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Medicine

Injectable Nanoparticles Maintain Normal Blood-sugar Levels For Up To 10 Days 121

cylonlover writes "Aside from the inconvenience of injecting insulin multiple times a day, type 1 diabetics also face health risks if the dosage level isn't accurate. A new approach developed by U.S. researchers has the potential to overcome both of these problems. The method relies on a network of nanoscale particles that, once injected into the body, can maintain normal blood sugar levels for more than a week by releasing insulin when blood-sugar levels rise."
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Injectable Nanoparticles Maintain Normal Blood-sugar Levels For Up To 10 Days

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  • Preemptively posting, because you know there's gonna be some idiot talking about fat people, and who doesn't understand the difference between type 1 and type 2 diabetes.
    • by Artifakt ( 700173 ) on Monday May 06, 2013 @09:51AM (#43641607)

      As a type 2 diabetic (male) who stands 6' 1" and weighs 180 lbs, I'm not sure you understand it either.

      • I have type 3 diabetes you insensitive clods!

        • by Lumpy ( 12016 ) on Monday May 06, 2013 @10:30AM (#43642057) Homepage

          Type 3.14 is better as it comes with Pie....

        • by Anonymous Coward

          Funny, a friend of mine jokingly calls his form of diabetes type 3... He took some shrapnel in Afghanistan that pretty much fried his pancreas. So good shape, but requires an insulin pump for the rest of his life.

          • It's effectively the same as type 1 diabetes in that the insulin producing cells are destroyed. There are probably other complications with your friend though as the pancreas produces a host of other enzymes that are needed for proper body function. I guess theoretically if they ever master islet transplants your friend could get off the pump though since true type 1 results from autoimmune destruction of beta type islets of Langerhans [wikipedia.org]
      • by ebno-10db ( 1459097 ) on Monday May 06, 2013 @10:12AM (#43641869)

        Sorry, no offense. Yes, I'm aware that weight is far from the only factor affecting type 2 diabetes. I have several relatives w/ type 2 that were able to reduce their medication dependence by losing weight (they were overweight to begin with), though of course it doesn't cure it.

        I made my OP only because whenever health care is discussed (especially these days) there are sanctimonious assholes who attribute all health problems to people's poor habits, and think universal health care (if we ever get it) will pick their virtuous pockets to pay for other people's lack of virtue.

        • I have several relatives w/ type 2 that were able to reduce their medication dependence by losing weight (they were overweight to begin with), though of course it doesn't cure it.

          Then there are those of us who managed a normal weight through diet and exercise until diagnosed Type-2 and put on medication.

        • Mostly, I think universal health care will steal my freedom to give it to government. That's a far greater concern to me than pontificating on other people's health issues. FWIW, it seems to be the Europeans in socialized medicine countries who really like to pick on the "fatties" who, in their opinion, only exist in the USA.
        • ...it will pick my virtuous pockets to pay for *anything*, and that makes it bad. But yes, I am complicit, since I voted for him, twice.. (or arguably voted against Romney, even though I agree with him on some issues.. yet he chickened out and withdrew his 47% comments).

      • by reebmmm ( 939463 ) on Monday May 06, 2013 @10:27AM (#43642039)

        As a T1D, I'll note that the GP didn't really comment on what it means to be a T2D. The characterization, however, is mostly true for an overwhelming majority of t2d, but completely false for t1d. T2D is controllable with diet and exercise alone in something like 80-90% of the T2D population. Weight and lifestyle factors make up an overwhelming percentage of the risk factors. And while there is clearly a genetic (usually associated with the likelihood that weight/lifestyle will give way to t2d, not that the genetics alone cause t2d) and medical condition component too, this is the clear minority.

        • Thank you for reading my post carefully. I made a post relating to political/social issues of universal health care, and inadvertently implied that type 2 is necessarily caused by being overweight. I apologized and clarified what I meant, but am not sure what else I have to do to atone for what was merely a clumsy attempt at making a point.
        • by mpe ( 36238 ) on Monday May 06, 2013 @01:34PM (#43644565)
          As a T1D, I'll note that the GP didn't really comment on what it means to be a T2D. The characterization, however, is mostly true for an overwhelming majority of t2d, but completely false for t1d. T2D is controllable with diet and exercise alone in something like 80-90% of the T2D population. Weight and lifestyle factors make up an overwhelming percentage of the risk factors. And while there is clearly a genetic (usually associated with the likelihood that weight/lifestyle will give way to t2d, not that the genetics alone cause t2d) and medical condition component too, this is the clear minority.

