Patients with type 1 diabetes have to test their blood several times a day to check their sugar levels and assess how much insulin to inject into themselves. Any lapse or miscalculation in this unrelenting regimen can lead to serious health complications and even death.

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Tests on mice with a form of type 1 diabetes showed that one injection of “smart insulin” works for at least 14 hours.

Now, a new study by Danny Chou, an assistant professor of biochemistry at the University of Utah School of Medicine in Salt Lake City, and colleagues suggests this burden could one day be considerably lighter for people with type 1 diabetes.

Writing in the Proceedings of the National Academy of Sciences, the team describes how they developed and tested a long-lasting “smart insulin” compound called Ins-PBA-F that self-activates when blood sugar is high and brings it back to normal levels.

The researchers are now developing the smart insulin into a therapy suitable for human use. They anticipate it being ready for clinical trials in 2-5 years.

Tests on mice with a form of type 1 diabetes showed that one injection of Ins-PBA-F works for at least 14 hours. During this period, the smart insulin activated several times in response to blood sugar rising after the mice were given amounts of sugar comparable to that consumed at mealtimes.

Both type 1 and type 2 diabetes are diseases where the body is unable to control blood sugar. This is most pronounced in type 1 diabetes, which arises when the beta cells in the pancreas that produce insulin are destroyed.

Without insulin, the body has no mechanism for moving sugar out of the blood and into cells, where it is used for energy. People with type 1 diabetes are completely dependent on their daily insulin injections for their survival.

Fast facts about diabetes
  • In 2012, 9.3% of Americans – 29.1 million people – had diabetes
  • Around 5% of diabetes patients have type 1 diabetes
  • The total cost of diagnosed diabetes in the United States in 2012 was $245 billion.

Find out more about diabetes

If a person with type 1 diabetes fails to manage their blood sugar properly, they can do serious damage to their health, or worse. Hyperglycemia, or high blood sugar, can lead to heart disease, blindness and other long-term complications. Hypoglycemia, or low blood sugar, can result in coma and even death.

The researchers suggest their smart insulin Ins-PBA-F could give a faster, more effective response to lowering blood sugar than the current long-acting insulin drug detimir, which is marketed under the brand name LEVIMIR.

The study results showed that the speed and chemical reactions of Ins-PBA-F normalizing blood sugar in diabetic mice are the same as in healthy mice responding to blood sugar changes with their own insulin.

Prof. Chou says the study “is an important advance in insulin therapy,” and adds:

“Our insulin derivative appears to control blood sugar better than anything that is available to diabetes patients right now.”

Although diabetes treatments have advanced considerably in recent decades – insulin pumps are now available and there are four types of insulin – patients must still make their assessment and adjust the dose themselves. The amount of insulin they need can be different each time depending on various factors, such as what they have eaten and how much exercise they do.

A smart insulin drug that automatically activates in response to rising blood sugar would get rid of the need for top-up shots of insulin, and eliminate the danger of incorrect dosing.

Ins-PBA-F is not the only smart insulin drug currently under development, but it is the only one that does not rely on being coated with a gel or protein barrier to inhibit insulin when blood sugar is low. Such products carry the risk of unwanted side effects such as an immune response, note the researchers.

Instead, Ins-PBA-F works because it has a tail made of phenylboronic acid (PBA) that under normal conditions binds Ins-PBA-F to circulating blood proteins that block its effect. But when blood sugar rises, the sugars bind to the PBA making it trigger the release of Ins-PBA-F so it can get to work and bring the sugar levels back to normal.

Prof. Chou says:

Ins-PBA-F fits the true definition of ‘smart’ insulin, where the insulin itself is glucose responsive. It is the first in its class.”

Funds for the study came from the National Institutes of Health, the Juvenile Diabetes Research Foundation, the Harry B. Helmsley Charitable Trust and the Tayebati Family Foundation.

Meanwhile, Medical News Today recently learned how researchers may have found a novel way to cure diabetes using a probiotic. The team – from Cornell University in Ithaca, NY – successfully reduced blood glucose levels in diabetic rats by up to 30% with the help of engineered human gut bacteria that reprogrammed cells in the animals’ intestines to produce insulin.