Type 1 Diabetes patients can now rely on a “holy grail” insulin, which will respond rapidly to changing blood sugar levels in real time. Until now, patients had to inject synthetic insulin up to 10 times a day in order to survive, but with ‘smart’ insulin, scientists have come close to a cure for type 1 diabetes.
Researchers in the US, Australia and China have successfully designed next-generation or novel insulins that mimic the body’s natural response to changing blood sugar levels and respond instantly in real time.
“The funded six new research projects address major shortcomings in insulin therapy. Potentially minimising the risk of hypoglycaemia through an insulin-glucagon combination would ease one of the major concerns associated with insulin therapy today. Therefore, these research projects, if successful might do no less than heralding a new era in insulin therapy,” Tim Heise, Vice Chair of Novel Insulins Scientific Advisory Panel of the Type 1 Diabetes Grand Challenge, said.
What is Type 1 Diabetes?
Blood sugars, also called blood glucose, are the primary source of energy in the body. When you eat food, the body breaks down most of it into glucose, which is released into the bloodstream. When glucose levels go up, the pancreas releases the hormone insulin, which helps glucose to be used as energy by your cells.
Those with type 1 diabetes have a pancreas that either cannot produce insulin or produces very little of it. High levels of glucose can lead to heart disease, kidney problems, extreme fatigue and other serious illnesses.
What is the Difference Between Type 1 and Type 2 Diabetes?
Type 1 diabetes is an autoimmune disease in which the body cannot make any insulin at all. The insulin-producing cells have been attacked and destroyed by the body’s immune system. While in type 2 diabetes, the body does not make enough insulin.
Type 1 diabetes affects 8% of people living with diabetes and type 2 diabetes affects 90% of people living with diabetes.
The risk of developing type 1 diabetes depends on family history and genes, and is often diagnosed in childhood or when you are under 40.
Type 2 diabetes develops with age, and your ethnicity can increase your risk. For instance, if you are white and over 40, the risk of developing type 2 diabetes is higher, whereas in African-Caribbean, Black African, Chinese or South Asians, chances of developing the illness increase if you are over 25.
In India, there are around 8.6 lakh people with Type 1 diabetes, with one in six young people dying without a diagnosis. An estimated 77 million people above the age of 18 years are suffering from type 2 diabetes, and nearly 25 million are prediabetics (at a higher risk of developing diabetes in near future), according to the World Health Organization.
The 10 countries with the highest estimated prevalence — USA, India, Brazil, China, Germany, UK, Russia, Canada, Saudi Arabia and Spain — account for 5.08 million or 60% of global cases of Type 1 diabetes.
What is the Need for Better Insulin?
The glucose levels in the body constantly change depending on your stress levels, whether you have exercised, the foods you eat and the hormone levels. This makes it hard for the people with type 1 diabetes to maintain a stable blood sugar level, even with the latest technology to administer insulin.
A standard insulin can stabilise blood sugar levels for a certain time, but it cannot typically help with future fluctuations. It means patients often need to inject more insulin again within just a few hours.
Faster insulins are also needed to improve the function of insulin pumps and hybrid closed loop technology – a system that relies on the stored insulin responding in real-time to changing blood sugar levels.
What is a Smart Insulin?
The new glucose-responsive insulins (GRIs) become active when they detect a change in sugar levels in the blood to prevent hyperglycaemia (high blood glucose). They become inactive again when levels drop below a certain point, avoiding hypoglycaemia (low blood glucose). In future, patients may only need insulin once a week, experts believe.
The effect of a smart insulin would be similar to that produced by a functioning pancreas, which only releases insulin when it is needed in the body.
The GRIs promise to end constant glucose monitoring, and could allow patients to swallow a pill or inject insulin once every morning.
What are the 6 Research Projects for Smart Insulins?
The six projects include teams at Stanford University in the US, Monash University in Australia and Zhejiang University in China. The aim is to accelerate development and launch trials as soon as possible.
The Monash University project involves development of a second generation of nano sugar-insulin system, based on advanced nanotechnology. These nano sugars react to very small changes in blood glucose and release insulin only when glucose levels are outside a range, without any intervention from the patient.
Researchers at the Wayne University are working to develop a “smart insulin” which can detect changes in blood glucose levels and respond by releasing the right amount of insulin at the right time.
The third project, conducted by researchers at the Jinhua Institute of Zhejiang University in China, involves novel insulins that respond immediately to rising blood glucose levels.
At the University of Notre Dame, US, researchers developed a smart insulin delivery system that uses tiny particles called nanocomplexes, which contain insulin. These nanocomplexes can also be injected under the skin to create a reservoir to automatically release insulin if blood sugar rises.
Scientists at the Stanford University, US are working on developing and testing an ultrafast-acting insulin that’s only active when needed and could reduce the risk of blood glucose highs and lows in people with type 1 diabetes.
A team of researchers at the Indiana University, US will combine insulin and glucagon in their project, to prevent the highs and lows in blood glucose.
Dr Elizabeth Robertson, the director of research at Diabetes UK, said, as quoted by The Guardian, the projects had the potential to revolutionise type 1 diabetes treatment. “By supporting these groundbreaking research projects, we are aiming to develop new insulins that more closely mimic the body’s natural responses to changing blood sugar levels.