          Diabetes is more of a "syndrome" than a "disease". Even divided into groups of T1 (typically no insulin produced in the body), T2 (insulin resistant), T1.5 (LADA), MODY, T3 ("Double Diabetes") & "Gestational Diabetes".
          Insulin resistance tends to promote conversion of glucose into fat since it reduces the amount the body can use for anything else. Obesity also tends to increase insulin resistance. Leading to a positive feedback loop. To make matters worst hyperglycemia is toxic to cells, including those which produce insulin.
          An important factor is that in the last 30 or so years dietary advice has been to eat lots of carbohydrates. (In some cases up to 70%.) With the result that both obesity and T2 diabetes has dramatically increased. Something previously unheard of called "diabulimia" has appeared amongst T1 diabetics (mostly young women.) But the idea that "Low fat, low calorie, high carbohydrate" might not be the best (let alone the worst) kind of diet for humans tends to result in the classic "heritic treatment". The biggest irony being that humans (possibly all mammals) do not actually need to eat any carbohydrates in the first place. Are there many high carbohydrate (especially high starch) foods which are not the product of agriculture?
          • by Rich0 ( 548339 )

            Are there many high carbohydrate (especially high starch) foods which are not the product of agriculture?

            Well, fruit probably qualifies, though obviously an orange isn't as carb-rich as a potato. Potatoes might also be eaten by hunter-gatherers, but I'm not sure how often that happened. I'm not sure if there was much rice-consumption in pre-agriculture Asia.

            But yes, in general an evolutionary diet is likely fairly low in carbohydrate content compared to a modern diet.

            I'm using "agriculture" above in the sense of farming - planting lots of something and then digging it up. If you define "agriculture" as anyt

            • You are ignoring nuts which are loaded with carbohydrates. These would include pine nuts, walnuts, etc. Then there is the "gatherer" part of hunter-gatherer. Many hunter-gatherer societies dig up roots and cook them in order to have a more reliable food supply. Potatoes and carrots are human selected versions of some of these edible roots.

              • FWIW I suspect type 2 diabetes basically was not a problem since given the life expectancies at the time the disease was not a significant issue. I suspect the same mutations which cause type 2 diabetes probably constituted some kind of evolutionary advantage at a time when there were significant food shortages.

      • We want developments as quockly as possible, as that is the most important factor in saving lives, not handing it out for free.

        That means research, government funded or private funded. We should be proud the US, "only 6% of the world's population, using 25% of it's energy" invents 50% of everything invented every year.

        Other nations should be more like us, not the other way around. If, and it's a big if, what you care about is saving lives.

        • Your type-o is interesting because I first read it as quackly as in we want to take every quack doctors suggestion as a cure for what ever he says it is. In the context of your request, quickly and quackly are very likely the same thing.

        • by Minwee ( 522556 )

          We should be proud the US, "only 6% of the world's population, using 25% of it's energy" invents 50% of everything invented every year.

          Indeed. And brave Americans like John Steele [forbes.com] are at the forefront of protecting that 50% from the world's other 94% who want to take away.

          Go USA.

      • by Dynamoo ( 527749 )
        I can beat you on that..type 2, 6.1" and 160 lbs. That raised a few eyebrows, but it can happen to anybody it seems..
        • by Merls the Sneaky ( 1031058 ) on Monday May 06, 2013 @12:24PM (#43643561)

          I developed type 2 after contracting pancreatitis due to complications associated with surgery to remove gall stones ( actually it was a second surgery to clear remnants of grit from the passage that ends at the bottom of the stomach). At the time I was 22 years old, 90 KG (about 198 pounds) and I am five foot nine. I am overwieght now but that is down to what diabetes has done to my metabolism. People shouldn't make assumptions about someones situation. Just because they are fat doesn't mean that's what cause their type 2 diabetes.

          Forgive me for the crudity of my medical terminology, I am not a medical student.

          • 90kg for five foot nine is still somewhat overweight, unless you're a body builder.

