Smart insulin could be the closest we get to a cure for type 1 diabetes

We might be closer than ever to curing diabetes . A few promising breakthroughs show it might be possible to repair the pancreas and restore insulin production . There are also behavioral therapies that work, like a liquid 900-calorie diet that can reverse diabetes. However, these developments can only apply to type 2 diabetes for the time being.

There’s also type 1 diabetes, the rarer but slightly more dangerous version. Here, it’s crucial to monitor glucose levels and administer insulin throughout the day to ensure blood sugar stays within optimal levels.

Without insulin, the body won’t break down sugars, which can lead to life-threatening events. Administer too much insulin, and you risk going in the other direction. You risk hypoglycemia or low blood sugar. That’s also a life-threatening condition.

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Research teams around the world are working on so-called smart insulin products. They could react to blood sugar levels in real time. These glucose-responsive insulins (GRIs) might be the closest thing we get to a type 1 diabetes cure. They’re seen as “holy grail” insulins.

If they work, they might allow type 1 diabetes to significantly improve the illness’s management. Some GRIs might let patients administer insulin only once a week without worrying about blood sugar levels being too high after a meal or too low after an insulin shot.

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Smart insulins would only become active when blood glucose reaches a certain threshold. They’d stabilize the blood sugar levels and then go dormant. The GRI would wait for the next glucose spike, which would occur after the next meal.

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According to The Guardian , the Type 1 Diabetes Grand Challenge is investing £50 million ($63.84 million) in funding research for new type 1 diabetes treatments. The initiative is a partnership between Diabetes UK, JDRF, and the Steve Morgan Foundation.

The Type 1 Diabetes Grand Challenge has already awarded almost £3 million ($3.83 million) to six research projects. Among them, teams at Stanford University in the US, Monash University in Australia, and Zhejiang University in China are working on type 1 diabetes smart insulins.

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Four of the six projects are exclusively working on GRI testing. They’re fine-tuning the smart insulin to act faster and more precisely. A project is working on a protein that combines insulin with another hormone, glucagon. The latter can stimulate the liver to release more glucose during hypoglycemia. This could be a key approach to ensuring blood sugar levels do not drop dangerously low.

The sixth project is developing ultrafast insulin that can act immediately. Even with the fastest insulins available, there’s a delay between injection and the point the insulin starts to reduce glucose levels.

That said, none of the teams have released studies detailing their breakthroughs. It’s unclear how the smart insulin detects blood sugar levels to activate. Funding from the Type 1 Diabetes Grand Challenge aims to accelerate progress and lead to trials, which is necessary to determine the safety and efficacy of any new drug.

“The funded six new research projects address major shortcomings in insulin therapy,” Dr Tim Heise, vice-chair of the novel insulins scientific advisory panel for the Type 1 Diabetes Grand Challenge, told The Guardian . “Therefore, these research projects, if successful, might do no less than heralding a new era in insulin therapy.”

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