New drugs to replace insulin, replacing or preserving beta cells in people with type 1 diabetes.

18

LIVING

The end of insulin?

By Susannah Hickling

People with Type 1 diabetes and some with Type 2

currently rely on insulin to live. But what might happen

in the future?

In parallel with the quest for ever better insulins,

including smart insulin, the search is also on for ways

of doing away with the need for this life-saving elixir

altogether. With news of developments ranging from

replacing or preserving beta cells in people with Type

1 diabetes, to new drugs to replace insulin and diet-led

remission for people with Type 2, dare we yet start to

whisper the word, 'cure'?

Cell therapy

Some experts certainly believe dispensing with insulin

might be possible, at least for some people, but no one

should be throwing away their pumps or insulin pens just

yet. Transplants of insulin-producing islet cells are now

available on the NHS for people with Type 1 diabetes who

experience severe hypos and/or are hypo-unaware. Islet

cells from a donated pancreas are implanted into the liver,

enabling the recipient to make their own insulin again.

However, the effect currently only lasts between one and

five years, because the transplanted cells are eventually

killed off by the body's own immune system. For this

reason, scientists are working on improvements.

One is the Biohub 'mini pancreas' from the Diabetes

Research Institute (DRI) in the US. Donor islet cells are

transplanted into the omentum, part of the lining of the

abdomen, with a biodegradable scaffold. Phase 1 and

2 trials are underway but in 2016, the first European,

a 41-year-old man, no longer needed insulin after

undergoing a successful transplant in Milan, Italy. A

similar encapsulation device that aims to keep the

attacking immune cells out is the Pec-Encap 'pouch' from

ViaCyte in the US, funded by JDRF. Again, it's undergoing

clinical trials.

Donor cells are in short supply, so scientists are aiming

to get round that with lab-produced stem cells. Stem cells

have the capacity to morph into any kind of cell in the

body. American biotech company Vertex has developed a

stem-cell treatment that is injected into a vein near the

pancreas. It has only been trialled on one person so far

but last October it was reported that three months after

the transplant the patient was making their own insulin,

injecting 91% less of the pharmaceutically produced stuff

and their HbA1c had dropped from 8.6% to 7.2%. But a

cell-based therapy is probably ten-to-15 years away.

Immunotherapy

A promising alternative is immunotherapy, which aims

to prevent the immune system's attack in the first place.

This would, in effect, treat the underlying cause of the

diabetes, resetting the immune system so it no longer

turns on the beta cells that produce insulin.

Scientists think that using immunotherapy could be

life-changing. They believe it might one day be able to

stop Type 1 diabetes from developing while some beta

cells still remain, or prevent or delay it in people who

are at high risk of developing it. It might even, it's hoped,

form part of a cure, by protecting beta cells that are

replaced through transplant or have regenerated.

There are some exciting trials taking place. Belgian

company Imcyse has embarked on Phase 2 trials of

an immunotherapy designed to kill the immune cells

that destroy the pancreas. A phase 1 trial of 41 people

newly diagnosed with Type 1 showed it was safe and

also lowered the number of autoimmune cells that

attack healthy cells. French biotech company Neovacs is

developing a vaccine that could stop Type 1 diabetes in its

tracks in the newly diagnosed. Belgian company Precigen

Actobio is trying to do the same thing - but with cheese!

Or, to be precise, it is using cheese bacteria to deliver two

drugs that would encourage the T cells that regulate the

Index

  1. Free online Desang diabetes magazine, diabetes information
  2. Free online Desang diabetes magazine, diabetes information
  3. Free online Desang diabetes magazine, diabetes information
  4. Desang diabetes magazine, diabetes news
  5. insulin pump, Dana i system, artificial pancreas, Advanced Therapeutics UK, CamAPS FX, Dexcom G6
  6. Desang diabetes magazine, diabetes news
  7. Abbott Freestyle Libre 2, Flash Glucose Monitoring, FSL2
  8. Desang diabetes magazine, diabetes news
  9. Glooko diabetes data download software. Stay on track in between visits.
  10. Page 0010
  11. Air Liquide Healthcare UK, Tandem t:slim insulin pump with Control IQ
  12. Desang diabetes magazine article on new NICE guidelines April 2022 spur far wider access to diabetes
  13. Home test HbA1c, A1C Now Self-Check
  14. Desang diabetes magazine article on new NICE guidelines April 2022 spur far wider access to diabetes
  15. Medtrum Touchcare Nano Patch Pump and CGM
  16. Diabetes technology, CGM sensors, FreeStyle Libre, Dexcom One, Glucorx Aidex CGM
  17. Diabetes technology, CGM sensors, FreeStyle Libre, Dexcom One, Glucorx Aidex CGM
  18. New drugs to replace insulin, replacing or preserving beta cells in people with type 1 diabetes.
  19. New drugs to replace insulin, replacing or preserving beta cells in people with type 1 diabetes.
  20. Stem cells and gene editing for a cure to Type 1 diabetes.
  21. Medtronic MiniMed 780G System Automated for an easier way to stabilise glucose levels
  22. Page 0022
  23. Stem cells and gene editing for a cure to Type 1 diabetes.
  24. Desang Diabetes Magazine, free diabetes magazine, living with diabetes
  25. Desang Diabetes Magazine, free diabetes magazine, living with diabetes
  26. JDRF's pathway to choice project for accdss to diabetes technology.
  27. JDRF's pathway to choice project for accdss to diabetes technology.
  28. Desang diabetes magazine, diabetes diet
  29. Diabetes technology education from Diabetes Technology Network DTN
  30. Desang diabetes magazine, diabetes diet
  31. Insulet Omnipod DASH insulin pump with insulin pods, podders, Omnipod DASH Personal Diabetes Manager
  32. Desang diabetes magazine, diabetes diet
  33. Desang diabetes magazine, diabetes diet
  34. Desang Diabetes Magazine, Making Carbs Count, carbohydrate counting for diabetes
  35. Making Carbs Count, Carbohydrate counting for diabetes, Desang diabetes magazine
  36. Making Carbs Count, Carbohydrate counting for diabetes, Desang diabetes magazine
  37. Desang diabetes kitbags, bag for diabetes kit
  38. Desang Diabetes Magazine, free diabetes magazine, living with diabetes

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