Type 1 diabetes happens when the body’s own defenses mistakenly attack and wipe out the important insulin-making β-cells in the islets of the pancreas. This leaves people without a natural way to control their blood sugar levels and makes them rely on insulin shots or special insulin pumps for their whole lives.
The disease takes hold during late childhood and adolescence and severely affects the quality of life. Managing blood sugar levels through regular testing, insulin injections, and dietary restrictions becomes an everyday necessity.
This relentless routine can lead to stress, anxiety, and feelings of being different among young individuals.
Although many treatments are available to control blood glucose concentration (BGC) in patients with type 1 diabetes, there are no satisfactory treatments available that would free people from their hassle.
Plus, even if the patient regularly takes insulin injections, he or she still might not be able to control glycemic levels efficiently, as a healthy range is too tough to achieve via this type of insulin administration.
The modern approaches to deal with Type 1 diabetes
Clinical trials are underway that are making insulin delivery in humans much more efficient and allowing better control over blood glucose levels among type 1 diabetes patients.
One such endeavor is the implantation of islet cells excised from a cadaver (dead body) of a person with a healthy pancreas into a patient suffering from type 1 diabetes. The idea is to supply the patient with insulin from those islet cells derived from the pancreatic tissue of the deceased, which will then get support from the patient’s body.
The problem
The problem with this method is that the body generates an immune reaction against the foreign antigen (of the tissue derived from the cadaver), which mainly destroys that tissue and leads to scarring (fibrosis) in the patient’s body.
The patient can take immunosuppressant drugs to lower the activity of the immune system against the implanted tissue but this has its own problem of subjecting the person at risk to opportunistic infections.
Some successful researchers have suggested the use of stem cells for creating islet cells which would produce insulin and avoid the immune reaction but still, the patient’s dependence on immunosuppressant drugs didn’t end.
To overcome the need for these immunosuppressant drugs, some scientists encapsulated the transplanted cells within a flexible coat made of the patient’s own cells to stop the immune response against islet cells but this modification severely decreased the oxygen supply to the islet cells. This hampered oxygen delivery to the cells leads to their nutritional deficiency, which will drastically decrease their lifespan.
Several methods were suggested to ensure uninterrupted oxygen delivery to these which included
- Creating an oxygen chamber that could supply the cells and avoid the immune reaction, but these chambers need a periodic reload to ensure constant oxygen supply which is again an inconvenient procedure.
- Or equip the implants with chemical reagents that can generate oxygen upon their reaction, but these reagents will eventually run out depriving the cells of nutrition to sustain insulin-forming activity.
The recent ground-breaking approach to treat Type 1 diabetes
Seeking a solution to this problem, a team of engineers from the Massachusetts Institute of Technology (MIT) designed an implant. It would carry hundreds of thousands of islet cells along with their own onboard oxygen factory to keep the cells alive and healthy. The prime purpose of developing this device was to help Type 1 diabetes patients eliminate the need for insulin injections and achieve better glycemic control.
The MIT engineers decided to equip the islet cells with proton-exchange membrane technology. It is the (a technology primarily used in Fuel Cells to liberate hydrogen). This technology zaps the water vapors in the body to Hydrogen (which diffuses harmlessly in the body) and Oxygen which is taken up by islet cells for their survival.
The device is powered wirelessly from the outside by a magnetic coil, which transmits the electric power from outside to the small, flexible antenna connected to the device. The transfer of power happens via the resonant inductive coupling. The external coil is designed to be in the form of a patch, which could be easily worn on the skin.
So far, the experimentation has gone very well with the diabetic mice, who have fully functional immune systems. Diabetic mice that had this device implanted under their skin achieved better glycemic control in contrast to the ones that had not been equipped with the proton-exchange membrane technology. The islet cells in the mice devoid of the technology developed hyperglycemia in under a month.
The device led to scarring in the mice, but even after the scars appeared, the device functioned properly and provided advanced glycemic control.
The devices automatically detect the sugar hike in the blood and secrete insulin in response to it making insulin available to the body optimally.
The New Horizons
This use of this method is not confined to the treatment of Type 1 diabetes alone, as this method allows millions of patients who require certain hormones and proteins in therapies to combat diseases.
This technique can be used for a wide range of diseases if its future testing in humans yields a positive result.
We can safely say that in this new era of diabetic treatments, this invention has the potential to serve as a testament to the incredible possibilities that lie ahead in our ongoing quest to conquer the global challenge of type 1 diabetes. We can look forward to a future where type 1 diabetes is not merely managed but conquered, enhancing the quality of life for millions and reducing the burden of this disease on society as a whole.
References
DiMeglio LA, Evans-Molina C, Oram RA. Type 1 diabetes. Lancet. 2018 Jun 16;391(10138):2449-2462. doi: 10.1016/S0140-6736(18)31320-5. PMID: 29916386; PMCID: PMC6661119. https://pubmed.ncbi.nlm.nih.gov/29916386/
Siddharth R. Krishnan, Claudia Liu, Matthew A. Bochenek, Suman Bose, Nima Khatib, Ben Walters, Laura O’Keeffe, Amanda Facklam, Robert Langer, Daniel G. Anderson. A wireless, battery-free device enables oxygen generation and immune protection of therapeutic xenotransplants in vivo. Proceedings of the National Academy of Sciences, 2023; 120 (40) DOI: 10.1073/pnas.2311707120