            • I'm not a bodybuilder but I have broad shoulders, I used to cycle a lot so my calves and thighs are rather bulgy. I never had a six pack or anything but I didn't have any weight issues ( I didn't look like I was over weight, and that's what really counts, not the numbers). While the BMI would make it look like I was over weight the BMI is bull shit. It doesn't account for body type.

    • Type 1 cannot survive without insulin. However, a lot of type 2s also inject insulin. If you get the dosage right, injecting insulin is a much better alternative to oral Sulphonylureas for Type 2s. The main reason Sulphonylureas are preferred is because people don't like injecting stuff.

      • Re:Both (Score:5, Interesting)

        by Andy Dodd ( 701 ) <atd7NO@SPAMcornell.edu> on Monday May 06, 2013 @10:30AM (#43642061) Homepage

        This advancement, if it pans out (most things don't, sadly...), it'll be great for Type Is.

        Right now, it can be difficult to manage weight as a Type I - if you exercise, you must reduce your insulin dosage in advance. Otherwise, your blood sugar drops and you wind up eating to make up the calories.

        While a normal person (or even a Type 2) can say "I'm gonna go for a run/long walk now because I feel like it", a Type 1's thought process, if they actually want to get benefit is, "I'm definitely going to go for a run/long walk after this meal. I will reduce my insulin dosage for this meal to compensate." Don't run after the meal? Bloodsugar goes high. Run after the meal without planning it before the meal? Bloodsugar goes low and you eat.

        My initial reaction to the description of this was "oh, somewhat longer-acting Lantus", but it appears that it is actually load-reactive, sort of acting as an artificial pancreas. However, taking only one injection for a week is unlikely to work - the amount of insulin required for a week is far more than is practical for a single injection unless you're a little kid. That said, going down to 1-2 injections per day, and having that insulin react to load, is a MAJOR improvement for diabetics... Especially, as I said before, load-reactiveness.

        • Re:Both (Score:5, Insightful)

          by overshoot ( 39700 ) on Monday May 06, 2013 @11:01AM (#43642463)

          Otherwise, your blood sugar drops and you wind up eating to make up the calories.

          If you're lucky. Sometimes someone gets unlucky and goes into insulin shock. If they're lucky, someone gets some sugar into them stat.

          Sometimes they're unlucky and a cop tries smacking them around for driving (or walking, or sitting) drunk. This doesn't end well.

        • Another thing to keep in mind is that since Type 1 is genetic, you've got it from birth, which means that there are little kids who have to manage their insulin levels. A weekly treatment could be much, MUCH easier for diabetic kids & their parents to deal with, and less invasive than an insulin pump.

          • Another thing to keep in mind is that since Type 1 is genetic, you've got it from birth...

            Not quite true - whilst it does seem to be genetic to a large degree, having Type 1 at birth is very rare. The average age of diagnosis is 6 - 7 years old. That said, having personally managed Type 1 in a 1 year old (and ever since) - you're absolutely right that a 10 day injection and I assume reduced blood glucose monitoring in between would be a great thing.

        • by Rich0 ( 548339 )

          Many of the issues with sugar management are somewhat-alleviated by a pump, which I imagine most Type 1's use these days. Continuous glucose monitors also help out. If you plan for exercise and then skip it, you just reset your basal rate to normal (instead of dropping it), or whatever (I'm not actually a diabetic - I'm sure anyone who is could tell you exactly how they handle it).

          However, I'll certainly agree that this shot sounds a heck of a lot better than a pump. I wonder if it would work for insulin

          • Many of the issues with sugar management are somewhat-alleviated by a pump, which I imagine most Type 1's use these days. Continuous glucose monitors also help out. If you plan for exercise and then skip it, you just reset your basal rate to normal (instead of dropping it), or whatever (I'm not actually a diabetic - I'm sure anyone who is could tell you exactly how they handle it).

            Being on the pump does make it much easier to exercise without having to plan too far in advance, and both the pump and CGM make it much easier to do long duration activities like Ultra marathons. Most people are NOT on the pump though - they are still using multiple daily injections of long acting and short acting insulin.

            • by Rich0 ( 548339 )

              Most people are NOT on the pump though - they are still using multiple daily injections of long acting and short acting insulin.

