Can technology help us to treat diabetes better?
Wearables, patches, nanosensors and other emerging technologies can radically enhance the quality of diagnostics and treatment of severe diseases such as cancer or cardio failure. We will address now the third part of the triptych: diabetes. According to WHO diabetes ‘will be the 7th leading cause of death in 2030’ with about 347 million people worldwide suffering from it. The sad revelation may come accidentally after blood checks in connection with other sickness such as, e.g., flue, but in any case with no suspicion of diabetes.
A diabetic patient has to stay on medication such as Metformin through years of his life combining this treatment with insulin injections on a later stage. But the concentration of glucose in the bloodstream is typically not stable and varies drastically depending on multiple factors: stress, food, physical activities, etc. The sugar may suddenly rise, but can also dramatically fall provoking hypoglycemia that could cause dizziness, vertigo or even bring a person into coma. To ensure the right balance of glucose in the blood one has to measure the glucose level several times per day. Unfortunately, the widely used consumer blood sugar measuring devices with all their test stripes and disposable needles are very uncomfortable and prone to infection due to the invasive nature of measurement.
For patients to monitor and control their conditions properly, easy to use and noninvasive methods of glucose checks are required. These methods are coming, but first of all why to confine ourselves only to blood checks?
Noninvasive glucose analysis in human fluids
Many years ago Microsoft Research and the University of Washington started experimenting with functional lenses that could be placed into the eye. This miniature lens was equipped with a biosensor that reacted on the level of sugar concentration in a tear. In case the sugar level exceeds the norm, a tiny antenna in the lens transmits the alert to the patient.
The project was later picked up and commercialized by Google in cooperation with Novartis who plans the first human tests with “smart” diabetic contact lens in 2016.
However, wearing even a tiny object in your eye is still uncomfortable. HealBe, a company that is specialized in wearable devices and wellness applications, is raising “crowd funding” to create devices that will measure sugar level in the urine.
GlucosAlarm can be simply installed in a toilet. The routine procedure each of us have to undergo every day may tell a lot about our health condition by measuring not only sugar, but also some proteins, e.g., albumin as well as ketones, pH, etc. to detect a wide range of disorders such as urinary tract infection, kidney diseases and many others. Maybe in the future our toilets will be equipped with wirelessly connected sensors that would inform us via smart phones if we are fit for the day or whether our body requires some extra attention.
Skin-based diabetic monitoring and therapy
Our sweat can tell us a lot about our health. We sweat when we are nervous, tired or sick to “cool” ourselves a bit. The scientific team from the Center for Nanoparticle Research at IBS decided to make a wearable graphene-based patch that monitors the increase in relative humidity (RH) in the sweat. The patch with the humidity sensor is attached to the skin. In about 15 minutes RH reaches over 80% and the sweat-uptake layer of the patch starts collecting sweat that initiates a glucose measurement. The connection to a portable/wireless power supply safeguards data transmission directly to the diabetic point-of-care treatment.
The patch is not only monitors, but also controls the sugar level by applying the necessary amount of medications. Covered by microneedles each of which containing Metformin, the glucose formation preventing drug, the patch is piercing the skin and the needles release Metformin directly into the bloodstream. The effect is much stronger and faster compared to per oral drug delivery during which the medication have first to be consumed by the digestive system.
So far tests were performed only on mice. But scientists are convinced that the device can in future be used by diabetic patients exempting them from an unpleasant routine of drug intakes.
Smart patches can also help us to get rid of insulin injections whatsoever. The researchers at the University of North Carolina and NC State have created a smart patch that detects the increase of sugar in the bloodstream and sprinkles insulin doses whenever needed. The patch is coated with culturally produced human beta cells that are responsible for monitoring the excess of sugar in the bloodstream releasing insulin when necessary. In case of diabetes (DM-2), beta cells fail to notice the extra sugar and thus to produce the required amount of insulin. To repair the process, tiny microneedles are attached to the patch containing the glucose-sensing enzyme. Poked into capillaries, the enzyme spots the sugar increase and communicates this message back to the beta cells. The mechanism is fixed and beta cells regain their functions.
Implanted “smart cells” to regenerate pancreas
Smart patches may soon give way to even “smarter” implanted cells that will regenerate damaged organs directly in our body. The team of researchers from MIT’s Department of Chemical Engineering, the Koch Institute for Integrative Cancer Research, the Institute for Medical Engineering and Science (IMES), as well as the Department of Anesthesiology at Boston Children’s Hospital are designing a system that can provide diabetics with a completely healthy pancreas that will keep the right balance of sugar without any drugs. The intention is to replace the destroyed islet pancreatic cells with the healthy ones, generated from human stem cells.
To deceive the immune system that will try protecting the body from the external cells, scientist have encapsulated those healthy islet cells with alginate, substance distributed widely in the cell walls of brown algae. After experimenting with 800 alginate derivations on mice and non-human primates, the triazole-thiomorpholine dioxide (TMTD) version was chosen. Placed into pancreas, the encapsulated cells immediately began producing insulin in response to blood sugar levels able to keep it under control for the length of the study, 174 days. So far the research was confined to laboratory tests, but the goal is to make this method available to humans thus releasing millions of diabetic patients form the burden of insulin injections.
When I was writing this post I thought: WOW! What amazing new ways technology is offering to treat people who have been struggling with a disease for many years of their life.
But my enthusiasm cooled down: what prevents those beautiful things from reaching the consumers and when can we expect the benefits they promise? I would greatly appreciate your thoughts.