oral insulin eventually becomes safe, effective, and affordable, it could also help improve treatment access in both rural and urban areas in resource limited countries. More people would be able to follow their insulin therapy with very little to no interruption while lowering the risk of complications. In sub-Saharan Africa, where healthcare systems are under-resourced, oral insulin could ease the burden on hospitals and families while giving diabetic patients more freedom in their daily lives.
Insulin injections have been the gold standard treatment for type 1 diabetes for over a century now, but the challenges that come with their use have pushed researchers to explore oral alternatives. Despite several setbacks, the science behind oral insulin is progressing rapidly. For Africans living with diabetes, oral insulin could bring hope of fewer needle pricks, simpler treatment, and a better quality of life. Though not yet available, the future of diabetes care may shift from injections to tablets, transforming how millions of people in the world manage this chronic condition.
1. Hirsch IB, Juneja R, Beals JM, Antalis CJ, Wright EE. The evolution of insulin and how it informs therapy and treatment choices. Endocr Rev. 2020;41(5):733-55. doi:10.1210/endrev/bnaa015. Available from here.
2. Nabi-Afjadi M, OstadHadi S, Liaghat M, Pasupulla AP, Masoumi S, Aziziyan F, Zalpoor H, Abkhooi L, Tarhriz V. Revolutionizing type 1 diabetes management: Exploring oral insulin and adjunctive treatments. Biomed Pharmacother. 2024;176:116808. doi:10.1016/j.biopha.2024.116808. Available from here.
3. Limenh LW. A review on oral novel delivery systems of insulin through the novel delivery system formulations: a review. SAGE Open Med. 2024;12:20503121231225319. doi:10.1177/20503121231225319. Available from here.
4. Zhang E, Zhu H, Song B, Shi Y, Cao Z. Recent advances in oral insulin delivery technologies. J Control Release. 2024;366:221-30. doi:10.1016/j.jconrel.2023.12.045. Available from here
Related:
Type 2 Diabetes: What Africans Need to Know
Management of Type 2 Diabetes in Nigeria
Published: November 22, 2025
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