Newly Designed 'Smart' Insulin Could Majorly Improve Type 1 Diabetes Treatment

Type 1 diabetes requires a complex combination of exercise, diet, and insulin therapy in order to maintain normal blood sugar levels. There are many ways to make diabetes patients' lives easier. However, there is a promising new way that focuses on insulin.Michael Weiss, a biochemist at Indiana University, has reworked the structure of the insulin molecule to react to simple carbohydrates. The goal is to reconnect the activation of insulin and internal blood sugar levels.Their modification focuses upon a feature already present in the molecule's structure, a protective "hinge" that allows the protein's function when it is open and keeps it stable while closed.(IU School of Medicine 2021).The new design of insulin means that the molecule opens only when there is a "key", such as simple sugar molecules.Weiss and his colleagues used the carbohydrate fructose to demonstrate that insulin can be controlled so that it activates only a small number of cells derived directly from the liver when it is'switched off' by a certain amount.The idea is more of a proof-of-concept than a clinically proven treatment. It would work in theory for an insulin-shaped "hinge" to activate in the presence glucose. This result could open the door to a way to reduce the guesswork involved in diabetes treatment.Weiss says, "The promise of this type of smart insulin is that it will transform diabetes care so people wouldn’t have to worry anymore."Type 1 diabetes, which affects approximately 15 out of every 100,000 people in the world, is an autoimmune condition. The body's immune system attacks cells in the pancreas that measure insulin levels and determine the exact amount of insulin needed to regulate glucose levels.The body cannot control the amount of insulin that is delivered to it at the right time. This locks down the glucose channels in cells, which would normally channel glucose into them. It also stops the fuel from reaching energy-hungry tissues.This would have tragically meant early death for diabetics centuries ago. With the discovery of insulin, the fates of millions have changed. It can be extracted and injected artificially to do the work of the pancreas.Although it is an effective treatment, there are many challenges. The body's need for glucose is not predictable. It drives levels up and down almost at will.Insufficient insulin can lead to blood sugar levels remaining high in hyperglycemia. This can cause excessive thirst, blurred vision, headaches, fatigue, blurred vision, and other symptoms.If you overload your body insulin, the cells will quickly absorb glucose from the bloodstream. This can lead to hypoglycemia. This low sugar level can cause excessive sweating, confusion and shakiness in mild cases. Hypoglycemia can lead to seizures and even death in severe cases.No matter what you do, if glucose is not in sufficient supply, the body will turn to fat for energy and produce ketones. Ketoacidosis can be dangerous if these substances build up in sufficient quantities.Technology and knowledge have made it possible for people to manage their sugar levels in a way that avoids tragic consequences. However, transforming insulin into a biochemical sensor could make it ineffective if blood sugar falls below a certain level.Weiss says that a glucose-responsive insulin is crucial because the greatest barrier to insulin's effective use, particularly in type 1, is the fear of blood sugar dropping too low.Other researchers are currently exploring the concept. A team of researchers from the University of Copenhagen, Gubra, and the biotech company Gubra created a form of insulin last year using a similar approach. The attached group was able to break down in the presence of glucose, making the molecule functional.It was demonstrated to work in rats and could be used as an automated insulin.There is a lot that needs to be done between now and then. Although the modified hormone is theoretically effective, it would have to be able to detect a specific level of glucose.2021 marks the 100th anniversary of insulin's discovery. People living with type 1 diabetes may look back in 100 years on another milestone where insulin has been improved.This research was published by PNAS.