              I don't get that. A pump is a motor attached to a syringe of sorts, some tubing, and an IV-like device that adheres to the skin, a few buttons, an LCD display, a battery compartment, and a 75-cent microcontroller. It might cost a bit more than a cheap watch to manufacture, but not all that much more. Sure, there is a bunch of cost in the engineering, and that is critical due to its intended use. However, there are a LOT of type-1's (and insulin-dependent type-2's) out there. You'd think the first world

              • by Talonius ( 97106 )

                The problem with the pump for me is that the reservoir isn't large enough. As a Type-1 insulin resistant diabetic of almost 30 years I currently take 250u of Apidra insulin a day, along with 85u of Lantus. When on the pump with Apidra insulin forming the baseline it comes out to 325u of Apidra a day. That's a single reservoir, meaning I'd be changing my kit every day - and that's something my insurance company won't pay for and is really a pain in the ass.

                And concentrated humulin R insulin does absolutel

                • by Rich0 ( 548339 )

                  Having lived with a type-2, I'd never tell you to eat less. It is a LOT harder than people make it out to be. She could probably eat two apples a day and end up with an A1C of 8 on 60 units of Lantus a day.

                  It seems like there should be some way to change the reservoir without changing the injection set. I'm sure it would involve some care (locks, wiping with alcohol, etc), but if you can plug in an IV line in a hospital without giving somebody sepsis you should be able to change a pump reservoir without

              • by Andy Dodd ( 701 )

                There are limitations to the pump:
                1) If the pump has any sort of problems, you need to start taking fast-acting injections once every hour or two, since you no longer have a nice Lantus baseline. You can get into a VERY bad state in a matter of hours from various people I've talked to.
                2) Pumps simply can't handle certain environments. Part of my job includes running EMI tests in an aircraft hangar on occasion - I'd have to remove my pump and go to hourly injections for the duration of such tests.

  • by Anonymous Coward

    That is some sweet science

  • Tested in mice only! (Score:5, Informative)

    by astaines ( 451138 ) on Monday May 06, 2013 @10:00AM (#43641711) Homepage

    This is a neat idea, but not yet remotely ready to try in people. There were quite significant local infammatory reactions (big lumps!) in some of the mice tested.
    There's probably ten years of work, and well north of $150 million dollars before the first human tests.
    Good luck!

    • by mpe ( 36238 )
      This is a neat idea, but not yet remotely ready to try in people. There were quite significant local infammatory reactions (big lumps!) in some of the mice tested. There's probably ten years of work, and well north of $150 million dollars before the first human tests.

      Would any sensible T1 want to try this if all it will do is get their blood glucose level below 200mg/dl? Which is still nowhere near normal (non diabetic) for either a mouse or a human.
      • As Astaines pointed out, this is still very early work. I'm sure that one of the goals is to get the blood glucose levels down to a more normal range. However, the fact that it appeared to control glucose at all is impressive.

        Even if a diabetic is fitted with a pump (3 of my friends have them), you still get abnormal spikes and dips in your blood glucose level over time. Based on some epidemiological data (of which I'm always sceptical to be sure) it appears as though these large swings in blood gluco
      • Depends -- if it could be combined with traditional insulin therapy to help prevent the serious highs, it could still be pretty beneficial for overall control. I don't know if that would work or not, but it seems like a possibility, at least.

        I'm also not sure what normal blood glucose levels are for mice. They refer to source that I found says that the mean level for mice is about 174 mg/DL.

  • by Begemot ( 38841 ) on Monday May 06, 2013 @10:03AM (#43641757)

    It doesn't only solve the two mentioned problems, it would completely change the life style!
    - eat whenever you want to
    - stop eating when you feel you had enough, instead of eating "enough" for the insulin you took
    - no need to wake up in the night to check sugar level
    - exercise whenever you want to w/o worrying that your sugar level is high enough for the effort

    And that for responsible adults. Now think about diabetic kids and their parents - how much easier and comfortable their life could be... I'm not even mentioning the first period when you get diabetes - it takes months to learn balancing insulin doses, timing of injections, type and amount of food and physical exercises.

    Pregnant diabetic women could be much less worried too.

    This medicine can be a complete game changer. No less.

