An all-in-one approach to diabetes treatment

Date:
January 20, 2022
Source:
Massachusetts Institute of Technology
Summary:
A team of researchers has come up with a new approach to
streamline the process that people with diabetes use to estimate the
carbohydrate content of a meal, draw blood to measure current blood
glucose levels, and calculate and deliver the correct insulin dose.



FULL STORY ========================================================================== Before consuming a meal, many people with diabetes need to inject
themselves with insulin. This is a time-consuming process that often
requires estimating the carbohydrate content of the meal, drawing blood
to measure blood glucose levels, and then calculating and delivering
the correct insulin dose.


========================================================================== Those steps, which typically must be repeated for every meal, make it
difficult for many patients with diabetes to stick with their treatment regimen. A team of MIT researchers has now come up with a new approach to streamline the process and help patients maintain healthy glucose levels.

"Any intervention that makes it easier for patients to receive therapy can
have an enormous impact, because there are multiple barriers that have
to do with time, inconvenience, dexterity, or learning and training,"
says Giovanni Traverso, the Karl van Tassel Career Development Assistant Professor of Mechanical Engineering at MIT and a gastroenterologist at
Brigham and Women's Hospital. "If we're able to overcome those barriers
through the implementation of new engineering solutions, it will make
it easier for patients to receive that therapy." Traverso and his
colleagues designed two different devices that can simplify the process
of calculating and injecting the correct dose of insulin. One, which
combines many of the existing steps into a single device, could be used in patients in the near future. Their second prototype incorporates flexible electronics onto the surface of a needle so that the blood measurement
and insulin delivery can happen through the same needle. This could
eventually make the process of managing diabetes even more streamlined.

MIT postdocs Hen-Wei Huang and Sean You, and visiting students Luca Di
Tizio and Canchen Li, are the lead authors of the paper, which appeared recently in the Journal of Controlled Release.

All-in-one device Diabetes affects 34 million people in the United States
and more than 400 million people worldwide. Patients with diabetes often
use two types of insulin to control their blood sugar levels: long-acting insulin, which helps control glucose levels over a 24-hour period, and short-acting insulin, which is injected at mealtimes. Patients first
measure their blood glucose levels with a glucose meter, which requires pricking their finger to draw blood and placing a drop of blood onto a
test strip. They must also estimate how many carbohydrates are in their
meal and combine this information with their blood glucose levels to
calculate and inject the proper insulin dose.



========================================================================== Existing technologies such as continuous blood glucose monitors and
insulin pumps can help with some parts of this process. However, these
devices are not widely available, so most patients must rely on finger
pricks and syringes.

"Every day, many patients need to do this complicated procedure at least
three times," Huang says. "The main goal of this project is to try to facilitate all of these complex procedures and also to eliminate the requirement for multiple devices. We also used a smartphone camera
and deep learning to create an app that identifies and quantifies
food content, which can aid in carbohydrate counting." The research
team devised two different types of "all-in-one" devices, both of which incorporate the new smartphone app. Patients first take a picture of the
food, and the app can then estimate the volume of food and also the amount
of carbohydrates, based on nutrient information from a USDA database.

The first all-in-one device that the researchers designed consolidates
many of the existing tools that patients use now, including a lancet for drawing blood and glucose test strips. Once the blood glucose measurement
is taken, the device conveys the information to the smartphone app via Bluetooth, and the app calculates the correct insulin dose. The device
also includes a needle that injects the correct amount of insulin.

"What our device is doing is automating the procedures to prick the skin, collect the blood, calculate the glucose level, and do the computation and insulin injection," Huang says. "The patient no longer needs a separate
lancing device, glucose meter, and insulin pen." Many of the components included in this device are already FDA-approved, but the device has not
been tested in human patients yet. Tests in pigs showed that the system
could accurately measure glucose levels and dispense insulin.



==========================================================================
A single jab For their second device, the researchers wanted to come up
with a system that would require just one needle prick. To achieve that,
they designed a novel glucose sensor that could be incorporated into
the same needle that is used for insulin injection.

"The idea would be that if we can integrate the glucose sensor directly
onto the surface of the insulin delivery needle, we would only need one
stick for the patient, which minimizes pain and also makes the whole
process easier to administer," You says.

The researchers designed a flexible electronic sensor that can be attached
to the needle and measure glucose levels in the interstitial fluid,
just below the surface of the skin. Once the needle penetrates the skin,
it takes between five and 10 seconds to measure the glucose levels. This information is transmitted to the smartphone app, which calculates the
insulin dose and delivers it through the inserted needle.

In tests in the pigs, the researchers showed that they could accurately
measure glucose levels with this system, and that glucose levels dropped
after insulin injection.

Because this device uses a novel type of glucose sensor, the researchers
expect that it will require further development to get to a point where
it could be tested in patients. They have filed for patents on both of
the systems described in the new study and hope to work with companies
to further develop them.

The research was funded by the MIT Department of Mechanical Engineering
and Brigham and Women's Hospital.

========================================================================== Story Source: Materials provided by
Massachusetts_Institute_of_Technology. Original written by Anne
Trafton. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Hen-Wei Huang, Siheng Sean You, Luca Di Tizio, Canchen Li,
Erin Raftery,
Claas Ehmke, Christoph Steiger, Junwei Li, Adam Wentworth, Ian
Ballinger, Declan Gwynne, Kewang Nan, Jia Y. Liang, Jason Li,
James D. Byrne, Joy Collins, Siddartha Tamang, Keiko Ishida,
Florencia Halperin, Giovanni Traverso. An automated all-in-one
system for carbohydrate tracking, glucose monitoring, and
insulin delivery. Journal of Controlled Release, 2022; DOI:
10.1016/j.jconrel.2022.01.001 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/01/220120135123.htm

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