Nearly a century after the discovery of insulin by Sir Frederick Banting and Dr. Charles Best in 1921, medical researchers continue to uncover new treatments for effectively managing and treating type 1 diabetes (T1D), shedding light on the condition and generating renewed optimism for the more than 300,000 Canadians living with T1D.
T1D is the form of diabetes caused when the pancreas can’t produce insulin, a hormone that enables the body to get energy from food. It occurs when the body’s immune system attacks and destroys the insulin-producing cells in the pancreas, called beta cells. Although its causes are not completely understood, unlike type 2 diabetes the onset of T1D has nothing to do with diet or lifestyle.
While insulin is a lifesaver for those living with T1D, it isn’t a cure for the condition or its devastating potential effects, which include kidney failure, blindness, heart attack and nerve damage that can lead to amputations. But there’s hope, because T1D treatments are improving all the time. Could a daily regime that includes multiple injections and ongoing glucose monitoring soon be a thing of the past for those living with T1D? Let’s take a look at some recent T1D advancements.
Insulin pump therapy and the quest for an artificial pancreas
In people living with T1D, the pancreas can't make or can't respond to insulin properly. As a result, glucose builds up in the bloodstream and can’t be delivered to the body’s cells for energy.
One way to deal with diabetes is to bypass a diabetic’s malfunctioning pancreas with an insulin pump that can mimic the biological function of the pancreas by producing needed insulin. Today, insulin pumps deliver insulin to the body through a catheter inserted under the skin. The insulin is stored in a pager-like device and is connected to the catheter by a long tube. While this is a great improvement over daily injections by needle, the wearer still has to adjust the insulin dosage manually.
JDRF (formerly known as the Juvenile Diabetes Research Foundation) has been a leader in type 1 diabetes research for more than 40 years; it launched the Artificial Pancreas Project in 2006 to help accelerate the development of a commercially viable artificial pancreas.
One such device, called a closed-loop system, is currently undergoing trials. It is designed to keep glucose levels stable in people with T1D by using a pump to infuse insulin, in addition to a continuous glucose sensor and a dosing algorithm. The glucose sensor continuously measures glucose levels and the dosing algorithm delivers insulin or glucagon (the hormone that raises the level of glucose in the blood when it drops too low), based on the sensor readings. This means that manual delivery of insulin by the wearer is not required.
Drug research shows potential
Other creative ideas are on the horizon, such as beta cell research. These cells produce insulin, but are destroyed during the onset and early stages of T1D, so researchers have been looking at drugs that can assist the beta cells.
One drug under the microscope is VC-01, which is being examined as a potential stem cell-derived therapy for patients with T1D. Although more research is needed, drugs like these could revolutionize diabetes care by providing an alternative source of insulin-producing cells, potentially freeing type one diabetics from daily insulin injections or pumps.
Researchers have also been able to treat diabetes in mice with lab-made beta cells, a development that is being hailed as a potentially major breakthrough.
Improved tools for managing T1D
While promising advancements in artificial organs and drug treatments exist, thousands of Canadians still have to deal with T1D and its complexities every day. Fortunately, a combination of diligent medical care, daily insulin injections and frequently monitoring glucose levels can help. These daily tasks have been made easier over the years. To better manage insulin injections, the insulin pump was invented and became portable in the 1980s. The pump is a battery-powered device that mimics a functioning pancreas by injecting specific doses of insulin under the skin at pre-programmed times.
In addition, ongoing glucose monitoring has become easier with the continuous glucose monitor, which uses a small sensor that’s injected under the skin to measure glucose levels and transmit them to a wireless monitor. This replaces the need for repeatedly pricking the skin to draw blood to test with a blood glucose monitor, and provides valuable information about how glucose levels fluctuate during the day and in response to meals.
Although T1D is a serious condition to live with, medical research in Canada and around the world is making strides in treating T1D all the time, giving hope and showing promise for the future. In the meantime, people with T1D can best manage their condition by eating a healthy diet, exercising and keeping their health in top shape.