MIT device could free those with type 1 diabetes from insulin injections and pumps

midian182

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In brief: Scientists have spent decades trying to find a cure for type 1 diabetes, an autoimmune condition with no known cause. While reprogramming a human body so it stops attacking the pancreatic islet cells that make insulin might still be a way off, researchers at MIT have developed what could be the next best thing: an internal device that removes the need to inject insulin or wear a pump.

It's estimated that 90% to 95% of people in the US with diabetes have type 2, the cause of which is thought to be mostly down to lifestyle factors and age. They become resistant to the insulin produced by the pancreas - used to remove glucose from the blood so it can be turned into energy - leading to high glucose levels (often called blood sugar). This can cause life-changing and potentially fatal conditions. Eventually, many type 2 diabetics need to inject insulin.

Type 1, which used to be called juvenile diabetes, is different. The condition involves the immune system attacking pancreatic islet cells responsible for making insulin. From the time of diagnosis, individuals with T1D must manually inject insulin into the body virtually every time they consume carbohydrates or if their glucose levels spike; this is usually administered in the stomach, legs, arms, or buttocks. Speaking from personal experience as a type 1, this is about as fun as it sounds. It's also difficult to get the dosage and timing exactly right, resulting in dangerously low or high glucose levels.

There's also the option of wearing pumps that administer insulin, but these have their own drawbacks, such as the occasional painful insertions and the fact they can be cumbersome to wear. Like injections, they aren't a perfect replacement for a working pancreas.

Research has been carried out that involves implanting pancreatic islet cells so diabetics don't need to inject, releasing insulin as and when needed. However, patients who receive these cells need to take immunosuppressant drugs - which can have extreme side effects - so the body doesn't reject them.

A solution is to encapsulate the transplanted cells within a flexible device that protects them from the immune system. The problem has been that these cells eventually run out of oxygen and stop producing insulin.

MIT engineers think they might have solved this problem with a new implantable device that has its own "on-board oxygen factory," which generates oxygen by splitting water vapor found in the body.

The device, about the size of a US quarter, has already been tested on diabetic mice, where it kept their glucose levels stable for at least one month.

The next step is to increase the size of the device and move on to larger animals before human testing begins. It would still require users to wear a tuned magnetic coil as a patch on the skin to transmit power to the device, but the hope for many type 1 diabetics is that the implant could mitigate the daily difficulties, discomfort, and potential health problems the condition brings.

"You can think of this as a living medical device that is made from human cells that secrete insulin, along with an electronic life support-system," senior author Daniel Anderson, a chemical engineer at MIT, said in a statement. "We're excited by the progress so far, and we really are optimistic that this technology could end up helping patients."

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Let's just hope they don't get bought out by big Pharma in order to supress a cure and to promote life long treatments that cost a fortune. Hopefully this group is working on a similar "cure" for type 2 diabetics .......
The cure for level 2 is extremely simple (for the vast majority): put down the f*cking fork, and get your arse up from the couch.

But people don't want it, they want nice little pills and syringes instead ... from big pharma.

So your comment is pretty darn hypocritical.
 
Let's just hope they don't get bought out by big Pharma in order to supress a cure and to promote life long treatments that cost a fortune. Hopefully this group is working on a similar "cure" for type 2 diabetics .......
This ignores the vast majority of the world which is not beholden to big pharma, and countries like china that would happily steal and use the tech without the wests approval. Or the billions the government could save from curing the disease, which causes major resource drain.
 
The cure for level 2 is extremely simple (for the vast majority): put down the f*cking fork, and get your arse up from the couch.

But people don't want it, they want nice little pills and syringes instead ... from big pharma.

As a type 1 diabetic who knows several type 2's in my social circle, I can agree that this is true in most cases.

It often shocks me how little most type 2 diabetics care. Some don't care at all and keep their habits and diet as if they weren't diabetic at all, and don't even take their prescribed medicine. Some do end up hitting the ER from time to time, medicated and released, and still won't change.
 
As a type 1 diabetic who knows several type 2's in my social circle, I can agree that this is true in most cases.

