'Smart' insulin may offer help to type 1 diabetics

Scientists are hopeful that “smart” insulins which are undergoing trials could revolutionise the way diabetes is managed.  This would effectively mean that diabetes patients could be spared the burden of constantly monitoring blood sugar levels. 

The new compound, which was shown to be effective in mice, automatically activates when blood sugar levels soar, and remains in circulation for up to 24 hours. In the future, patients could inject the insulin once a day, or even less frequently, overcoming the need for constant self-monitoring and insulin top-ups after meals.

Instead of repeated blood tests and injections throughout the day to keep blood sugar in check, a single dose of smart insulin would keep circulating in the body and turn on when needed.

About 400,000 people in Britain have type 1 diabetes, including 30,000 children. The condition, which normally begins in childhood, is an autoimmune disease in which the body kills off all its pancreatic beta cells. The cells produce insulin, which regulates blood sugar, and without beta cells, the body’s sugar levels fluctuate wildly, meaning that patients need to monitor glucose and typically inject insulin several times each day.  

People with type 1 diabetes, who either do not make or cannot use their own natural insulin, rely on insulin injections to stay well.  Taking too much insulin can drive blood sugar levels too low, leading to hypoglycaemia– such episodes are responsible for around 10% of deaths in type 1 diabetes.   Without these, their blood sugar would get dangerously high.

But injecting insulin can also make blood sugar levels dip too low, and people with type 1 diabetes must regularly check their blood glucose levels to make sure they are in the right zone.  Diabetes experts have been searching for ways to make blood sugar control easier and more convenient for patients, which is where “smart” insulins come in.

There are two main types: type 1 and type 2

In type 1, which accounts for about 10% of diabetes, the body’s immune system destroys the cells that make insulin

Type 2 diabetes is when the body either cannot make enough insulin or the body’s cells do not react to it

Insulin treatment is always needed for type 1 diabetes, while if you have type 2 you may be able to control your symptoms by eating a healthy diet, exercising regularly and monitoring your blood sugar.