Oral insulin (human, murine, or porcine) does not prevent diabetes in the non-obese diabetic mouse

- Treatment with oral insulin did not prevent diabetes in our NOD mouse colony.
- Testing of linked suppression by DTH had no reproducible effect.
- Insulin incubated with jejunum extracts was instantly digested.
- Protective encapsulation of oral insulin may be required.

Studies have shown oral insulin prevents type 1 diabetes (T1D) in mouse models, however human trials were inconclusive. We tested the ability of different insulins to prevent T1D in non-obese diabetic mice. Mice received oral insulin or PBS twice weekly and disease was monitored. Contrary to previous studies, no insulin tested showed significant ability to prevent T1D, nor did testing of linked suppression in a delayed type hypersensitivity model have reproducible effect. To investigate delivery of antigen within the GI tract, blue dye was fed to mice. Dye traveled 5-8 cm from stomach to small intestine within 10 s, suggesting orally administered antigen may not get digested in the stomach in mice. Insulin incubated with jejunum extracts was instantly digested. Thus, in humans large doses of insulin may be required to achieve tolerance as antigen may be more vulnerable to digestion in the stomach even before reaching the small intestine.