15
NEWS
glucose for energy, and glucagon is
the hormone responsible for a raising
in blood glucose. This molecule was
then able to take advantage of the
body's built in 'on/off switch' in the
liver. The liver naturally responds
more to insulin when glucose is high
and more to glucagon when glucose
is low. When blood glucose is high,
the insulin part of the molecule is
active, lowering blood glucose like
regular insulin. However, when
blood glucose is low, the glucagon
part is active, signalling to the liver
to release glucose and preventing
low blood sugar episodes (known as
hypoglycaemia, or hypo).
The research team tested the
new insulin in rats, with positive
initial results. The insulin behaved
as intended: lowered blood glucose
when high and helped raise blood
glucose when low - unlike regular
insulin. It also reduced the need for
emergency glucose injections in the
rats during hypoglycaemia.
The two parts of the molecule
(insulin and glucagon) worked
independently but in balance,
just like separate hormones. The
promising results indicate that the
new molecule could help lower the
chance of hypoglycaemia in people
with Type 1 diabetes. The study also
showed that the new form of insulin
stayed stable for weeks without
the need for refrigeration before
opening, giving it a longer shelf life
than expected. This makes it more
reliable for people with T1D and
easier for manufacturers to produce,
store, and transport.
Low blood glucose is as
unpleasant side effect of Type 1
diabetes. It normally occurs due
to an imbalance between insulin
dose, food intake and physical
activity. Having a hypo is something
which, if possible, all people with
Type 1 diabetes would want to
avoid. It can be dangerous as when
blood glucose is low as the brain
is deprived of its energy source -
glucose. This leads to a sensation
of weakness, dizziness or blurred
vision, alongside feeling angry or
confused. There are many other
potential symptoms.
Grand Challenge
This research has been funded by the
Type 1 Diabetes Grand Challenge, a
partnership between Breakthrough
T1D, Diabetes UK and the Steve
Morgan Foundation. The partnership
is investing £50m into the most
promising research projects led by
exceptional scientists to accelerate
the development of new treatments
and cures for Type 1 diabetes.
Michael Weiss, distinguished
Professor in the Department of
Biochemistry & Molecular Biology,
Indiana University School of
Medicine, said: "For the past century,
coping with hypoglycaemia (the lows)
has been an ever-present challenge
in Type 1 diabetes. This has made
creating glucose-responsive insulins
(smart insulins) a major goal. Our
approach simplifies such design by
exploiting an endogenous 'smart'
switch in the liver, how the body
naturally adjusts relative hormonal
responses based on whether the
blood glucose level is high or low:
Too high, insulin wins; too low,
glucagon wins."
Weiss was also supported by
lab partner and colleague at Yale,
Associate Professor Raimund Herzog,
who was part of the team proposal
and oversaw the testing.
Rachel Connor, Director or
Research Partnerships, says of the
research, "This new development
in novel insulins research hold
exciting promise for people with
T1D. Avoiding low blood glucose is
a constant balancing act for people
with Type 1 diabetes, as so many
factors can combine to affect blood
glucose levels. An insulin offering
protection from hypoglycaemia
could have a profound impact on
the mental burden of living with
T1D. With funding from the Type
1 Diabetes Grand Challenge, we're
excited to be driving innovations as
fast as possible toward testing with
people who live with T1D."
Dr Elizabeth Robertson, Director
of Research and Clinical at Diabetes
UK, added, "The Type 1 Diabetes
Grand Challenge is committed to
supporting innovation that meets
the needs of people living with Type
1 diabetes. These positive results
are an exciting step towards nextgeneration
insulins that could ease
the burden of daily management with
insulin therapy. We look forward
to seeing this promising research
advance into human studies and,
ultimately, improve the lives of
everyone who depends on insulin
therapy."
Early stages
With new research such as this,
Breakthrough T1D believes there is
the possibility to reduce the number
of hypos, which would be safer for
all people living with Type 1 diabetes.
This research is in its early stages,
with many more steps to occur
before it will be made available to the
public. The eventual aim is to create
two different types of new insulins;
a longer-lasting version for use once
a week, and a shorter-acting version
for use in insulin pumps.
www.breakthrought1d.org
Caption XXXXX