It often shocks me how little most type 2 diabetics care. Some don't care at all and keep their habits and diet as if they weren't diabetic at all, and don't even take their prescribed medicine. Some do end up hitting the ER from time to time, medicated and released, and still won't change.
As I see it, @bviktor s comment is spot on and is exemplified by this https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8234895/ which shows that T2's can see remission through very-low calorie diets and losing significant weight. In addition, it suggests that those who keep off that weight exhibit continued remission of their condition.

However, as I see it "marketing" is the trouble with the "medical industry" these days. Their marketing aims to make people think they have the answer for everything - just take a pill. I've a very skeptical viewpoint, or perhaps its realistic, that the "medical industry" is only interested in how much money they can make from people they've duped to think that they have the answer to their troubles.

I agree, though. Many people, or so it seems, want to think that the condition is not serious and they have not lost that childhood "I'm invincible" attitude. For some, it takes a serious complication as a result of their condition, for them to actually take the condition seriously and get down and do the hard work like weighing everything you eat and basing your insulin doses on your current BG reading and the number of carbs in your next meal, and get off their arses and exercise regularly. Some, however, even after experiencing a serious complication from the condition still don't get the message.
I've been type 1 for about 45 years now. It would be nice to have an alternative to daily injections.
While I agree the injections are a PITA, I've lessened their effect by using 33g 4mm pen needles. No need to pinch your skin with the 4mm needles - which makes it easier to rotate sites and also more comfortable, too. I've been insulin-dependent type 2 since I was 12 - which is challenging because my body still produces some insulin - unpredictably so.

While I cannot prove it, my take on "insulin resistance" is that its my body's way of saying "you have enough fat on you already, why do you need more?"

And I would not wear a pump if you paid me.
 
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I agree, though. Many people, or so it seems, want to think that the condition is not serious and they have not lost that childhood "I'm invincible" attitude. For some, it takes a serious complication as a result of their condition, for them to actually take the condition seriously and get down and do the hard work like weighing everything you eat and basing your insulin does on your current BG reading and the number of carbs in your next meal, and get off their arses and exercise regularly. Some, however, even after experiencing a serious complication from the condition still don't get the message.

Yes, I know some Type 2's in my social circle that have already experienced serious complications (like being to the ER several times with ketoacydosis, needing heart surgery, needing eye surgery) and still don't change. Or might change for some time and then return to the old habits. They're still alive and haven't lost limbs, eyesight or need dyalisis yet only because they have very good genetics - if I lived like them I probably wouldn't be here anymore or would have developed some serious handicap already.

While I agree the injections are a PITA, I've lessened their effect by using 33g 4mm pen needles. No need to pinch your skin with the 4mm needles - which makes it easier to rotate sites and also more comfortable, too. I've been insulin-dependent type 2 since I was 12 - which is challenging because my body still produces some insulin - unpredictably so.

While I cannot prove it, my take on "insulin resistance" is that its my body's way of saying "you have enough fat on you already, why do you need more?"

And I would not wear a pump if you paid me.

I'm also insulin-dependent and I don't even use pens, just regular needle syringes, haha. Just got used to them and they don't bother me anymore. Never used pumps but would like to try one, however where I live they're very expensive (and anything related to them) and not covered by any health insurance or public healthcare.
 
Yes, I know some Type 2's in my social circle that have already experienced serious complications (like being to the ER several times with ketoacydosis, needing heart surgery, needing eye surgery) and still don't change. Or might change for some time and then return to the old habits. They're still alive and haven't lost limbs, eyesight or need dyalisis yet only because they have very good genetics - if I lived like them I probably wouldn't be here anymore or would have developed some serious handicap already.
I've been there - relatively minor heart attack in 1987. That's when I started to take things seriously carb counting, etc. I also looked for a meter that would give me the most accurate and repeatable results and when I found one, that made a world of difference in estimating my insulin needs. The estimation is not perfect, but my body still produces some insulin - perhaps enough for basal purposes.
I'm also insulin-dependent and I don't even use pens, just regular needle syringes, haha. Just got used to them and they don't bother me anymore. Never used pumps but would like to try one, however where I live they're very expensive (and anything related to them) and not covered by any health insurance or public healthcare.
Regular syringes can also be bought with 4mm needle lengths. For me, that 4mm needle is the difference between using both hands and one hand only. It opens up more sites for me to give myself an injection.