    • by ColdWetDog ( 752185 ) on Monday May 06, 2013 @10:09AM (#43641825) Homepage

      This medicine can be a complete game changer. No less.

      It's not a medicine. It's an early proof-of-concept in mice. If we managed to produce viable treatments from every mouse experiment ever done we'd all be six feet tall, weigh 150 pounds, run the mile in 4 minutes, have full heads of hair and have secondary sex characteristics that would cause members of the opposite sex (or several other odd combinations) to furiously engage in uninhibited sex.

      Reality isn't quite like a Hentai movie so you can just go back downstairs for a while.

    • I'm curious if this approach has any inherent advantages over implantable insulin pumps (which have been around for a few decades), and why they haven't take off wildly (for all the benefits you mention).
      • I'm a Type 1 who's been wearing a pump for the past 6 years. I also have the relatively new real-time glucose monitoring attachment.

        I haven't read through the fine details of the article, but if the nanoparticles are somehow able to determine when to release insulin without intervention, that would be a definite benefit over the current pump technology. As it stands right now, the real-time monitoring only tells you that your blood-sugar levels are high, and requires manual intervention to make correction

        • by Begemot ( 38841 )

          Thanks for the tip.

          In my case, very unfortunately, medical insurances in my country (Israel) do not fund a pump because I'm relatively well balanced. Oh the irony...
          It would cost me a fortune to buy and maintain one myself :( can't afford it.

          • That's actually the thing that concerns me about this treatment. A very good friend of mine with IDDM has been forced to take insane risks with her blood sugar because she didn't have a job that provided health insurance, but she worked part time at a couple jobs (this is right out of college) and thus made just enough money to not be eligible for the various aid programs. She could no longer afford the injection kits for her pump (they have to be replaced frequently) and could barely afford the insulin its

    • As a Type 1 diabetic:
      I can already eat whenever I want.
      I bolus my insulin for the amount of carbohydrates I'm eating, so I don't have to keep eating to compensate.
      I don't need to wake up in the middle of the night to test my glucose - if I wake up in the middle of the night and feel low, I will test and have a glucose table if necessary.
      I do check before I go to the gym, especially if I'm feeling low - again, I take a glucose tables or two if required.

      • Aw crap. I just wrote exactly these 4 points in reply to the GP & then saw your answer before submitting.

        I would just add: I consider it to be the 'silver lining' of getting type 1 (aged 35) that I think a bit more about what I eat and whether I need to eat it. My diet was already quite good, but it's improved since.
      • s/tables/tablets/g

    • Not only that, but there's a lot of other problems with quality of life when you're a diabetic. Scott Hanselman (has a podcast, works for Microsoft) [hanselman.com] has mentioned a few times that when he travels the world he ends up eating at Subway all the time, because it's the only place you have a really good idea of how the meal is going to affect your blood sugar. Imagine going to a foreign country and not being able to eat any of the local cuisine because you don't know if it's going to send you into a coma. It's
      • Imagine going to a foreign country and not being able to eat any of the local cuisine because you don't know if it's going to send you into a coma. It's like being a vegan, except that breaking the rules means that you end up getting sick. Vegans can usually find something to eat at almost any restaurant

        Man, oh man. First, study up before you go somewhere, then you'll know what you can eat. Second, vegans can't eat anything in a lot of restaurants (well, not can't, won't) because of influences like fish sauce. Of course, if you just don't tell them it's in there, they'll tell you how much more delicious it is than most vegetarian food they've had... not least because fish sauce contains natural MSG

        • What are you supposed to study up? Unless you're going to limit yourself to chain restaurants, you're probably out of luck. Most independently owned places don't even have the information you're looking for. Even chain restaurants tend to vary their menu quite a bit between different places. And I'll admit, if you don't get the count right, you probably won't die. But if you're going to be on stage in front of 1000 people, you don't want to let them down because your blood sugar is a bit off and you ca
      • Not only that, but there's a lot of other problems with quality of life when you're a diabetic. Scott Hanselman (has a podcast, works for Microsoft) [hanselman.com] has mentioned a few times that when he travels the world he ends up eating at Subway all the time, because it's the only place you have a really good idea of how the meal is going to affect your blood sugar. Imagine going to a foreign country and not being able to eat any of the local cuisine because you don't know if it's going to send you into a coma. It's like being a vegan, except that breaking the rules means that you end up getting sick. Vegans can usually find something to eat at almost any restaurant. But for people with diabetes, it can be quite difficult to eat at a lot of restaurants, especially non-chain restaurants as they usually don't have any nutritional information (nor are they required to).

