I have "type 1" diabetes for 27 years. I hear similar stories like this (revolutionary cure working on animal models) every year or two. Until now non of them worked. I hope this one will be beeter but my expectations are quite low.
This is really compelling, and the principle seem like it should work in humans. Can anyone with more knowledge of biochemistry think of any reasons why this gluconic acid polymer approach might not work in humans?
Like most cool biotechnology tools like this, the hangups will probably come from ironing out safety, dosing, and delivery issues in the clinic, rather than some mismatch in the biochemistry. They mention one of them in the paper:
In the long term, a balance is assumed to be established between the amount of injected PLL-FPBA and cleared PLL-FPBA. Thus, the long-term toxicity of the complex formulation needs to be thoroughly evaluated for clinical translation.
Proving that PLL-FPBA only responds to glucose fluctuation (and no other physiological changes, with a large enough sample size to cover the range of possible physiological changes that could be experienced by patients), proving that it is biocompatible with all patients, proving that the dose-response is uniform and can be correctly tailored in all patients, and then proving that all of these results hold over very long periods of time with material that can be cost-effectively manufactured at scale will probably be the tricky part. There probably aren't any fundamental reasons that the chemistry of the gluconic acid polymer wouldn't work in humans.
Citations 13-40 provide a pretty good overview of the history of glucose-responsive insulins. These ideas are awesome and I hope they can be successful some day, but I also get the impression that engineering improvements (and cost reductions) in insulin pump technology will provide more immediate quality-of-life improvements for the broader Type-1 Diabetic population.
There is also what Sigilon (now Eli Lilly) is doing, which is to encapsulate living cells in a matrix they cannot escape. The cells sense glucose levels and secrete appropriate levels of insulin locally. In the current iteration I think the millimeter sized beads are injected in the peritoneum, and are removable.
From the article, this is a small animal study involving less than 10 animals, no one knows if this even works in humans or if the benefits seen here will translate into a larger study.
This is so far from being a commercial product that asking about costs means nothing.
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Citations 13-40 provide a pretty good overview of the history of glucose-responsive insulins. These ideas are awesome and I hope they can be successful some day, but I also get the impression that engineering improvements (and cost reductions) in insulin pump technology will provide more immediate quality-of-life improvements for the broader Type-1 Diabetic population.
This is so far from being a commercial product that asking about costs means nothing.
People still smuggle in a little, but there are penalties if they get caught with a lot of insulin.
I live in Texas, about 12 hours from the Mexican border, so it's not worth the trip.
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