Patients with Type 1 diabetes know the routine all too well: the frequent skin pricks to test their blood, the need for insulin injections or a mechanical pump to prevent dangerous spikes or drops in blood sugar. Scientists at University of North Carolina and NC State are developing what they hope will be a less painful, more convenient alternative: “smart” artificial beta cells that can detect the need for insulin and secrete it automatically.
In Type 1 diabetes and some cases of the Type 2 form of the disease, the loss or malfunctioning of beta cells in the pancreas that secrete insulin is the culprit. So the researchers made versions of the cells that can be inserted under the skin and replaced every few days. In mouse models of diabetes, a single injection of the cells normalized blood sugar and kept levels steady for up to five days, they reported in the journal Nature Chemical Biology.
The cells are modeled after real beta cells in that they have membranes made of two levels of lipids. The research team then added special vesicles to the cells that contain insulin and that have a coating that changes chemically when blood sugar rises. That change prompts the cells to release insulin.
The biotech industry has invested hundreds of millions of dollars into developing alternatives to frequent finger pricks and insulin injections—with limited success. MannKind launched its inhaled insulin product, Afrezza, in 2015, but sales were so disappointing that the company’s marketing partner, Sanofi, pulled out in 2016.
Medical device makers have had considerably more success developing products to simplify diabetes care. In June, for example, Medtronic won FDA approval for the MiniMed 670G, the first insulin pump that includes a built-in glucose sensor and that automatically dispenses the drug as needed. And in September, Abbot nabbed an FDA thumbs-up for FreeStyle Libre Flash, a wearable skin sensor that measures blood sugar without requiring finger pricks.
The North Carolina research team believes their smart beta cells could be administered via a painless, disposable skin patch. They are now developing a patch and planning more preclinical tests of their technology. Separately, they are also working on a smart patch that will work without cells to detect blood glucose and dispense insulin as needed.