An implantable device could enable injection-free control of diabetes(news.mit.edu)
news.mit.edu
An implantable device could enable injection-free control of diabetes
https://news.mit.edu/2023/implantable-device-enable-injection-free-control-diabetes-0918
47 comments
This is the coolest bit of biotech I've seen lately because the approach feels very complete: custom cells so the device is self-regenerative, and an encapsulation system so it's protected from the immune system.
It does make you wonder what else could be done: i.e. could we implant some cells which produce antivenom?
It does make you wonder what else could be done: i.e. could we implant some cells which produce antivenom?
Or drugs like in Culture.
Out of all the wild future tech in those books, a universally accessible easily controllable gland capable of pumping out whatever molecules the body could use, from hormones to party drugs, still stands out as the single most beneficial thing possible.
As a kid I had an idea for a pill that would do that. I had no idea how it would work if course, but I thought one day in the future we could have a pill that you took that detected issues with the body and produced the needed drugs to fix it, so nobody needs to take a bunch of pills or the wrong pills. I'll have to read it.
For the oxygen supply there's a techology, already widely used, that runs 24/7 with no marginal maintenance cost. It takes O2 from the environment and outputs waste as a gas back into the environment, has a distribution system that can reach the entire body, and even its own pump that is self-repairing and typically lasts 70-100 years.
Seriously, why not extract O2 from the bloodstream? Is it that difficult? I don't doubt they considered this option; I just wonder what the issues are.
Seriously, why not extract O2 from the bloodstream? Is it that difficult? I don't doubt they considered this option; I just wonder what the issues are.
Speaking as a layman here.
I do know which one is safer, as to gain access to blood you have to gain access to a vein, likely by inserting a small tube made of [something] inside the vein, expect it to never break down and enter the bloodstream, become compromised, or be hit with an impact and tear the vein open to create internal bleeding. Then you also have to have a system to get rid of the waste blood (everything but the small amount of oxygen you want) all entirely within a closed system implanted into the arm, thigh, etc.
I do know which one is safer, as to gain access to blood you have to gain access to a vein, likely by inserting a small tube made of [something] inside the vein, expect it to never break down and enter the bloodstream, become compromised, or be hit with an impact and tear the vein open to create internal bleeding. Then you also have to have a system to get rid of the waste blood (everything but the small amount of oxygen you want) all entirely within a closed system implanted into the arm, thigh, etc.
> vein
Artery - not a lot of O2 in veins.
But other than nitpicking defensively, I agree those good points. I'd still like to see what any actual bio-whatever engineers have to say.
Artery - not a lot of O2 in veins.
But other than nitpicking defensively, I agree those good points. I'd still like to see what any actual bio-whatever engineers have to say.
Well, if you're going to be really nitpicky, pulmonary veins also carry oxygenated blood ;)
Fair enough. Probably we don't want to tap into those!
Also a layman (but t1d), I believe what you are saying is correct/Insulin is injected into fatty tissue, and I presume this implant would go in fatty tissue. Getting to a vein sounds like a much higher risk.
My guess would be this:
> Another possibility, which could prevent the need for immunosuppressive drugs, is to encapsulate the transplanted cells within a flexible device that protects the cells from the immune system. However, finding a reliable oxygen supply for these encapsulated cells has proven challenging.
Hemoglobin is a large molecule. It is difficult to create a barrier that allows it to pass without also allowing in anti-bodies. Trying to extract the oxygen outside of the barrier and that pass just the oxygen through is theoretically another approach. But at that point, doing the same thing with water instead of hemoglobin is just easier.
> Another possibility, which could prevent the need for immunosuppressive drugs, is to encapsulate the transplanted cells within a flexible device that protects the cells from the immune system. However, finding a reliable oxygen supply for these encapsulated cells has proven challenging.
Hemoglobin is a large molecule. It is difficult to create a barrier that allows it to pass without also allowing in anti-bodies. Trying to extract the oxygen outside of the barrier and that pass just the oxygen through is theoretically another approach. But at that point, doing the same thing with water instead of hemoglobin is just easier.
Oxygen is obtained from hemoglobin all the time (obviously). Is it that hard to recreate what the body does?
> generates oxygen by splitting water vapor found in the body
This will also generate hydrogen. Is there any mention in the paper about what happens to the waste hydrogen? I can't get past the paywall and I'm curious
This will also generate hydrogen. Is there any mention in the paper about what happens to the waste hydrogen? I can't get past the paywall and I'm curious
The article says it will "diffuse away" which implies they just let it escape the device. It'll then move through the tissue / fluids, reach the blood and eventually be breathed out. I did a quick google search to see if we already had some level of hydrogen gas in our body.
It seems that bacteria in the human gut already produce some hydrogen gas and that breath contains measurable levels of it[0]. This was news to me, but means that dumping a tiny amount of H2 into the body is probably fine.
