Scientists have developed a “holy grail” insulin that responds in real time to changing blood sugar levels and could revolutionize treatment for millions of people with type 1 diabetes worldwide.
Patients currently have to give themselves synthetic insulin up to 10 times a day to survive. Constant swings between high and low blood sugar levels can result in short- and long-term physical health issues, and the struggle to keep levels stable can also affect their mental health.
Scientists have found a solution that experts say comes as close to a cure for type 1 diabetes as any drug therapy can: smart insulin that lies dormant in the body and only kicks in when needed. Researchers in the US, Australia and China have successfully designed new insulins that mimic the body’s natural response to changing blood sugar levels and respond instantly in real time.
Standard insulins stabilize blood sugar levels when they enter the body, but once they’ve done their job, they usually can’t help with future fluctuations. This means that patients often have to inject more insulin again within a few hours.
The new glucose-responsive insulins (GRIs) only become active when there is a certain amount of sugar in the blood to prevent hyperglycemia (high blood glucose). They become inactive again when levels fall below a certain point, avoiding hypoglycemia (low blood glucose). In the future, patients may only need insulin once a week, experts say.
Scientists behind the smart insulins have received millions of pounds in grants to speed up their development. The funding comes from type 1 Diabetes Grand Challenge, a partnership between Diabetes UK, JDRF and the Steve Morgan Foundation. It is investing £50 million in cutting edge research to find new treatments for type 1 diabetes.
Dr. Tim Heise, vice-chair of the scientific advisory panel for new insulin for the Type 1 Diabetes Grand Challenge, said smart insulin could usher in a new era in the war on diabetes. “Even with the currently available modern insulins, people living with type 1 diabetes have to put a lot of effort into managing their diabetes every day to find a good balance between acceptable glycemic control on the one hand and avoiding hypoglycaemia on the other. the other side.
“Glucose-responsive – so-called smart – insulins are considered the holy grail of insulin, as they will come as close to a cure for type 1 diabetes as any drug therapy can.”
Almost £3 million has been awarded to six research projects developing different types of smart insulins. These include teams at Stanford University in the US, Monash University in Australia and Zhejiang University in China. The goal is to accelerate development and launch trials as soon as possible.
Each project aims to refine smart insulin to act faster and more precisely, easing some or all of the major burden of managing type 1 diabetes and reducing the risk of long-term complications. Four of the projects are solely focused on testing GRIs.
A fifth developed a new ultra-rapid, short-acting insulin. Even with the fastest insulins now available, there is still a delay between the drug being administered and the point at which it begins to act on glucose in the blood. This can cause blood glucose to rise to unsafe levels before insulin can act to lower it.
Faster insulins are also needed to improve the function of insulin pumps and hybrid closed-loop technology, a system that relies on stored insulin responding in real time to changing blood glucose levels.
The sixth project is focused on a protein that combines insulin with another hormone, glucagon. Unlike insulin, which helps remove glucose from the blood, glucagon stimulates the liver to release more glucose when blood levels become low. Including both hormones in one formulation can keep blood glucose levels stable by working to prevent high and low blood glucose levels.
“The six new research projects funded address major shortcomings in insulin therapy,” Heise said. “Therefore, these research projects, if successful, can do no less than usher in a new era in insulin therapy.”
Rachel Connor, the director of research partnerships at JDRF UK, said: “While insulin has been saving lives for over 100 years now, and previous research has driven important changes for people with type 1, it’s still not good enough – managing glucose levels with insulin is really hard, and it’s time for science to find ways to lift that burden.
“By imagining a world where insulins can respond to changing glucose levels in real time, we hope these six projects will help create that new reality, relieving people with type 1 of the relentless demands that life with the condition poses today they set.”
Dr Elizabeth Robertson, the director of research at Diabetes UK, said the projects had the potential to revolutionize type 1 diabetes treatment. “By supporting these ground-breaking research projects, we aim to develop new insulins that better mimic the body’s natural responses to changing blood sugar levels.
“This could significantly reduce the daily challenges of managing type 1 diabetes, and improve both the physical and mental health of those living with the condition. We are hopeful that this research will lead to life-changing advances in type 1 diabetes care .”
