More than 194 million people worldwide are affected by diabetes, with the number expected to rise to 350 million over the next two decades. In Australia, one adult in twelve has diabetes and the prevalence is increasing. Research has shown that for every person with known diabetes, there is another who has it but has not yet been diagnosed. The diabetes treatment market is estimated at US$18.6 billion. Global sales of insulin, considered the most effective treatment for a proportion of diabetics, totalled $4.7 billion in 2003.

Diabetes is a chronic condition that develops when the pancreas stops producing a hormone called insulin (Type-1 diabetes) or when the pancreas does not produce sufficient insulin and the body does not respond to insulin properly (Type-2 diabetes). As a result, the body cannot maintain normal blood glucose levels. Glucose is the body's main energy source, made by the breakdown of carbohydrate from digested food.

Insulin helps glucose move from the blood into the cells. When the body does not produce enough insulin or cannot use its own insulin effectively, the cells cannot use glucose and the blood glucose level rises. Diabetes occurs when there is too much glucose (sugar) in the blood.

Diabetes can reduce life expectancy by as much as 15 years because high blood glucose levels can damage blood vessels and nerves. These complications of diabetes may cause damage to eyes, nerves and kidneys and increase the risk of heart attack, stroke, impotence and foot problems. The International Diabetes Institute estimates that the direct and indirect healthcare costs associated with diabetes exceed $153 billion globally.

Type-1 diabetes affects around 10% of people with diabetes. It is an autoimmune condition, meaning the body's immune system turns on its own tissue; in diabetes, it is the insulin producing cells that are destroyed. This form of diabetes occurs in people who have genes that make them susceptible to the condition. To stay alive, Type-1 diabetics require daily insulin injections and urged to eat healthier meals and be physically active.

Type-2 diabetes accounts for about 90% of people with diabetes. In Type-2 diabetes, insulin is still produced by the pancreas but is less effective than normal. This condition is referred to as insulin resistance and is believed to be inherited, made worse by carrying extra body fat or being inactive. A small proportion of sufferers have Gestational Diabetes, which is a temporary form of diabetes that occurs during pregnancy when various hormones prevent the body's naturally produced insulin from working properly. Although Type-2 diabetes is usually treated with a healthy diet and exercise program, insulin injections may be required for some patients.

There is currently no cure for diabetes. For Type-1 diabetes the only treatment currently available is insulin therapy. Treatment with insulin injections can be conventional (two injections per day) or intensive (four to seven injections per day), but in both cases, the goal is to achieve normal blood glucose levels. Glycemic control is essential, both for preventing short-term problems, such as hypoglycemic episodes (where blood sugar drops suddenly, causing fainting and other symptoms), and long-term complications, such as damage to the retina, kidneys and nervous system. Insulin can also be used by people affected by Type-2 diabetes to regulate glucose levels. It may be combined with weight reduction and exercise, which are believed to be able to reduce the burden of Type-2 diabetes by about 50%.

Currently, people with diabetes can only administer insulin by injection. Research into alternative delivery forms for insulin has been driven by a patient preference for non-needle forms of delivery. Issues that have challenged research into alternatives revolve around the amount of dose that can be delivered and how long-acting its effect is. Professor Paul Zimmet, Foundation Director of the International Diabetes Institute has commented: "The potential to deliver insulin orally has always been a high priority in diabetes research - it has been considered the 'holy grail' of diabetes treatment." Read more…

Apollo is working to develop insulin in tablet form using its proprietary oral delivery and targeting technology.