[0] https://link.springer.com/article/10.1007/s00216-013-7606-6
It seems that bacteria in the human gut already produce some hydrogen gas and that breath contains measurable levels of it[0]. This was news to me, but means that dumping a tiny amount of H2 into the body is probably fine.
[0] https://link.springer.com/article/10.1007/s00216-013-7606-6
Hydrogen in the body is not normally a problem. It's such a light gas that it diffuses out the lungs readily, if it's in diatomic form, and your body has good mechanisms for dealing with ionized hydrogen already.
Most people's gut already produces hydrogen (normal levels at or below 16ppm in breath)
Most people's gut already produces hydrogen (normal levels at or below 16ppm in breath)
That's in the gut, but I wonder how that works when it's pumped out into the subcutaneous fat layer.
It's an interesting question, but I suspect it's not a big deal. H2 is _very_ good at escaping, doesn't really do anything biologically, and our bodies already have ways to get rid of small amounts of gas from various places.
I'm curious if it'd just do the same thing that CO2 does. That might all just be governed by physics and there probably isn't much chemistry involved in that being expelled after it's generated in cells?
I looked up the solubility of H2 in water, and it is _much_ worse than CO2's, so maybe that does suggest it'd at least not use the same mechanisms to escape, not sure.
I'm curious if it'd just do the same thing that CO2 does. That might all just be governed by physics and there probably isn't much chemistry involved in that being expelled after it's generated in cells?
I looked up the solubility of H2 in water, and it is _much_ worse than CO2's, so maybe that does suggest it'd at least not use the same mechanisms to escape, not sure.
Something like this happens: https://m.youtube.com/watch?v=YD-3vE_R7p8&pp=ygUoY2hhcmxpZSB...
Why does the radio antenna need to be outside of the body for energy harvesting? Why not just use a pair of terminals in that case?
"A tuned magnetic coil located outside the body transmits power to a small, flexible antenna within the device, allowing for wireless power transfer."
Energy reciever is completely inside the body and the energy transmitter completely outside. Piercing skin for prolonged times is generally a very bad idea because it's a channel for infection.
Energy reciever is completely inside the body and the energy transmitter completely outside. Piercing skin for prolonged times is generally a very bad idea because it's a channel for infection.
I see, thank you! I had totally misunderstood.
“ Most patients with Type 1 diabetes have to monitor their blood glucose levels carefully and inject themselves with insulin at least once a day.”
Once a day lol. Tell me you don’t know anything about Type 1 diabetes without telling me you don’t know anything about type 1 diabetes.
Once a day lol. Tell me you don’t know anything about Type 1 diabetes without telling me you don’t know anything about type 1 diabetes.
If you have type 1, you too can lead a normal life if you don't do any physically demanding activity, eat nothing, have no stress, do not get any common infection like the common cold, do not have any natural metabolic rate changes.. etc etc /s.
There are so many things that affect blood sugar both in the short and long run. T1D treatment is constant correcting for the past hours, not just the moment and future.
I wish it was easier to communicate this to people and journalists, because there are so many misconceptions like the one quoted here that makes T1D an even more invisible disability.
There are so many things that affect blood sugar both in the short and long run. T1D treatment is constant correcting for the past hours, not just the moment and future.
I wish it was easier to communicate this to people and journalists, because there are so many misconceptions like the one quoted here that makes T1D an even more invisible disability.
Another T1 here, fast-acting insulin wasn't invented until recently. One large dose of mixed insulin and a fixed diet may have been prescribed back in the day.
Before fast acting there was human analog, this is also somewhat short term. What was quite common for a while was the mixed insulins (the cloudy ones you would have to make sure mixed before injecting) which you took twice a day. The same could be achieved with individual doses of course. In general the very long acting insulins are highly variable and not much subscribed (as in they work between 12 and 48h, good luck if it varies a lot).
Long story short, NPH insulins for medium length (about 18h to a day but still lots of variation) was available since the 50's and was usually combined with normal human analog in either a mixture taken twice a day or in separate doses. I was on the twice a day regime of mixtard for most of the 90's.
Long story short, NPH insulins for medium length (about 18h to a day but still lots of variation) was available since the 50's and was usually combined with normal human analog in either a mixture taken twice a day or in separate doses. I was on the twice a day regime of mixtard for most of the 90's.
Thank you for enlightening us, I was diagnosed around 2004. At that time, fast acting insulin was the norm. But I knew that some patients used mixed insulin.
I still know T1Ds who continue to use mixed insulin, because it works for them.
I still know T1Ds who continue to use mixed insulin, because it works for them.
Lantus was approved in 2000. Diagnosed in early 2001, I spent maybe six months on NPH before they got me switched over. There’s also regular which is a mix of nph and fast acting, I still hear of people using that now as it works okay and is very cheap.
> Another T1 here
There are dozens of us! Dozens!
There are dozens of us! Dozens!
Heya! You seem knowledgeable about this. What is a normal amount?
Thanks!
Thanks!
