Combating Type 1 Diabetese — Through Artificial Pancreas or Tablets

Tejinder Singh Bedi
9 min readDec 9, 2022

By when can an artificial pancreas or tablets be a reality for Type I diabetics; especially infants & toddlers below 8?

All the pieces getting in place .. now, is the time to pace up unlocking this puzzle

Tejinder Singh Bedi
@tsinghbedi

Photo Courtesy by Karolina Grabowska: https://www.pexels.com/photo/person-holding-a-vaccine-4047143/

(Photo Courtesy — Karolina Grabowska: https://www.pexels.com/photo/person-holding-a-vaccine-4047143/)

As per the latest published figures by the WHO (World Health Organization) over 422 million persons are suffering from Diabetes. Another estimate puts this figure around 462 million. On a very rough note, nearly ten percent of these, i.e. about 45 million are estimated to be suffering from Type I Diabetes the world over, and yet there is no immediate cure in sight primarily for the research activities being pursued by the very few dedicated organizations and some selfless professionals still gasping for lots of funds to pace up the same. A trail of a number of adverse setbacks left on the health of the population exposed to the deadly pandemic COVID has worsened the situation further with a large number of young infants and kids also getting trapped by Type I diabetes during this phase.

Of late, there does seem to be an increasing focus on combating this dreaded disease. *ViaCyte a company dedicated to the development of bio-artificial pancreas deploying stem cells from an embryonic stem cell source of humans by 2021 had already proved that their cells could successfully work in people where after they have partnered with CRISPR to design a cell line where no anti-rejection drugs would be needed.” Families affected by an onslaught of Type I Diabetes are eagerly hoping now that companies like ViaCyte should succeed in their trials at the earliest though there is a talk of a wait for another five years still until the product can be ensured to reach the needy the world over.

As a concerned grandparent of a little angel afflicted with this great challenge when just two and a half, it is my earnest desire that the WHO & all the health related agencies of the United Nations use all their might to support such research initiatives as best as it can to ensure sustainable solutions emerge for the youngest population on top most priority for their most primary need for normal growth in the early developing years of their lives.

(Headquartered in San Diego, this research institution -*ViaCyte is a regenerative medicine company focused on the discovery, development, and commercialization of novel cell replacement therapies to treat human diseases. It is considered a leader in the field of advancing stem cell-derived islet cell replacement therapies to treat insulin-requiring diabetes, including type 1 and type 2. I happened to come across a movie by the name Beyond Type I which very closely highlights its consistent efforts to succeed in this mission besides many firsthand reactions of a few patients suffering from Type I D and their response levels to the clinical trials being conducted on some as a very useful insight into the possibilities of foolproof success sooner than later now).

Here is the link to this great movie that also puts the great strides being made by Viacyte into the spotlight, it so well deserves and urge all readers facing such challenges to watch it for once at least: https://www.filmplatform.net/impact-event/the-human-trial-blue-circle-diabetes-foundation/

(About the movie — In 2011, Lisa Hepner and her husband Guy Mossman heard about a radical stem cell treatment for diabetes, a disease that shockingly kills more than five million people each year. Driven by a desire to cure Lisa of her own type 1 diabetes (T1D), the filmmakers were given unprecedented, real-time access to a clinical trial by ViaCyte — only the sixth-ever embryonic stem cell trial in the world. What followed is an intimate journey with the patients and scientists who put themselves on the line to be first. The Human Trial peels back the headlines to show the sweat, passion, and sacrifice poured into every medical breakthrough. It interweaves the stories of the patients — who have borne the physical and financial burdens of type 1 diabetes (T1D) — with the researchers who epitomize the struggle of innovating cures. Director Lisa Hepner — whose own T1D fuels her search for a cure — truly becomes the bridge between these two worlds, The narrative arc in the movie being the clinical trial itself. For seven years, Lisa and Guy embedded themselves with a biotech company in San Diego. They filmed the researchers’ triumphs and failures in the lab, following them from Tokyo to Riyadh as they raised money to keep their trial going. At the same time, the husband/wife team followed two patients, the self-described “guinea pigs” at the University of Minnesota. Combining these two points of view, the filmmakers reveal the emotional and physical rollercoaster that scientists and patients go through as they travel along the road to a cure for the disease).

Likewise, by the end of August this year, a UBC (University of British Columbia) research team developing oral insulin tablets as a replacement for daily insulin injections had also reported encouraging breakthrough results in a game-changing discovery of sorts. (For more information, agencies interested in supporting such humanitarian research and developments contact Collins Maina). This team of researchers has discovered that insulin from the latest version of their oral tablets is absorbed by rats in the same way that injected insulin is. “These exciting results show that they (we) are on the right track in developing an insulin formulation that will no longer need to be injected before every meal, improving the quality of life, as well as mental health, of more than nine million Type 1 diabetics around the world.” Professor Dr. Anubhav Pratap-Singh the principal investigator from the faculty of land and food systems is quoted to have said so on sharing the results of their latest research. Ironically, as for the Viacyte team, his inspiration behind the search for non-injectable insulin too came from a close family relation, his diabetic father who has been injecting insulin 3–4 times a day for the past 15 years.

