[HN Gopher] An implantable device could enable injection-free co...
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       An implantable device could enable injection-free control of
       diabetes
        
       Author : thebigspacefuck
       Score  : 143 points
       Date   : 2023-10-08 02:09 UTC (20 hours ago)
        
 (HTM) web link (news.mit.edu)
 (TXT) w3m dump (news.mit.edu)
        
       | dave8088 wrote:
       | " Most patients with Type 1 diabetes have to monitor their blood
       | glucose levels carefully and inject themselves with insulin at
       | least once a day."
       | 
       | Once a day lol. Tell me you don't know anything about Type 1
       | diabetes without telling me you don't know anything about type 1
       | diabetes.
        
         | [deleted]
        
         | epilys wrote:
         | If you have type 1, you too can lead a normal life if you don't
         | do any physically demanding activity, eat nothing, have no
         | stress, do not get any common infection like the common cold,
         | do not have any natural metabolic rate changes.. etc etc /s.
         | 
         | There are so many things that affect blood sugar both in the
         | short and long run. T1D treatment is constant correcting for
         | the past hours, not just the moment and future.
         | 
         | I wish it was easier to communicate this to people and
         | journalists, because there are so many misconceptions like the
         | one quoted here that makes T1D an even more invisible
         | disability.
        
         | t-writescode wrote:
         | Heya! You seem knowledgeable about this. What is a normal
         | amount?
         | 
         | Thanks!
        
           | terminalcommand wrote:
           | One fast acting insulin per meal and one long term insulin a
           | day, 4 at minimum if you eat 3 meals. Most of us use insulin
           | pumps where we can get insulin any time we want.
        
           | stranded22 wrote:
           | Before being on an insulin pump, my wife would be injecting
           | 1-2 times a day with long acting insulin (to manage
           | background levels) and then at least 3 times a day with food
           | - not just meals, snacks too (and if levels running high). So
           | realistically, 8-10 times a day would not be uncommon.
           | 
           | That's after 3-5 times a day finger pricks too.
           | 
           | Now, she just has the pain of the libre once a fortnight and
           | pump every few days (along with finger pricks when the libre
           | is out).
           | 
           | People do not realise how all consuming T1D is - she has to
           | be on the ball all the time. If she isn't, then her numbers
           | screw up and she can't drive (or live, tbh).
           | 
           | This project could make a huge difference to her life - but
           | there are always 5-10 years away
        
             | kakoni wrote:
             | At the moment open source artificial pancreas systems are
             | way to go.
             | 
             | Have you checked androidaps or loopkit?
        
               | stranded22 wrote:
               | I had a look over the years - the libre can pretty
               | unreliable with levels, so I am concerned about someone
               | else's life being in jeopardy if I made a mistake (would
               | be different if it was my own - I'd have done it a long
               | time ago)
               | 
               | She's waiting for a closed loop system from her hospital
               | - should be within the next few months (omnipod is due an
               | upgrade). That said, I'll check out androidaps and loop
               | kit, thank you!
        
               | ninjin wrote:
               | The Libre has been life changing for me, but in
               | particular during sleep I do find that the levels can be
               | _very_ unreliable if you end up sleeping on the same side
               | as where you have attached the sensor.
        
               | bdcravens wrote:
               | I have a Dexcom, and it's frequently 10-20% off of manual
               | finger sticks. When paired with my pump (Tandem T-Slim)
               | it keeps me in a good range, but still not perfect.
        
               | [deleted]
        
               | nonplus wrote:
               | I briefly used the libre 3, and found it very accurate
               | (but was skeptical as the 2 and 1 could not even warn you
               | about a low/we're passive) and durable. Currently on the
               | Dexcom G7, waiting for support for either of these with
               | my pump.
               | 
               | The libre3 and G7 seem to be leaps and bounds better than
               | anything else I've used (G4, G5, Guardian 3).
               | 
               | I hope you two find something that works well!
        
