Smart insulin announced: will need to be injected once a week

New projects promise a revolution in diabetes treatment

Scientists welcome the advent of «smart» insulin, which responds to changes in blood sugar levels in real time. People with type 1 diabetes may need to inject themselves with insulin only once a week in the future, experts hope.

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Scientists have developed insulin, which has already been dubbed the “holy grail”, which responds to changes in blood sugar levels in real time and is capable of revolutionizing the treatment of millions of people with type 1 diabetes around the world.

As The Guardian reports, patients are currently forced to inject themselves with synthetic insulin up to 10 times a day to survive. Constantly swinging between high and low blood sugar levels can lead to short-term and long-term physical health problems, and the struggle to maintain stable levels can also affect their mental health.

Scientists have found a solution that experts say is as close to curing type 1 diabetes as any drug therapy can get: smart insulin that lies dormant in the body and only kicks in when needed. Researchers in the US, Australia and China have successfully developed new insulins that mimic the body's natural response to changes in blood sugar levels and respond instantly in real time.

Standard insulins stabilize blood sugar levels when they enter the body, but once they have done their job, they are generally unable to help with future fluctuations. This means that patients often need to be re-administered insulin after just a few hours.

The new glucose-sensing insulins only begin to work when there is a certain amount of sugar in the blood to prevent hyperglycemia (high blood glucose levels). They become inactive again when their levels fall below a certain point, which helps avoid hypoglycemia (low blood glucose levels), writes The Guardian. In the future, patients may only need insulin once a week, experts say.

Scientists behind smart insulins have received millions of pounds in grants to speed up their development. Funding comes from the Type 1 Diabetes Grand Programme, a partnership between Diabetes UK, JDRF and the Steve Morgan Foundation. The company is investing £50 million in cutting-edge research to help find new treatments for type 1 diabetes.

Dr Tim Hayes, vice-chair of the Scientific Advisory Group for New Insulin, said smart insulin could usher in a new era in the fight against diabetes. “Even with modern insulins, people with type 1 diabetes still struggle to manage their diabetes on a daily basis, finding the right balance between achieving acceptable glycaemic control and preventing hypoglycaemia. Glucose-sensing – or smart – insulins are considered the holy grail of insulin, as they bring us closer to curing type 1 diabetes than any drug therapy.”

Almost £3m has been allocated to six research projects developing different types of smart insulin. They include teams from Stanford University in the US, Monash University in Australia and Zhejiang University in China. The aim is to speed up development and start trials as soon as possible.

Each project aims to make smart insulin faster and more accurate, alleviating some or all of the huge burden of treating type 1 diabetes and reducing the risk of long-term complications. Four projects are focused exclusively on testing glucose-sensing insulins.

A fifth company has developed a new, short-acting, ultra-rapid insulin. Even with the fastest insulins currently available, there is still a delay between when you inject the drug and when it begins to affect your blood glucose. This can cause your blood glucose to rise to unsafe levels before the insulin can lower it.

Faster insulins are also needed to improve the performance of insulin pumps and hybrid closed-loop technology, a system that relies on stored insulin to respond in real time to changes in blood glucose levels.

The sixth project focuses on a protein that combines insulin with another hormone, glucagon. Unlike insulin, which helps remove glucose from the blood, glucagon stimulates the liver to release more glucose when blood levels drop. Including both hormones in one preparation can maintain stable blood glucose levels, preventing blood glucose levels from rising and falling.

“The six new research projects being funded are aimed at addressing the major shortcomings of insulin therapy,” said Tim Hayes. “Thus, if successful, these research projects could be nothing less than the beginning of a new era in insulin therapy.”

Rachel Connor, Director of JDRF Research Partnerships UK, said: “While insulin has been saving lives for over 100 years, and previous research has led to important changes for people with type 1, it is still not good enough — controlling glucose levels with insulin is really difficult and it’s time for science to find ways to remove this burden. By imagining a world where insulins can respond to changing glucose levels in real time, we hope these six projects will help create that new reality, freeing people with type 1 diabetes from the constant demands that living with the condition places on them today.”

Dr Elizabeth Robertson, Director of Research at Diabetes UK, said these projects have the potential to revolutionise the treatment of type 1 diabetes. “By supporting these pioneering research projects, we aim to develop new insulins that more closely mimic the body’s natural responses to changing blood sugar levels. This could make everyday tasks associated with type 1 diabetes management much easier and improve both the physical and mental health of people with the disease. We hope that this research will lead to a fundamental change in the treatment of type 1 diabetes.”