The Triple Helix @ UChicago

Fall 2016

"Functionally Curing Type 1 Diabetes?" by Maritha Wang

 

A diagnosis of type 1 diabetes, or diabetes mellitus, means daily insulin injections, constant monitoring of glucose levels, and unending misconceptions from people who think you somehow brought it upon yourself. After all, don’t you get diabetes from poor diet and lack of exercise? Type 1 diabetes is oftentimes confused with type 2 diabetes, the type of diabetes where your body is resistant to insulin, thereby causing your blood glucose levels to rise to higher levels than normal. In actuality, type 1 diabetes is an autoimmune disease where your body cannot produce insulin, the key hormone the body uses to regulate blood sugar levels. The body actually attacks the beta cells in your pancreas that produce insulin. Without this insulin, the body’s sugar levels fluctuate wildly, causing symptoms including increased thirst, frequent urination, extreme hunger, and in some cases, blurred vision.[1] 

Currently, there is no cure for type 1 diabetes. The search for a cure is one of the most pressing issues in medical research in the 21st century and has led to the creation of organizations specifically focusing on treatment of type 1 diabetes like the Junior Diabetes Research Foundation (JDRF) and the American Diabetes Association. Researchers, many of whom are associated with these foundations or at least garner funding from them, have made much progress in the management of type 1 diabetes in the last few decades. 

One of the most widely used technologies currently for the management of type 1 diabetes is the insulin pump.[2] These pumps deliver insulin through a catheter-like tube that is inserted into the skin with a needle. However, they are large, clunky, and inconvenient. 

Other studies currently being conducted include the islet transplantation experimental procedure in which insulin-producing clusters of cells called islets are transplanted into the pancreas. This has been a difficult procedure since the islets must be grown first from stem cells (a procedure that was under much scrutiny in the early 2000s) and then successfully transplanted without being killed off by the human body’s natural immune response. 

Other efforts to patients who have type 1 diabetes include the creation of smartphone applications such as the Sugar.IQ application, created by Medtronic and IBM, that uses “real-time personalized insights” to predict the onset of hypoglycemia (low blood sugar). It also enables users to track their food consumption and provides data about the impact of specific foods on their diabetes. The application was just unveiled this past September.[3] Sugar.IQ is expected to be fully released later this year after some user testing. 

Most recently, many doctors, engineers, and scientists from all around the world have turned their attention to artificial pancreas systems. One of the most promising systems so far, the PEC-Encap device, has even made it to human clinical trials. 

ViaCyte, a San Diego, California based biomedical device company that currently holds more than 200 patents world-wide, has in recent years been developing the PEC-Encap device. This device could potentially act like bioartificial pancreas, which could be the “holy grail” of type 1 diabetes treatment.[4] The first part of the solution is creating the pancreatic cells the type 1 diabetes patients lack. This is achieved using PEC-01 cells, which are manufactured from pluripotent embryonic cells that scientists can induce into the needed cells.[5] The second part is the device, which in itself is an engineering challenge. It must be able to protect the PEC-01 cells from the body’s immune system while remaining permeable so that the insulin can be released from the islets in the device to the cells outside of it. 

Essentially, ViaCyte’s device encapsulates insulin-producing islets. The device and procedure are currently in clinical trials, which began on humans in 2014. The initial phase is focusing on testing the safety of the device, while future studies will focus on determining insulin dosage requirements. 

While the development of this device has passed many hurdles, it still has a long way to go before we can determine whether it will functionally cure type 1 diabetes. Federal regulation of biomedical devices is stringent since the cost is high if something goes wrong. Nevertheless, PEC-Encap is one new technology giving us hope for type 1 diabetes patients. The days of unending injections and finger pricks are not yet over, but may be soon.

References

[1] Mayo Clinic. 2014. Diseases and Conditions: Type 1 Diabetes. http://www.mayoclinic.org/diseases-conditions/type-1-diabetes/basics/symptoms/con-20019573. 
[2] American Diabetes Association. 2015. Insulin Pumps. http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/insulin-pumps.html?referrer=https://www.google.com/. 
[3] HealthcareITNews. 2016. Medtronic introduces IBM Watson-powered Sugar.IQ diabetes app. http://www.healthcareitnews.com/news/medtronic-introduces-ibm-watson-powered-sugariq-diabetes-app. 
[4] American Diabetes Association. 2015. Type 1 Diabetes at a Crossroads! http://care.diabetesjournals.org/content/38/6/968. 
[5] Viacyte. PEC-Encap™ (VC-01™) – Improving Diabetes Treatment. http://viacyte.com/products/pec%E2%80%90encap-vc-01/.

 
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