According to Dr. Alberto Baldelli, a senior fellow in Dr. Pratap-Singh’s lab, they are now seeing nearly 100 percent of the insulin from their tablets going straight into the liver. In previous attempts to develop drinkable insulin, most of the insulin would accumulate in the stomach as per their investigations. “Even after two hours of delivery, we did not find any insulin in the stomachs of the rats we tested. It was all in the liver which is the ideal target for insulin — and really what this team wanted to see,” says Yigong Guo, first author of the study and a Ph.D. candidate working closely on the project. Dr. Pratap-Singh’s team developed a different kind of tablet that isn’t made for swallowing, but instead dissolves when placed between the gum and cheek. This method makes use of the thin membrane found within the lining of the inner cheek and back of the lips (also known as the buccal mucosa). It delivered all the insulin to the liver without wasting or decomposing any insulin along the way. “For injected insulin, we usually need 100 iu per shot. Other swallowed tablets being developed that go to the stomach might need 500 iu of insulin, which is mostly wasted, and that’s a major problem we have been trying to work around,” Yigong says. Most swallowed insulin tablets in development tend to release insulin slowly over two to four hours, while fast-release injected insulin can be fully released in 30–120 minutes. “Similar to the rapid-acting insulin injection, our oral delivery tablet absorbs after half an hour and can last for about two to four hours long,” says Dr. Baldelli.

Potential broad benefits

This study is yet to go into human trials, and for this to happen Dr. Pratap-Singh says they will require more time, funding, and collaborators. But beyond the clear potential benefits to diabetics, he says the tablet they are developing could also be more sustainable, cost-effective, and accessible. “More than 300,000 Canadians have to inject insulin multiple times per day,” Dr. Pratap-Singh says. “That is a lot of environmental waste from the needles and plastic from the syringe that might not be recycled and go to landfill, which wouldn’t be a problem with an oral tablet.” He explains that their hope is to reduce the cost of insulin per dose since their oral alternative could be cheaper and easier to make. Transporting the tablets would be easier for diabetics, who currently have to think about keeping their doses cool.

The first part of this study was published in Nature Publishing Group’s journal Scientific Reports.

Dual hormone systems

Researchers are currently developing and testing systems that use two hormones — insulin to lower glucose levels and glucagon to raise blood glucose levels. Using two hormones to control blood glucose is similar to the way the pancreas works in people who do not have diabetes. These systems may be able to tightly control glucose levels without causing hypoglycemia. Researchers are also testing how well other combinations, such rapid-acting insulin, and pramlintide NIH external link, can control blood glucose levels.2

The National Institute of Digestive & Kidney Diseases (NIDDK) in the US has also announced a Funding Opportunity as below which too can be supported by our great philanthropists always keen to support such research projects for the larger benefit of humanity.

Clinical, Behavioral, and Physiological Studies of Open- and Closed-loop Platforms: Toward Personalized, Fully Automated, Accessible Systems (R01 Clinical Trial Required)

The purpose of this funding opportunity announcement (FOA) is to promote clinical research using current and emerging technologies to address barriers that limit progress toward physiological pancreatic hormone replacement open- and closed-loop systems. It will support research to 1) test and improve the safety, reliability, and clinical efficacy of these technologies; 2) address behavioral/psychosocial factors that play a role in the usability and acceptance of these systems and validation of measures that may be used as outcomes for the demonstration of efficacy and benefit; 3) test these technologies in subpopulations of patients not usually included in clinical trials who may benefit the most from their use; 4) test these technologies in individuals who are underserved or in low income and/or racial and ethnic minority groups, and better understand disparities in the use and adoption of these systems, and 5) use the technologies as tools to advance understanding of glucose regulation and its pathophysiology in patients with type 1 diabetes (T1D) including counter-regulation and impaired awareness of hypoglycemia. Research goals include improved metabolic control with decreased glycemic excursions, prevention of acute and chronic complications, and improved quality of life in patients with diabetes and their caregivers. Only human studies will be considered responsive to this FOA, applications involving animal or in vitro studies are not responsive to this FOA.

Office of the Program Director Guillermo Arreaza-Rubin has confirmed to this author that active funding opportunities for NIH can be accessed on the Office of Extramural Research website, where the interested viewers can also see the grants process overview and can Learn more about NIDDK research by viewing information on the funding process and how to apply as well as our current funding opportunities like the one extracted beneath:
Funding Opportunity Details
Full Announcement: RFA-DK-22–020 NIH external link
Related Notices or Announcements: NOT-OD-22–190 NIH external link
Program Contact: Guillermo Arreaza-Rubin, M.D.
Activity: R01 — Research Project Grant NIH external link
Key Dates
Open Date: 1/28/2023
Letter of Intent Due Date: January 28, 2023, and September 26, 2023

*WION news has also recently reported FDA’s approval for a life changing therapy for diabetics suffering from Type I Diabetes though this therapy as of now is going to be beneficial for only delaying the onset of this disease among such genetically or otherwise prone population with prevention thereof for the 8 plus and for toddlers below 8 years of age still remaining a big challenge for all researchers and their related healthcare supply chains across the globe. I do hope the UN & the WHO support this and other similar research efforts far more vigorously!

  • https://www.wionews.com/videos/gravitas-fda-approves-life-changing-therapy-for-diabetes-535448
  • #WHO #UN #UnitedNations #WION #GRAVITAS #PriyankaSharma — Please develop the Story Audio-Visually further

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Tejinder Singh Bedi

(*Author Tejinder Singh Bedi is a former technocrat, a people management, CSR Adviser, free-lance writer and a passionate singer)