With more than 245 million people with diabetes worldwide, a number that is expected to increase to 380 million within 20 years, a giant push is underway to create easier ways of monitoring the disease. Many people with diabetes know that the disease, if poorly controlled, can lead to blindness, kidney failure, heart disease, stroke and amputation. Unfortunately, the grim outlook is not always enough to keep diabetics on track with treatments, whether it involves simply diet and exercise or consistent blood glucose monitoring and insulin injections.
As the 5 million people who depend on daily insulin injections know (and this number is growing too), there are both literal and figurative pains of keeping up with diabetes. Insulin is a large-particle protein that cannot easily find its way into the bloodstream. So daily injections of insulin have been the mainstay for diabetics for more than 25 years. Depending on the severity of their case, people with diabetes must keep track of many items, such as blood glucose monitor strips, needles and insulin, and keep them readily available. Diabetes researchers looking into the future of disease treatment are looking for ways around the needle. In 2006, insulin inhalers became available in the U.S., marking a tremendous leap toward alternative insulin delivery methods. The following developments represent only a sliver of what the future holds for treating and monitoring diabetes.
Delivering a large protein like insulin in pill form to the human body without it being destroyed in digestion has been the subject of well-funded research for decades. Several companies have begun to make headway in this area, and one company has already completed its second phase of testing. Diabetology Ltd. released the results from this testing, which consisted of 16 Type 2 diabetics who continued their normal diet and lifestyle habits while taking two insulin pills per day. The product, called Capsulin™, carries the insulin in a capsule that protects it from the stomach acids, which was effective in this sample. In fact, this insulin delivery resembles the natural pancreatic pathways of delivery in nondiabetics, which shows promise in reducing side effects from insulin injections.
Consumers are used to seeing skin patches that deliver nicotine and birth control, but will diabetics ever be able to use a patch that delivers insulin? Researchers have found that ultrasonic transmission is an effective means of insulin delivery, which paved the way for the U-Strip Insulin Delivery System, still in clinical testing. The concept includes a small battery-powered ultrasonic device, which, when attached to a transdermal patch, would enlarge the skin’s pores, enabling large molecule drug delivery. The patch is in its second phase of human testing, this time to address skin sensitivity.
Implantable medical devices must overcome biocompatibility problems to avoid the device being attacked by the user’s own immune system. Research is well underway on different implantable insulin devices that will create long-term alternatives for diabetics who rely on insulin. The implantable pump is one such device that would be permanently implanted to measure blood sugar levels and deliver the exact amount of insulin needed, making it possible to approximate actual insulin delivery from a pancreas. Users could control the amount of insulin delivered with a remote control and refill the pump every two to three months. The implantable insulin capsule is a similar device that would continuously release insulin into the bloodstream. The capsule contains insulin-secreting cells that use the body’s own nutrients to produce insulin indefinitely. These products still require more testing to determine the long-term effects of such delivery methods.
Micro Glucose Sensors
With today’s blood glucose monitors, pricking fingers to obtain blood is just one more hassle that people with diabetes must live with. Fortunately, the future looks full of options for reliable alternative methods of measuring blood glucose. One device is a glucosesensing Radio Frequency Identification (RFID) microchip. The microchip, once implanted under the skin, allows users to scan it to receive wireless glucose data. This device is currently awaiting FDA approval. A similar device, the prototype under-skin glucose sensor, is no bigger than one centimeter by one-half centimeter. It is composed of a special metallic glass that responds to and creates magnetic fields to communicate with a detector. The device is coated with an enzyme that reacts with glucose, which enables it to report glucose levels.
Even though some people with diabetes might say that they get used to the fingerpricking and needle-injections, finding new means of insulin delivery and monitoring is important not just to alleviate pain, but to help a greater number of people actively control their disease. Already, there is a growing burden placed on the healthcare system by untreated diabetics showing up in emergency rooms. The future of diabetes treatment hinges on giving diabetics greater control and ease in their daily regimen.