The main reason that I use pens is that pens allow me to give myself 1/2 unit increments in insulin dose. The pens very accurately measure and deliver the exact amount of insulin. I looked for a syringe that was as accurate, and at the time, and probably still, there are none available that are as accurate in dose. For me, it makes a big difference in how tightly I can control my BG levels. I used to use a jet-injector (Medi-Jector) until they stopped making the "injection heads" for it, and that used to allow me 1/2 unit precision in dose, too. Honestly, the 33g 4mm needles are more comfortable than the jet was. I would not go back to a jet now even if I had the opportunity.

And yes, given I've been dealing with the condition for 52-years, I've gotten used to what I have to do to deal with it.

As to pumps - I'm on a "high deductable" plan. I'd pay out of pocket, and it seems no matter where you are, pumps are expensive. The biggest advantage, as I see it, of a pump is its ability to deliver a basal dose of insulin around-the-clock. However, my body's insulin production is relatively equal to a basal dose for me. Given that, it would likely cause problems. I've tried Lantus which does roughly the same thing, and I had crazy lows overnight - so I gave up on Lantus and get up at around 3AM to measure and take a small amount of Humalog. Which does the trick to cover what I have noticed is a pre-awakening BG spike. Personally, I won't touch any long-acting insulins and I prefer to take multiple shots per day to cover my meals.

When I was in the hospital for the heart attack, I had already started doing this and I had an attending doctor ask me "Why would you want to take multiple shots a day?" My answer was so that I was not bound to long-acting (NPH or similar) insulin peaks. Then about four or five years later, research revealed that taking multiple shots a day was a superior way of treating insulin dependent diabetes.

BTW - if you are in the US, I'll recommend this place - https://www.adwdiabetes.com/ Typically, if you don't use insurance with them, they are significantly more inexpensive than even when using insurance. for instance, their cheapest 33g lancet is about $1.12/100. If I get that locally using insurance, its about $7/100 - go figure.
 
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As a LADA type 1, this would be a Godsend. The cost of islet cell transplants is >100,000 GBP and criteria for doing the surgery is VERY restrictive, so it's just not an option for the vast majority. That and you'll be taking immunosuppressants for life.

I'm just very thankful I got the diagnosis in an age where we have insulin, ultra-rapid insulin at that, and CGMs.
 
It's probably a bit confusing people reading all this to understand what the causes and treatments are for the different types (type 1 & 2) of diabetic are. Type 2 "tends" to be brought on in middle age from lack of exercise and poor diet. That isn't always the case though as I know a type 2 diabetic that was always at the gym though she did like a drink ;) Type 1 diabetes is genetic and tends to appear a few years after puberty. If it came on any sooner then the genes obviously wouldn't be passed on. Type 2 tend to be treated with pills while type 1 need injections.

One of the issues of getting something serious when young is that people choose to ignore the condition and eat what they like. On the other hand, it is an early reminder that you're not immortal and that you better get out there and do something with your life.
 
Regular syringes can also be bought with 4mm needle lengths. For me, that 4mm needle is the difference between using both hands and one hand only. It opens up more sites for me to give myself an injection.

The main reason that I use pens is that pens allow me to give myself 1/2 unit increments in insulin dose. The pens very accurately measure and deliver the exact amount of insulin. I looked for a syringe that was as accurate, and at the time, and probably still, there are none available that are as accurate in dose. For me, it makes a big difference in how tightly I can control my BG levels. I used to use a jet-injector (Medi-Jector) until they stopped making the "injection heads" for it, and that used to allow me 1/2 unit precision in dose, too. Honestly, the 33g 4mm needles are more comfortable than the jet was. I would not go back to a jet now even if I had the opportunity.