Before being on an insulin pump, my wife would be injecting 1-2 times a day with long acting insulin (to manage background levels) and then at least 3 times a day with food - not just meals, snacks too (and if levels running high). So realistically, 8-10 times a day would not be uncommon.
That’s after 3-5 times a day finger pricks too.
Now, she just has the pain of the libre once a fortnight and pump every few days (along with finger pricks when the libre is out).
People do not realise how all consuming T1D is - she has to be on the ball all the time. If she isn’t, then her numbers screw up and she can’t drive (or live, tbh).
This project could make a huge difference to her life - but there are always 5-10 years away
That’s after 3-5 times a day finger pricks too.
Now, she just has the pain of the libre once a fortnight and pump every few days (along with finger pricks when the libre is out).
People do not realise how all consuming T1D is - she has to be on the ball all the time. If she isn’t, then her numbers screw up and she can’t drive (or live, tbh).
This project could make a huge difference to her life - but there are always 5-10 years away
At the moment open source artificial pancreas systems are way to go.
Have you checked androidaps or loopkit?
Have you checked androidaps or loopkit?
> At the moment open source artificial pancreas systems are way to go.
He said confidently lol.
I won’t give up multiple daily injections (Lantus morning and night, Humalog with meals and for corrections) unless I absolutely have to. Diagnosed in 2014 at around 30 years old. Been 5.5-5.9 A1C for the past ~6 years. Maybe one scary low a year and able to keep up with my marathon running and live a semi-normal life.
No clue why I’d want to mess with that to try some hacker project.
He said confidently lol.
I won’t give up multiple daily injections (Lantus morning and night, Humalog with meals and for corrections) unless I absolutely have to. Diagnosed in 2014 at around 30 years old. Been 5.5-5.9 A1C for the past ~6 years. Maybe one scary low a year and able to keep up with my marathon running and live a semi-normal life.
No clue why I’d want to mess with that to try some hacker project.
T1D that was also diagnosed somewhat later in life (24), the convenience of having something like a tandem that can buy and large manage my levels, is really nice. I definitely still keep needles around for when I need to do a larger injection, anything over about 20 units in an hour and you're going to have leakage and at that point you need to replace the infusion site.
I had a look over the years - the libre can pretty unreliable with levels, so I am concerned about someone else’s life being in jeopardy if I made a mistake (would be different if it was my own - I’d have done it a long time ago)
She’s waiting for a closed loop system from her hospital - should be within the next few months (omnipod is due an upgrade). That said, I’ll check out androidaps and loop kit, thank you!
She’s waiting for a closed loop system from her hospital - should be within the next few months (omnipod is due an upgrade). That said, I’ll check out androidaps and loop kit, thank you!
I‘m actually using the Libre + Omnipod Dash with a closed loop and it works pretty well (almost „flat“ blood sugar with a few spikes here and there) beside that’s, for me as tech nerd, cool to inject insuline with my phone :-).
Those are the pieces I‘m using on my iPhone:
https://nightscout.github.io/ -> to store historical data
https://github.com/Artificial-Pancreas/iAPS -> to connect the libre and pump and control the pump and make the close loop
Those are the pieces I‘m using on my iPhone:
https://nightscout.github.io/ -> to store historical data
https://github.com/Artificial-Pancreas/iAPS -> to connect the libre and pump and control the pump and make the close loop
The Libre has been life changing for me, but in particular during sleep I do find that the levels can be very unreliable if you end up sleeping on the same side as where you have attached the sensor.
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I have a Dexcom, and it's frequently 10-20% off of manual finger sticks. When paired with my pump (Tandem T-Slim) it keeps me in a good range, but still not perfect.
I briefly used the libre 3, and found it very accurate (but was skeptical as the 2 and 1 could not even warn you about a low/we're passive) and durable. Currently on the Dexcom G7, waiting for support for either of these with my pump.
The libre3 and G7 seem to be leaps and bounds better than anything else I've used (G4, G5, Guardian 3).
I hope you two find something that works well!
The libre3 and G7 seem to be leaps and bounds better than anything else I've used (G4, G5, Guardian 3).
I hope you two find something that works well!
One fast acting insulin per meal and one long term insulin a day, 4 at minimum if you eat 3 meals. Most of us use insulin pumps where we can get insulin any time we want.
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https://www.inknowvation.com/sbir/companies/solgene-therapeu...
“ Solgene Therapeutics' patented drug-delivery technology enables the encapsulation, in a porous ceramic material, of living cells that secrete therapeutic compounds. After implantation, the material shields the encapsulated cells from the host's immune system while allowing passage of nutrients and therapeutic cell-secreted compounds. Implanted cells continue to function, thus mimicking natural processes. Solgene believes it can create competitive advantages in under-served biotech markets. It seeks revenues through alliances to commercialize hard-to-deliver, cell-secreted, large-molecule therapies. Solgene proved its concept by overcoming diabetes in diabetic mice. Target applications include delivery of livestock therapies, growth factors for bone healing, and a cell-secreted HIV therapy.”