The most obvious question is how dosing would be calculated since we all adjust our doses constantly. Illness, stress, hormones, exercise & countless other variables effect what we do & how we do it. One thing with mice, rats & rabbits on a carefully controlled diet & another with humans. It seems that a rapid acting insulin would be needed for correction, so it might not truly be a monthly one shot scenario.
The links, which all have the same info & are basically press releases, don’t go into any detail of how time released insulin responds to food when we don’t need a trickle. Smart insulin in theory responds to BG levels to release as needed without highs or lows.
As always, the future date is 4-6 years away.
This is an interesting statement from one article: “Indians are more prone to develop diabetes thanks to a high-fat diet and a tendency to gain weight in the abdomen.” What does that have to do with auto-immune T1? Or even T2?
Yes, I saw a program called “Young Turks” which deals with business entrepreneurs in India and the company manufacturing this insulin was profiled. I have a very good feeling about this, as well as Smart Insulin. And here’s the good news… India does not have to go through the FDA process so we should know in a reasonable amount of time how successful this is. Even if we could use this as an aid to injected insulin or the pump, perhaps keeping an ongoing 75 percent of basal running through this injection, controlling the rest through the insulin pump, we would be interested. The timeframe was five or six years and, since they do not have to face the restrictions we do bringing this drug to market, we will know soon.
ARRGH! So I guess the timeframe will have to be expanded to ten to fifteen years? It would be nice to have some new technology on the market before she starts college and has to handle this daily tightrope on her own.
Actually the flying car already exists. Look here in link. http://video.yahoo.com/watch/7795222/20620979
It’s based on a paper that came out a while back, and I personally don’t believe it is the ‘smart insulin’ that is sometimes claimed. I DO, however, believe that it could be a long-lasting ‘basal’ insulin. I don’t want to dismiss it as an advance; a long-lasting basal could be very useful for some patients. But I won’t give up my pump’s ability to tightly control basal in favor of it. And as Gerri said, dosing could get tricky.
The reason I doubt that this is a ‘smart’ insulin is that, in the published paper, they tested it in chemically diabetic mice which typically retain some beta cell function. So they’re more like honeymooning T1D or T2D than full-fledged T1D, which means a few things: 1) Like some in those patient groups, some of the mice will do ok on basal insulin without bolus insulin making them appear totally euglycemic, 2) Mice regenerate beta-cells much faster than humans so recovery is more likely in such an animal model, and 3) Most long-term human T1Ds lose glucagon responses to hypos due to the insulin loss and will probably be more prone to hypoglycemia than a mouse that retains even a small amount of insulin production.
I have to jump on you a bit, John, about the “Unfortunately…US hands now” comment.
The first synthetic human insulin, Humulin was developed by the gene splitting geniuses at Genentech, a US company. US scientists aren’t all bad.
Unless you are talking about the fact that it took them about 4 years to get FDA approval and about another year for it to actually be produced commercially by Eli Lilly.
Gotcha JohnG
Would be nice, of course. One has to dream before making a previously unheard of thing a reality. It’s trickier with the human body however than with inanimate objects…
But thumbs up for starting at square one with the dream.
John,
Can see you’re a Lewis Black fan. I am also!
Agreed!
Smart Insulin purports to work in an entirely different manner than previous long term basal insulins. A long term basal would be very helpful for pumpers – if the action was stable like Lantus. One shot covering 70 percent of basal would eliminate the possibility of ketoacidosis. You might be able to take the pump off for hours at a time. You can easily control the percentage of basal not covered by the insulin through the insulin pump. A 70 or 80 percent basil would still “leave room” for modification via pump. I think this would also eliminate a lot of highs. In Third World countries this insulin could mean the difference between life and death. Yes, you can do the same untethered regimen with one Lantus shot a day but Lantus stings. Most kids do not want to take a Lantus shot in addition to site changes for the pump. This shot would not have to be given every day.
Sounds goofy. But you never know.
Re-read my post, please. I know what smart insulin is and iterated the specific reasons that I believe that this is long-term basal and not smart insulin. A long-term basal is NOT a smart insulin, no matter how you slice it. I also clearly said that a long-term basal could be useful for some, but not for me. As an avid runner, I need as much control over basal as I can get, whatever the risk of DKA is. I’ve tried a 65% lantus / 35% pump basal untethered regimen with lantus and it simply does not provide the same level of control that pump alone does. I wouldn’t chose it, plain and simple.
Lol!
This is kind of old news already but Tom is correct. I think this insulin was designed to release small increments of insulin for a long long period of time. I doubt it will be glucose responsive in humans though its claiming to adapt to meal spikes and not cause hypos. As far as smart insulin goes though they don’t have any proof yet in humans the fact that it was used up to 4 times actual needed dosage and hasn’t shown hypos is outstanding. I don’t see why that wouldn’t translate into humans. If injecting an animal that doesn’t have the ability to counteract an insulin surge and Smart Insulin doesn’t lower it any lower then a baseline level of say 90 no matter how much is injected then I can’t see any reason this won’t work. I’d kill to be involved in those trials when they start. If it works I’d want to stay in the trial until its commercialized.
Snake oil