               | Scotrix wrote:
               | I'm actually using the Libre + Omnipod Dash with a closed
               | loop and it works pretty well (almost ,,flat" blood sugar
               | with a few spikes here and there) beside that's, for me
               | as tech nerd, cool to inject insuline with my phone :-).
               | 
               | Those are the pieces I'm using on my iPhone:
               | 
               | https://nightscout.github.io/ -> to store historical data
               | 
               | https://github.com/Artificial-Pancreas/iAPS -> to connect
               | the libre and pump and control the pump and make the
               | close loop
        
               | paulcole wrote:
               | > At the moment open source artificial pancreas systems
               | are way to go.
               | 
               | He said confidently lol.
               | 
               | I won't give up multiple daily injections (Lantus morning
               | and night, Humalog with meals and for corrections) unless
               | I absolutely have to. Diagnosed in 2014 at around 30
               | years old. Been 5.5-5.9 A1C for the past ~6 years. Maybe
               | one scary low a year and able to keep up with my marathon
               | running and live a semi-normal life.
               | 
               | No clue why I'd want to mess with that to try some hacker
               | project.
        
         | terminalcommand wrote:
         | Another T1 here, fast-acting insulin wasn't invented until
         | recently. One large dose of mixed insulin and a fixed diet may
         | have been prescribed back in the day.
        
           | consp wrote:
           | Before fast acting there was human analog, this is also
           | somewhat short term. What was quite common for a while was
           | the mixed insulins (the cloudy ones you would have to make
           | sure mixed before injecting) which you took twice a day. The
           | same could be achieved with individual doses of course. In
           | general the very long acting insulins are highly variable and
           | not much subscribed (as in they work between 12 and 48h, good
           | luck if it varies a lot).
           | 
           | Long story short, NPH insulins for medium length (about 18h
           | to a day but still lots of variation) was available since the
           | 50's and was usually combined with normal human analog in
           | either a mixture taken twice a day or in separate doses. I
           | was on the twice a day regime of mixtard for most of the
           | 90's.
        
             | terminalcommand wrote:
             | Thank you for enlightening us, I was diagnosed around 2004.
             | At that time, fast acting insulin was the norm. But I knew
             | that some patients used mixed insulin.
             | 
             | I still know T1Ds who continue to use mixed insulin,
             | because it works for them.
        
               | eep_social wrote:
               | Lantus was approved in 2000. Diagnosed in early 2001, I
               | spent maybe six months on NPH before they got me switched
               | over. There's also regular which is a mix of nph and fast
               | acting, I still hear of people using that now as it works
               | okay and is very cheap.
        
           | eep_social wrote:
           | > Another T1 here
           | 
           | There are dozens of us! Dozens!
        
       | blackle wrote:
       | > generates oxygen by splitting water vapor found in the body
       | 
       | This will also generate hydrogen. Is there any mention in the
       | paper about what happens to the waste hydrogen? I can't get past
       | the paywall and I'm curious
        
         | Expez wrote:
         | The article says it will "diffuse away" which implies they just
         | let it escape the device. It'll then move through the tissue /
         | fluids, reach the blood and eventually be breathed out. I did a
         | quick google search to see if we already had some level of
         | hydrogen gas in our body.
         | 
         | It seems that bacteria in the human gut already produce some
         | hydrogen gas and that breath contains measurable levels of
         | it[0]. This was news to me, but means that dumping a tiny
         | amount of H2 into the body is probably fine.
         | 
         | [0] https://link.springer.com/article/10.1007/s00216-013-7606-6
        
         | jaggederest wrote:
         | Hydrogen in the body is not normally a problem. It's such a
         | light gas that it diffuses out the lungs readily, if it's in
         | diatomic form, and your body has good mechanisms for dealing
         | with ionized hydrogen already.
         | 
         | Most people's gut already produces hydrogen (normal levels at
         | or below 16ppm in breath)
        
           | CommitSyn wrote:
           | That's in the gut, but I wonder how that works when it's
           | pumped out into the subcutaneous fat layer.
        
