What I learned last night

So I went to a research update meeting yesterday presented by John Brady, JDRF International Executive Committee Member.

There are four items that caught my eye big time and some other stuff so I figured I'd post it all out here for general consumption (yes, I think you've probably seen or heard about all this stuff somewhere - but if not...):

The first news was on the work being done with immune suppression and regeneration.  There are a myriad of projects in both of these areas and all are making steady progress.  Of the items, I have to mention, this is probably the furthest from becoming a reality but it is also some of the coolest work because in the more distant future it will (i believe) most likely lead to the real cure down the road.

The second item of note is the Therecyte (already FDA approved) encapsulation device.  They have a Teflon mesh that is small enough to keep the immune cells out and they are placing beta cells inside.  The mesh allows the flow of other blood fluids (including glucose and insulin) and the transplants they have done in animal models have worked keeping pig islets alive in non-human primates for > 266 days post transplant.  Undifferentiated stem cells delivered in Therecyte macroencapsulation device survived, proliferated and corrected T1 in mice.  (Yes, we’ve seen mice cured a million times with a million different therapies – but - still exciting)

The third bit of news is an update on the Smart Insulin project.  They have proved its effectiveness in people and its safety. They were unable to induce hypoglycemia, even at four times the normal dose.  The next step for them is to make sure that all of the product is being either metabolized or expelled.  They want to be absolutely certain that the compound they are using is not staying (in part or otherwise) in tissue (my interpretation was particularly the kidneys and liver).

Fourth and most impressive was the discussion on the artificial pancreas project.  They have models where you just push a button to let it know you’re going to eat.  That is ALL the interaction required.  It is completely closed loop between CGMS and pump with logic to figure out automatically what needs to happen.  They are looking to roll out an intermediate product that detects highs and lows and bumps you back into a range (rather than aiming at a target number), as an early step.  There was talk of already trying to find an equipment manufacturer to partner with on getting it into production.  *fingers crossed* I guess… 
 
Also - one of the manufacturers is coming out with a new needle for insulin delivery that is about as thin as a human hair - interestingly the early testing seems to indicate that the insulin infused (more shallowly) with this delivery system is picked up nearly instantly by the capillaries - instant insulin action may be on the horizon... would be a nice adjunct to the APP
 
I am still trying to track down data on a mention of an older Pittsburgh 15 year study that was referenced stating that for people who have had T1 for over 15 years without complications their chances of developing any complications going forward are extremely low…  The theory, as it was explained to me is that if you are genetically predisposed to developing the complications, they will show up inside that window.  I didn’t get journal or other information with this so until I can find it – I am treating it as an encouraging rumor…

Also of note was a general comment and definite feel that the JDRF seems to be really gearing up to improve their communications with all of us.  It sounds like they are making some real changes and I believe the excitement is going to be something that will be spreading like wild-fire over the next few years...

Okay – that’s everything I’ve got in my tiny li’l pea  brain from last night…

Cheers!

A-D

A-D, 

Thank you very much for the great update! I have some questions that hopefully you can answer.

1) smart insulin - how long as this been developing for? I thought this was just an idea as of now? Is this referring to the insulin that activates when glucose enters the blood?

2) artificial pancreas - How exactly is the insulin administered? If it's subcutaneous, how could hyperglycemia be prevented following a meal? If it just injects insulin as you begin eating, you will definitely rise waiitng for it to absorb. Is the infusion set hooked up venously?

3) Insulin needle - that is really cool -  if things turn out I imagine this will replace our pump boluses.  

      Dylan,

I'll take a first swing at your questions:

      1)     smart insulin - how long as this been developing for? I thought this was just an idea as of now? Is this referring to the insulin that activates when glucose enters the blood?

SmartInsulin by SmartCells, Inc. has been in human trials for a while now.  The remaining question (which may take some time to answer) is whether all the bits that are not metabolized are also excreted completely. 

To follow up on the function, there is a scaffolding that has a glucose receptor with the insulin contained inside.  The scaffolding is not soluble so the insulin remains in this molecular container.  When a glucose molecule gets plugged into the glucose receptor in the scaffolding, the structure becomes soluble and the insulin is released.  They were able to give four times the standard dose without triggering any hypoglycemia and the reaction time is really quite similar to a healthy body’s pancreas…

2) artificial pancreas - How exactly is the insulin administered? If it's subcutaneous, how could hyperglycemia be prevented following a meal? If it just injects insulin as you begin eating, you will definitely rise waiitng for it to absorb. Is the infusion set hooked up venously?

I was wondering about this prior to the seminar.  This is a closed loop system effectively using and insulin pump and a CGMS with intelligence to drive the two.  Eating is the obvious stop-gap for the math.  The solution (for the latter models)?  They still have you push a button before you start to eat!  It will do a good job of keeping pace once it knows what’s coming.



3) Insulin needle - that is really cool -  if things turn out I imagine this will replace our pump boluses.  

 

It is really cool – It may replace our canulas, I suspect..

I hope that helps!  If I failed on any of my answers – let me know and I’ll try to either get more information or do a better job of explaining myself… J

Cheers!

A-D

Hey thanks A-D that was the information I was looking for. This is pretty uplifting stuff. There was a large section of the Toronto Star all on diabetes last week that I just read this morning. Apparently JDRF is pouring a lot into the artificial pancreas and hope to have it commercially ready in only 2-3 years, which I assume is very optimistic, but still great to hear. 

mmm SMART INSULIN!!! I don't care if i am ever cured if this stuff works!! =X no wait i do, but as of now this would make my life!