Personally I don't like very short needles - for me, they tend to be more painful and uncomfortable than longer needles, regardless of the injection site. 12mm are my favorites. Too bad 4mm and 8mm needles are a lot more common in pharmacies here, I usually have to order 12mm online because often I can't find them in local pharmacies, or I just settle for 8mm sometimes. And I have very low body fat. Guess I'm weird like that :laughing:

And yes, given I've been dealing with the condition for 52-years, I've gotten used to what I have to do to deal with it.

As to pumps - I'm on a "high deductable" plan. I'd pay out of pocket, and it seems no matter where you are, pumps are expensive. The biggest advantage, as I see it, of a pump is its ability to deliver a basal dose of insulin around-the-clock. However, my body's insulin production is relatively equal to a basal dose for me. Given that, it would likely cause problems. I've tried Lantus which does roughly the same thing, and I had crazy lows overnight - so I gave up on Lantus and get up at around 3AM to measure and take a small amount of Humalog. Which does the trick to cover what I have noticed is a pre-awakening BG spike. Personally, I won't touch any long-acting insulins and I prefer to take multiple shots per day to cover my meals.

When I was in the hospital for the heart attack, I had already started doing this and I had an attending doctor ask me "Why would you want to take multiple shots a day?" My answer was so that I was not bound to long-acting (NPH or similar) insulin peaks. Then about four or five years later, research revealed that taking multiple shots a day was a superior way of treating insulin dependent diabetes.

I just use a combination of NPH (for longer acting) and regular (for short acting) insulin that has always worked well for me. Tried many other different types of more modern, more expensive insulins such as Lantus, Lispro and others, and never adapted well to them. These insulins always made me feel weird and made my glucose levels go all crazy with huge swings, peaks and downs, even after experimenting with different dosages. Another aspect where I'm weird I guess :yum

BTW - if you are in the US, I'll recommend this place - https://www.adwdiabetes.com/ Typically, if you don't use insurance with them, they are significantly more inexpensive than even when using insurance. for instance, their cheapest 33g lancet is about $1.12/100. If I get that locally using insurance, its about $7/100 - go figure.

No, I'm not in the US, but anyways thanks for everything you shared and all the info and help. Take care man

It's probably a bit confusing people reading all this to understand what the causes and treatments are for the different types (type 1 & 2) of diabetic are. Type 2 "tends" to be brought on in middle age from lack of exercise and poor diet. That isn't always the case though as I know a type 2 diabetic that was always at the gym though she did like a drink ;) Type 1 diabetes is genetic and tends to appear a few years after puberty. If it came on any sooner then the genes obviously wouldn't be passed on. Type 2 tend to be treated with pills while type 1 need injections.

There is of course also LADA type 1 diabetes (as mentioned by Lozzy), which is type 1 diabetes that develops well into adulthood. My type 1 diabetes is also LADA variation, diagnosed at 27 years old, just a year before that my glucose levels have always been normal in all exams.

One of the issues of getting something serious when young is that people choose to ignore the condition and eat what they like. On the other hand, it is an early reminder that you're not immortal and that you better get out there and do something with your life.

Most type 2 diabetics I know who have chosen to completely ignore the condition are middle aged or elderly :neutral: And younger type 2's usually are more conscious of their condition and take better care of themselves. At least that's what I have witnessed in my bubble.
 
@arrowflash Thank you, too, for your sharing. I realize everyone is different, and everyone needs to follow their own path. I swore off NPH years ago because of the need to eat at or near its peak action time.

A doctor once classified me as a MODY - https://en.wikipedia.org/wiki/Maturity-onset_diabetes_of_the_young

If it might be useful to anyone, I thought I would share this - http://www.diabetespilot.com/ Its been instrumental for me to manage the diabetes I have. It has a completely customizable nutrition database. I've customized mine to measure most things in grams. I use both the Windows and the iPad (its the main reason I have an iPad) version of it - they share data between them. If you do use it, though, and you "sync" between devices, make sure that you choose "overwrite" instead of "sync" as "sync" duplicates entries for some reason. I've pointed that out to the developer as a bug, but they have done nothing about it.
 
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