There are approximately 9 million people with type 1 diabetes. Their typical routine might look like this: Wake up at 7 am and check your blood sugar. Have breakfast at 9 am, count carbs, and check your blood sugar. Have lunch at 11:30 am and take insulin. Have a snack at 1 pm, count carbs, and take insulin. Repeat every 1-2 hours depending on your blood sugar.
“With type 1 diabetes, you have to think carefully about every decision you make from the moment you wake up,” says Grace Bennett, who works for type 1 diabetes charity Breakthrough T1D.
Grace was diagnosed with type 1 diabetes when she was 12 years old.
“When you feel like snacking, you have to ask yourself if you really want to snack,” she explains. “Is your blood sugar really at a level where you should be snacking, or am I eating because I'm hungry?”
People with type 1 diabetes (T1D) have bodies that can't produce insulin, so they need regular injections of the synthetic hormone. Daily life with type 1 diabetes involves closely monitoring blood sugar levels and carefully adjusting insulin intake.
But what if a once-weekly dose of insulin was enough? Or what if insulin itself could “sense” blood glucose levels, making hourly checks a thing of the past?
Six new research projects at universities in the US, China and Australia aim to accomplish just that, as researchers continue to explore newer, “smarter” insulin composite materials.
What is Type 1 Diabetes?
Blood sugar, also known as blood glucose, is the body's main source of energy.
When you eat food, your body breaks it down into mostly glucose and releases it into your bloodstream. When glucose levels rise, your pancreas releases a hormone called insulin, which allows your cells to use the glucose for energy.
In people with type 1 diabetes, the pancreas cannot or barely produces insulin. No or low insulin production blocks the uptake of glucose into the body's cells, causing glucose to build up in the bloodstream.
High blood sugar levels are dangerous. If left untreated, they can lead to heart disease, kidney damage, extreme fatigue, and other serious conditions.
In 2019, diabetes was the direct cause of 1.5 million deaths worldwide.
“It's something that's basically lifelong, but at the same time it's also a disease that's largely invisible unless you're looking at an insulin pump or a continuous glucose monitor,” Grace says.
Why do we need better insulin?
Your blood sugar level is constantly changing. It can go up or down depending on your stress levels, whether you exercise, the foods you eat, and the levels of other hormones in your body. Weather can also affect your blood sugar levels.
“You can do the exact same thing as the day before in terms of insulin, food and exercise, but depending on your hormones and exercise your blood sugar can change drastically – it's something you should never ignore,” Grace explains.
This makes it very difficult for people with type 1 diabetes to maintain stable blood sugar levels, even with the latest technology to monitor blood sugar levels and administer insulin when needed.
“There were times when I literally had to tell myself that I had no other choice. There was no option to say, 'I'm not going to take my medicine because it makes me feel bad' or 'I need to take a day off'. Doing so would land me in the emergency room, which could be the worst thing,” she added.
What is “smart” insulin?
Glucose-responsive insulin (or “smart” insulin) promises to put an end to continuous glucose monitoring, which can be a significant burden for many T1D patients.
Instead, patients can take a pill or inject insulin once each morning. Smart insulin remains inactive in the body until blood sugar levels rise. When smart insulin detects a change in blood sugar levels, it “wakes up” and stabilizes blood sugar levels before returning to its inactive state.
The effect would be similar to that produced by a functioning pancreas, releasing insulin only when the body needs it.
For Grace, the possibility of using glucose-responsive insulin would not only impact the physical aspects of type 1 diabetes, but also ease the mental strain of maintaining a rigorous daily routine.
“Knowing that you're using insulin to sense and respond to your blood sugar levels means you spend less time thinking about what you're doing. For example, you can take a walk around the block without having to carry a bag of honey in case your blood sugar gets low,” Grace added.
Have you arrived yet?
Research into smart insulin is still in its early stages, but it's hoped that it could one day ease the burden on people who currently have to monitor their blood sugar levels multiple times a day.
of Type 1 Diabetes Grand Challenge The company is funding more than €3m (£2.7m) across six projects involving universities in the US, China and Australia to develop smart insulin.
One project, from Stanford University in the US, aims to develop an ultrafast insulin that can be released quickly into the bloodstream, mimicking a type of insulin that cone snails use to immobilise their prey.
Another project at China's Zhejiang University aims to reduce insulin injections to once a week by tweaking how the hormone is released from the body's stores.
“If you would have told me at age 12 that we would one day be starting to research insulins that might work in this way in humans, I would have said, 'No way, that's crazy,'” Grace says. “The progress that's been made in researching these new insulins and management tools is truly amazing.”
Editor: Derrick Williams
Arabic
Dutch
English
French
German
Italian
Portuguese
Russian
Spanish