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Currently, patients must administer synthetic insulin up to 10 times a day to survive. The constant fluctuations between high and low blood sugar levels can cause short- and long-term physical health issues, and the effort to maintain stable levels can also affect mental health.
Researchers in the US, Australia, and China have designed novel smart insulins that remain dormant in the body and activate only when needed, mimicking the body's natural response to blood sugar changes. These glucose-responsive insulins (GRIs) stabilize blood sugar levels and prevent hyperglycemia and hypoglycemia by becoming active only when blood sugar levels are too high and inactive when levels drop too low. Experts believe that in the future, patients may only need insulin once a week.
Standard insulins stabilize blood sugar levels but typically cannot help with future fluctuations, requiring patients to inject more insulin within just a few hours. The new smart insulins address this issue, offering a more effective solution.
Scientists behind this innovation have received millions of pounds in grants to accelerate their development, funded by the Type 1 Diabetes Grand Challenge, a partnership between Diabetes UK, JDRF, and the Steve Morgan Foundation, investing £50 million into cutting-edge research.
Dr. Tim Heise, vice-chair of the novel insulins scientific advisory panel for the Type 1 Diabetes Grand Challenge, believes smart insulin may herald a new era in diabetes treatment. "Even with modern insulins, people with type 1 diabetes must put in significant effort to balance glycemic control and avoid hypoglycemia. Glucose-responsive insulins, regarded as the holy grail, could be as close to a cure for type 1 diabetes as any drug therapy."
Nearly £3 million has been awarded to six research projects developing different types of smart insulins. These projects, based at Stanford University in the US, Monash University in Australia, and Zhejiang University in China, aim to fine-tune smart insulin to act faster and more precisely, reducing the burden of managing type 1 diabetes and the risk of long-term complications.
Four projects focus exclusively on testing GRIs, while a fifth has developed a new ultrafast, short-acting insulin. Even the fastest available insulins have a delay between administration and action, which can cause blood glucose to rise to unsafe levels before the insulin can act. Faster insulins are needed to improve insulin pumps and hybrid closed-loop technology, which relies on stored insulin responding in real-time to blood glucose changes.
The sixth project combines insulin with another hormone, glucagon, which stimulates the liver to release more glucose when blood levels are low. Including both hormones in one formulation could stabilize blood glucose levels by preventing highs and lows.
Dr. Elizabeth Robertson, director of research at Diabetes UK, said these projects could revolutionize type 1 diabetes treatment. "By supporting these groundbreaking research projects, we aim to develop new insulins that closely 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 the physical and mental health of those living with the condition. We are hopeful that this research will lead to life-changing advancements in type 1 diabetes care."
Rachel Connor, director of research partnerships at JDRF UK, emphasized the importance of this research. "While insulin has been saving lives for over 100 years, managing glucose levels with insulin is still challenging. By envisioning a world where insulins can respond to changing glucose levels in real-time, we hope these six projects will create a new reality, relieving people with type 1 diabetes from the relentless demands of managing their condition."
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