Diabetes is one of the largest global public health concerns, imposing a heavy global burden on public health as well as socio-economic development, and is a leading cause of mortality and reduced life expectancy worldwide. According to estimates from the International Diabetes Federation (IDF), worldwide approximately 537 million adults, between the ages of 20 and 79, were living with diabetes in 2021. By 2030 the number of adults living with diabetes is expected to reach 643 million, and to increase to 783 million by 2045.
These startling figures, as well as the fact that more than half the people living with diabetes are unaware they have the condition, highlight the need to raise public awareness on the illness, and that it can be treated and controlled through early diagnosis, regular monitoring, medication and therapies, as well as through lifestyle changes such as eating a healthy diet and engaging in physical activities.
Diabetes is a chronic health condition that affects your body’s ability to turn food into energy. Normally, most of the food you eat is broken down by the digestive process into sugar (glucose) which is released into the bloodstream that carries it to your cells where it is converted into energy needed by the body. The hormone insulin, produced in the pancreas, acts like a key to allow blood sugar into your body’s cells.
When your blood sugar goes up, it signals islet cells in your pancreas to release insulin. With diabetes, your body does not make enough insulin or it cannot use it as effectively as it should. When there is not enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream. Over time, that can cause serious health problems, such as heart disease, vision loss, and kidney disease. There is no cure as yet for diabetes, but losing weight, eating healthy food, and being active can really help.
There are three main types of diabetes: type 1, type 2, and gestational diabetes. Type 1 diabetes is thought to be caused by the body’s immune system destroying cells in the pancreas that produce insulin necessary to regulate blood sugar levels. In type 2 diabetes, the body cannot use insulin effectively to maintain blood sugar at normal levels. Gestational diabetes, which develops during pregnancy, also increases the mother’s and baby’s risk for type 2 diabetes later in life.
While gestational diabetes usually goes away after childbirth, and engaging in healthy lifestyles and medical treatments can help manage type 2 diabetes, people with type 1 diabetes will have to take insulin shots every day, or wear an insulin pump that provides the body with the required dose of insulin.
In what could be a breakthrough achievement in the treatment of type 1 diabetes, scientists at Massachusetts Institute of Technology (MIT) in the United States have developed an innovative approach of implanting pancreatic islet cells that produce insulin within the body, which produces insulin whenever it detects an increase in blood glucose levels.
Previous attempts at implanting pancreatic cells had run into several hurdles. For instance, attempts to implant pancreatic islets cells from human cadavers, or from stem cells, to deliver long-term control of diabetes, were saddled by the additional need for patients to take regular doses of immunosuppressive drugs to prevent their body’s natural immune system from attacking the implanted cells.
Attempts to overcome immune system attacks by encapsulating the transplanted cells in a casing also proved short-lived as the implanted cells could not then access the needed oxygen supplies. To overcome these challenges, the MIT engineers designed a new implantable device that not only carries hundreds of thousands of insulin-producing islet cells, but also has its own oxygen factory, which could generate oxygen indefinitely by splitting water vapor found in the body.
Oxygen supplies were facilitated by using a proton-exchange membrane — a technology originally deployed to generate hydrogen in fuel cells — located within the device. This membrane can split water vapor available in the body into hydrogen, which diffuses harmlessly away, and oxygen, which goes into a storage chamber that feeds the islet cells through a thin, oxygen-permeable membrane.
A significant advantage of this approach is that it does not require any wires or batteries. Splitting this water vapor requires a small voltage (about 2 volts), which is generated using a phenomenon known as resonant inductive coupling. A tuned magnetic coil worn as an outside patch on the patient’s skin transmits power wirelessly to a small, flexible antenna within the device in the body.
Additionally, the fibrosis or scar tissue formed around the device by the body’s immune system did not appear to reduce the effectiveness of the device. The implanted self-oxygenated pancreatic cells continued to produce insulin that diffused out of the device, thereby enabling the continued control of blood glucose levels.
The researchers showed that when implanted into diabetic mice, this device could keep the mice’s blood glucose levels stable for at least a month. One group of mice received the oxygen-generating device while the other received a device that contained only islet cells. The researchers found that mice implanted with the oxygen-generating device were able to maintain normal blood glucose levels, comparable to healthy animals.
However, mice that received the non-oxygenated device became hyperglycemic (with elevated blood sugar) within about two weeks.The researchers now hope to create a larger version of the device, which could extend the period of its effectiveness within the body, as well as to eventually test it on patients with type 1 diabetes. While the researchers’ main focus was on diabetes treatment, they said that similar devices could be adapted to treat other diseases that require repeated delivery of therapeutic proteins.
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