Smarter Insulin

I don't usually wax poetic about new products in the gizmo field. So a meter has a bigger screen or holds more in memory or whatever. Big deal. It's still the same basic product.

But this gizmo has me excited, although it may be some time before it's commercially available. The idea of "smart insulin" that is only activated when blood glucose (BG) levels are elevated was reported last year. To do this, the researchers inserted insulin into microbubbles along with glucose-sensing chemicals similar to those in our meter strips. When BG increased, the microbubbles fell apart and released insulin into the bloodstream through microneedles in a patch.

What is exciting about the new research, done by the same group in North Carolina, is that instead of putting insulin in the patches, they've encapsulated beta cells, which are exquisite sensors of BG levels. The BG level in the blood increases and gets into the patch, the beta cells secrete just the right amount of insulin, as they do in the pancreas of nondiabetics, and BG levels go down.

Because the beta cells in the patch are encapsulated, they won't be rejected by the immune system, which is one of the problems with attempts at beta cell transplants.

Both types of patch were tested in mice, and it will be a long time before they're available for us, as noted in this analysis of the first device. Still, I think it's an exciting new way of looking at possible solutions to freeing people with diabetes from the burden of having to think about their BG levels 24/7.

As an aside, I always chuckle when popular-press articles always mention freeing people from "painful shots"  as if that were the biggest problem with diabetes. In fact, except for a tiny minority with real needlephobia, injecting insulin or pricking the fingers is not very painful and is not the major burden of diabetes, as Dr John Buse , a coauthor of the studies points out: "Managing diabetes is tough for patients because they have to think about it 24 hours a day, seven days a week, for the rest of their lives."

How wonderful it will be if these new patches work out.