        That's rubbish. Type 1 Diabetics can easily eat the local cuisine. All we need to do is to take a smaller dose before the meal, then test soon after the meal and add a corrective bolus. I eat different food every day and travel extensively and have no problem. You don't need to restrict yourself to a limited range of food unless you want to - and if so, don't blame the diabetes for that.

    • by Dynamoo ( 527749 )
      It's not going to happen overnight (assuming it works). And you can guess that it will be *expensive* to start with. But for some people the difference in quality of life will be enormous, with children in particular. But the demand for this would be huge..
    • by mpe ( 36238 )
      It doesn't only solve the two mentioned problems, it would completely change the life style!
      - eat whenever you want to
      - stop eating when you feel you had enough, instead of eating "enough" for the insulin you took


      No doubt there are plenty of T1s who can regulate their insulin dosage to be able to do this.

      - no need to wake up in the night to check sugar level

      If someone is frequently interrupting their sleep then it might be better to adjust their control methods.

      - exercise whenever you want to w/o
    • - stop eating when you feel you had enough, instead of eating "enough" for the insulin you took

      Does this really happen often?

  • Kick-ass concept (I have two close relatives who are Type 1 and on insulin pumps). But this seems to be only half the solution. You still have to monitor your levels to be absolutely sure and currently this is still an invasive albeit simple process. When a non-invasive measurement method that fits in a wristwatch arrives, then it will be a lot better form of treatment. You'll probably still have to keep insulin pens around for emergencies though.

    • You'll probably still have to keep insulin pens around for emergencies though.

      I'll assume that is a small mistake on your part. The term "insulin pen" is typically used to describe pre-mixed insulin in a pen-like device that will last for anywhere from 5-7 days worth of dosages. I think you mean "glucose pen" which is used when a diabetic goes way low. An extreme low is an immediate danger to a diabetic and can cost them the faculties (confusion, lack of body control) to even deal with the situation. While high can be an immediate danger in extreme circumstances it's much easier

  • This appears to be a 'new and improved' way to dispense insulin 1) adaptively and 2) with a single dose that lasts an entire week. Type 1 diabetics will benefit most since they must take insulin already. They're likely to find this a god send.

    But this technology will also appeal to Type 2s who now may be a lot more likely to take insulin rather than an insulin secretagogues drug like sulfonylureas (e.g. glipizide, glibenclamide). A significant benefit of taking insulin rather than an insulin stimulant is

    • Of course, they have yet to make it work in pimates and humans. No small hurdle.

      Combination of a missing letter and being in a /. frame of mind led me to wonder why a drug approved for humans wouldn't work for _pirates_. I'll go ask the FSM about this.

  • All hail our evil robotic overlords?
  • Doesn't that increase the risk of an embolism?

    • Why group them into a network? Doesn't that increase the risk of an embolism?

      From the supplementary materials PDF [acs.org], it looks like these particles are about 300nm in diameter. That's a fraction of the diameter of a single red blood cell, individual particles wouldn't be big enough to block even our smallest capillaries. However, 300nm is about the size of a large virus; I don't know how immunogenic these things are, but even if moderately inert they'd likely be targeted by our normal debris-removal functions, as the immune system really does not like virus-sized foreign particles.

  • Another example of publicly funded research hidden behind a profit motivated paywall. Too bad the public can't RTFA.
  • Bear in mind that it's the degradation of normally smooth artery walls by, e.g., high blood pressure that enables plaque build up. What happens if they impact a plaque deposit?

    I ask because the treatments might start to get expensive if it's not quantified before people start using the treatment and J. Edgar Pure-Butter-Diet takes them to court over their "contribution" to the arterial furring that put his head in a jar.

  • If the costs are low and side effects minimal. How stablely can it regulate blood sugar? The modern practioce of three meals a day just isn't very optimal for good mood regulation and high productivity and creativity. Of course, we should probably all be taking naps, too :)

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