Artificial Beta Cells: hope for diabetics

The discovery of a single dose of Artificial Beta Cells (ABCs), which can maintain steady blood glucose levels for as long as five days, is a major breakthrough in the treatment of diabetes. Especially for many diabetic patients who have to jab a needle, sometimes twice or thrice, it would make an important difference. The ABC injection obviates the need for daily insulin injections, according to the study published in Nature Chemical Biology, October 2017.

India, the 'diabetes capital' of the world, has over 70 million diabetic patients. Over the past few decades, diabetes mellitus has hit low and middle-income class families the most. This trend could be attributed to sedentary lifestyles characterised by little physical exercise and an unhealthy diet, besides the genetic predisposition of Indians to diabetes.

The main problem that plagues many diabetic patients is that they have to consume medicines lifelong. Whether the medicine is an injectable or oral formulation, it cannot control blood glucose levels efficiently, in the manner that normal insulin-secreting pancreatic cells are able to. To some extent, transplants of pancreatic cells can solve the problem, but such transplants are expensive and there could be a long wait to get donors.

Researchers, under the guidance of Prof Guin of the University of North Carolina, have made a breakthrough that could benefit diabetic patients across the globe. They have successfully synthesised ABC (Artificial Beta Cells) which have been extremely effective in keeping glucose/blood sugar levels normal.

They administered a single injection of ABC to mice, which restored normal level of glucose within an hour. It also kept the blood glucose levels steady for five days with controlled release and regulation of insulin. If the same results can be re-created in humans, it would significantly benefit those diabetic patients dependent on insulin shots/injection or even mechanical pumps.

Given that around 5% of the country's population suffers from this malady, there should be increased awareness about timely intervention to reduce the burden of this disease. Many people tend to be unaware of the symptoms that precede diabetes.

They are also unaware of the significance of the pancreas, a small gland located at the back of the stomach near the small intestine, which plays a critical role in controlling blood sugar.

Beta cells of the pancreas secrete a hormone called Insulin. This hormone can convert excess glucose in blood to a stored form called glycogen. So, in normal people, even if blood glucose shoots up by intake of more food, insulin can keep the blood glucose under control. Diabetic patients have hampered Beta cells and hence reduced (Type II Diabetes) or zero (Type I Diabetes) insulin production. This leads to increased blood sugar and urine sugar. If untreated, this will adversely impact other organs in the body like the heart and kidney, among others.

Risk of vulnerability

Diabetes can decrease life expectancy by almost 10 years due to the risk of vulnerability to various heart diseases and an almost 20-fold increased chance of lower limb amputations due to impaired nerve and sensory perceptions. In turn, this causes serious infections and bacterial sepsis.

Diabetes can also cause gradual damage to the retinal veins behind the eyes that cause them to bleed or leak fluid, ultimately leading to blurred vision and even blindness. Diabetes has a wide variety of symptoms, such as increased urination, increased thirst and hunger accompanied by sudden weight loss. It is also known to cause recurrent vaginal infections in women and lead to an overall state of fatigue and nausea.

The ABC function more or less like natural Beta cells. Researchers at North Carolina University were successful in recreating the actual process of delivery of insulin by Beta cells and mimicked it to near-perfection. The scientists synthesised ABC which possess a two-layered lipid membrane with specially designed pouches with insulin in them. Whenever there is an increase in blood sugar level, the surfaces of these pouches fuse with the ABC's outer membrane and thereby release insulin into the blood stream.

According to Zhaowei Chen, one of the researchers, "This is the first demonstration using such a vesicle fusion process for delivering insulin". Unlike transplanted Beta cells or genetically engineered cells, these artificial cells can be produced on a much larger scale and enjoy a much longer shelf life. The ABC doesn't cause complications with respect to dosage-related issues and is completely self-sufficient, thereby making it the best bet to combat diabetes.

So far, using pills as a mode of delivery for insulin has remained a challenge despite being conceived decades ago. This is due to the huge size of the insulin molecule which, upon ingestion, is easily degraded by digestive juices and acids. Due to its controlled and almost near-perfect similarity to actual Beta cells, ABC could prove to be a huge leap forward in the management of diabetes. And any potential strategy to treat diabetes would be welcome in India.

(The writers are Associate Professor and undergraduate student, respectively, at the Department of Life Sciences, Christ Deemed to be University, Bengaluru)

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