34
LIVING
and Novo Nordisk's insulin detemir, Levemir, came along.
They keep blood glucose levels consistent when the
person isn't eating and mimic the release of a human
pancreas. They were a huge success and were used by
people with Type 2 as well as those with Type 1 diabetes.
With the new insulins, diabetes care improved
radically. They led to basal-bolus therapy, in which people
with diabetes take basal (or 'background') insulin to
keep blood glucose levels stable when they are fasting,
combined with shorter-acting 'bolus' injections to prevent
blood sugar spikes from meals. This is still standard
insulin therapy for people with Type 1 diabetes, even
those using a pump. With pumps, a small background
infusion is the same as the basal - humans need insulin to
be present all of the time - with pump users doing a bolus
when having food.
But this is far from being the end of the story. Insulin
science is still very young; it's just the first 100 years.
In recent history, the price of insulin rocketed. That
many animals died in the making of this medication is
an inescapable fact, but science is now, thankfully, much
more humane than in Banting's day. Research continues
on newer, better types of insulin, including once-a-week
basal insulin and glucose-sensitive "smart" insulin, which
would activate when it detects rises in blood glucose.
Might it be possible to inhale or take insulin orally?
Investigations are ongoing. And wouldn't it be wonderful
not to have to have to administer insulin at all? Trials of
stem-cell therapy, in which human stem cells are turned
into functioning beta cells, the cells that reside in the
islets of Langerhans and produce and secrete insulin, are
trying to address that. Research into preventing Type 1
diabetes in newborns is also underway. But it will take
many years before they have a place in the diabetologist's
toolbox.
For now, people with Type 1 diabetes - and some
with Type 2 - will need to continue with insulin to stay
alive, considering all the while how far we've already
come thanks to Frederick Banting (and others) and lucky
14-year-old Leonard Thompson. He was a guinea pig
icon for those with diabetes, but he did live. Everything
changed that day for people who had diabetes then, and
those who came after them.
* NPH (neutral protamine hagedorn) insulin lowers
blood glucose within 1 to 2 hours after administration and
exerts a peak effect at 6 to 10 hours. It is also known as
isophane insulin and is often administered twice a day.
These days, we call it 'long acting' insulin.
To read about Nobel Prize winner Dorothy Hodgkin,
CLICK HERE.
Susannah Hickling is an experienced health writer
with a particular interest in diabetes, having previously
worked with Diabetes UK.
British chemist Dorothy
Hodgkin identified the
3D molecular structure of
porcine insulin in 1969
Chemist Dorothy Hodgkin portrait by
Maggi Hambling, discovery of structure of insulin.
NEXT ISSUE:
Insulin today - and tomorrow, an update.
LIVINGLIVING
be delivered with its dime-sized patch.
Based on technology originally developed
at the University of Queensland, Vaxxas'
HD-MAP includes a 9-by-9 mm array
of thousands of very short projections
around 250 microns in length. Invisible to
the naked eye and coated with vaccine,
the projections can quickly deliver vaccine
to immune cells.
Vaxxas also claims that the patches
can deliver vaccine more efficiently - a
positive when people around the world are
clamouring for a vaccine against COVID19. The
company points to a recent
clinical study in which their micropatch
delivering a sixth of an influenza vaccine
dose produced an immune response
comparable to a full dose by intramuscular
injection. A two-thirds dose by HD-MAP
generated significantly faster and higher
overall antibody responses.
Because a vaccine is dried onto the
patch, the vaccines are stable outside
of cold-chain (they do not have to be
refridgerated), a potential answer to the
question of how to keep a traditional
COVID-19 vaccine cold in developing
countries and even developed countries.
Vaccines delivered through HD-MAP in
the clinical study stayed stable at 40oC
(104o F) for 12 months.
EDIT COMMENT: It's a different use
for patch, in the diabetes sector at this
stage, sensors are used to sense glucose,
not deliver drugs, but it's not beyond the
realms of reason that a similar micropatch
could be used for such a purpose in the
future to deliver diabetes medications.
Life Sport Diabetes
Mel Stephenson-Grey's home workout
circuit consists of six different exercises.
She explains, "With each exercise we'll
do consecutively for 30 seconds and then
rest for 30 seconds. If someone is new to
fitness or this type of activity, they might
choose to take a longer rest between
each exercise, for say a minute or two.
Once all of the exercises are completed,
we then take a six-minute rest (which
again is adaptable) and once recovered,
we repeat the circuit all over again."
Stephenson-Grey took part in the
London 2012 Olympics Games torch
relay and still trains (prior to lockdown) at
the track and in the gym. The exercises
she does include standing squats, pressups, the
plank, lunges, the superman
pose (when the opposite arm and leg are
stretched out) and sit ups.
She says, "This type of fitness session
is inspired by the type of session I've often
done with my training group over the
years, particularly at the start of the winter
or summer training season, as it helps
build strength and fitness as a foundation
to move onto other things. It works the
arms, legs and core areas throughout
the session, which can be helpful when
training a lot, because no one area is
necessarily over-worked or strained."
The home workout videos have been
accepted by many in the community.
She adds, "I'm sharing what training
sessions work for me. Please remember
that you know your own fitness, health
and diabetes best. Seek medical advice
if you are concerned about undertaking
physical activity."
Home workouts with Mel Stephenson-Grey of Life Sport Diabetes.
www. lifesportdiabetes.co.uk
ISSUE 88
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Access to blood test strips
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EAT YOUR GREENS!
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RINGING
A BELL?
Alarm fatigue and
how to prevent it
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An update on the
MiniMed 780G
AND
Explore our
'new look'!
ISSUE 119
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LUSCIOUS LYCHEES
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DIY SYSTEMS
The ultimate in self-care?
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Roche's new
meter launch:
introducing
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Instant
Image: National Portrait Gallery