Diabetes Management, Transformed

BIOtech Now
Jim Greenwood

Millions of people with diabetes know all too well the time-consuming and difficult process of calculating the precise amount of insulin they must administer multiple times each day in order to manage their blood glucose levels.

But times are changing. Last year, the Food & Drug Administration approved the first-ever “artificial pancreas,” a combination of a monitor that automatically measures blood glucose levels every five minutes and a pump that delivers insulin as needed to keep patients in a safe range.  The breakthrough reminds us how far innovation can take us in improving the daily lives of patients, and it offers fresh optimism for the places we can yet go in diabetes treatment.

There’s palpable excitement about the potential of a new therapy in development called “smart insulin,” which potentially could transform the complicated process of disease management even further. The idea behind smart insulin is that the drug would filter through the body until a person’s blood glucose level is outside an acceptable range. As soon as that happens, the insulin would spring into action, bringing the levels back to safe ranges.

Scientist Todd Zion began working on smart insulin in 1999, even before the artificial pancreas was invented. He was a doctoral student at Massachusetts Institute of Technology when he began experimenting with chemically modifying insulin to see if it would react automatically to changing blood glucose levels. His company, SmartCells, worked with the JDRF and the National Institutes of Health (NIH) to obtain financing to develop and conduct initial safety testing on the idea.

Recognizing smart insulin’s potential to transform the lives of people living with type 1 diabetes, Merck acquired SmartCells in 2010 and began phase 1 human clinical trials in 2015. A decision by the FDA is still a number of years away, but Merck scientists are enthusiastic about this prospective breakthrough.

Researchers at other companies and universities are pursuing promising research along similar lines. JDRF is helping to fund a laboratory project at the University of Birmingham in England, where researcher John Fossey is developing a smart insulin gel that only dissolves in the presence of glucose. His idea is to inject the gel into the blood stream of a person with diabetes, where it would only dissolve upon detection of high glucose levels. The dissolution, in turn, would release pockets of insulin. Fossey’s experiments are still in the early stages of pre-clinical research.

FDA also took steps to improve diabetes management recently when it approved an expanded indication for continuous glucose monitors, allowing the devices to replace the finger stick method for testing blood glucose to make diabetes treatment decisions.

Other cutting-edge products to manage diabetes are in development. A biotech company in Israel is working on a device to measure glucose with electromagnet waves. A company in London would use laser sensors to accomplish the same end. Other researchers are working on a patch and an implanted device to track blood sugar.

These innovations could play a vital role in improving global health, helping more people successfully manage their condition. The World Health Organization (WHO) considers diabetes an epidemic and projects it will be the seventh leading cause of death globally by the year 2030. The number of people living with diabetes worldwide has quadrupled over the last 35 years to 422 million, according to the WHO.

The Centers for Disease Control and Prevention (CDC) says 29 million Americans are living with diabetes. It is already the seventh-leading cause of death in the United States and a driver of kidney failure, lower limb amputations, and adult-onset blindness.

Today is Diabetes Alert Day. It’s a one-day wake-up call to encourage all Americans to ask about their family’s history of diabetes and take the Diabetes risk test. On this day, we at BIO are encouraged by the advances biotech companies are making in treating diabetes, and we’re optimistic about current research and the potential for future therapies. Right now, there are more than 170 medicines in development for type 1 and type 2 diabetes and related conditions.

When it comes to transformative products like smart insulin, we’re inching closer every day. In the meantime, the incredible science happening at American biopharmaceutical companies holds the promise of a better future for those living with this serious condition.


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