More than 37 million people in the United States have type 2 diabetes, a long-term condition where the body struggles to manage sugar levels in the blood.
According to the CDC, it’s the seventh leading cause of death in the country. While lifestyle changes and medications like insulin can help, many patients still have difficulty keeping their blood sugar under control.
One highly effective treatment is bariatric surgery, which changes the structure of the digestive system to help with weight loss and blood sugar control. It’s especially useful for people with obesity—about 80% of those with type 2 diabetes are overweight.
However, this type of surgery is expensive, irreversible, and carries risks such as infections, bleeding, and even serious digestive problems. As a result, fewer than 1% of the patients who might benefit from it actually get the surgery.
Dr. Ashish Nimgaonkar, a gastroenterologist at Johns Hopkins, was inspired to find a safer and simpler alternative. He was amazed when one of his patients had their diabetes symptoms nearly disappear within 24 hours of having bariatric surgery. He wanted to recreate those benefits—without the need for surgery.
One type of bariatric surgery, called gastric bypass, works by making the stomach smaller and rerouting it to skip the first part of the small intestine, known as the duodenum. The duodenum plays a major role in controlling metabolism and blood sugar.
In people with diabetes, the signals coming from the duodenum are abnormal and lead to poor blood sugar control.
Some new treatments try to block these signals by inserting a plastic sleeve inside the duodenum through a scope. But this method still requires a procedure and the sleeve doesn’t last forever. So, Dr. Nimgaonkar asked: What if you could block the duodenum’s signals with a simple pill?
In 2013, he teamed up with Johns Hopkins’ Center for Bioengineering Innovation & Design and later co-founded a company called Glyscend Therapeutics. Together, they created a daily pill called GL200. This pill releases a special polymer—a type of drug that coats the inside of the duodenum, temporarily blocking its signals, much like surgery would.
The tricky part was getting the pill to survive the stomach’s acid and still work in the intestines. The team solved this by designing the pill to dissolve in water in the stomach, but become active when it reaches the higher pH of the duodenum.
So far, the pill has been tested in three small human trials. It passed safely through the body without entering the bloodstream and was well tolerated. More importantly, early results show that it helps lower blood sugar levels, both while fasting and after meals—similar to the effects of surgery.
The next step is much bigger: testing the pill in thousands of people over longer periods—up to a year or more—to prove it’s safe and works well in the real world. These large studies are costly, so Dr. Nimgaonkar’s company is talking with big pharmaceutical companies to take over the next phase.
If successful, this pill could revolutionize diabetes treatment. It might offer a surgery-free option for millions of people who need help managing their blood sugar, without the risks or cost of traditional surgery. The research is still ongoing, but the idea of “surgery in a pill” could soon become a reality.
If you care about diabetes, please read studies about This drug combo can treat type 2 diabetes in the long run effectively and findings of Eating fewer than 3 meals a day may help reduce risk of type 2 diabetes and obesity.
For more about diabetes, please read studies about How to choosing the right fruits for type 2 diabetes and findings of New higher dose diabetes drug promises better blood sugar control and weight loss.
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