             | kadoban wrote:
             | It's an interesting question, but I suspect it's not a big
             | deal. H2 is _very_ good at escaping, doesn't really do
             | anything biologically, and our bodies already have ways to
             | get rid of small amounts of gas from various places.
             | 
             | I'm curious if it'd just do the same thing that CO2 does.
             | That might all just be governed by physics and there
             | probably isn't much chemistry involved in that being
             | expelled after it's generated in cells?
             | 
             | I looked up the solubility of H2 in water, and it is _much_
             | worse than CO2's, so maybe that does suggest it'd at least
             | not use the same mechanisms to escape, not sure.
        
         | willcipriano wrote:
         | Something like this happens:
         | https://m.youtube.com/watch?v=YD-3vE_R7p8&pp=ygUoY2hhcmxpZSB...
        
         | bookofjoe wrote:
         | https://archive.ph/QFUXb
        
       | idontknoworcare wrote:
       | [flagged]
        
         | cursuve wrote:
         | I like how you think you just found the cure to Type 1
         | Diabetes...
         | 
         | It doesn't work like that. People on keto/carnivore still need
         | insulin to digest the protein and proteins will still
         | eventually elevate the blood sugar.
         | 
         | https://pubmed.ncbi.nlm.nih.gov/9416027/
        
         | GordonS wrote:
         | Doesn't that only work for T2 diabetes?
        
       | jmercouris wrote:
       | Why does the radio antenna need to be outside of the body for
       | energy harvesting? Why not just use a pair of terminals in that
       | case?
        
         | scotty79 wrote:
         | "A tuned magnetic coil located outside the body transmits power
         | to a small, flexible antenna within the device, allowing for
         | wireless power transfer."
         | 
         | Energy reciever is completely inside the body and the energy
         | transmitter completely outside. Piercing skin for prolonged
         | times is generally a very bad idea because it's a channel for
         | infection.
        
           | jmercouris wrote:
           | I see, thank you! I had totally misunderstood.
        
       | alexcaps wrote:
       | I would love to finally see some progress here. Worked on
       | something similar 20+ years ago and got so burned out by the
       | process and huge amount of capital needed.
       | 
       | https://www.inknowvation.com/sbir/companies/solgene-therapeu...
       | 
       | " Solgene Therapeutics' patented drug-delivery technology enables
       | the encapsulation, in a porous ceramic material, of living cells
       | that secrete therapeutic compounds. After implantation, the
       | material shields the encapsulated cells from the host's immune
       | system while allowing passage of nutrients and therapeutic cell-
       | secreted compounds. Implanted cells continue to function, thus
       | mimicking natural processes. Solgene believes it can create
       | competitive advantages in under-served biotech markets. It seeks
       | revenues through alliances to commercialize hard-to-deliver,
       | cell-secreted, large-molecule therapies. Solgene proved its
       | concept by overcoming diabetes in diabetic mice. Target
       | applications include delivery of livestock therapies, growth
       | factors for bone healing, and a cell-secreted HIV therapy."
        
       | wolverine876 wrote:
       | For the oxygen supply there's a techology, already widely used,
       | that runs 24/7 with no marginal maintenance cost. It takes O2
       | from the environment and outputs waste as a gas back into the
       | environment, has a distribution system that can reach the entire
       | body, and even its own pump that is self-repairing and typically
       | lasts 70-100 years.
       | 
       | Seriously, why not extract O2 from the bloodstream? Is it that
       | difficult? I don't doubt they considered this option; I just
       | wonder what the issues are.
        
         | CommitSyn wrote:
         | Speaking as a layman here.
         | 
         | I do know which one is safer, as to gain access to blood you
         | have to gain access to a vein, likely by inserting a small tube
         | made of [something] inside the vein, expect it to never break
         | down and enter the bloodstream, become compromised, or be hit
         | with an impact and tear the vein open to create internal
         | bleeding. Then you also have to have a system to get rid of the
         | waste blood (everything but the small amount of oxygen you
         | want) all entirely within a closed system implanted into the
         | arm, thigh, etc.
        
           | wolverine876 wrote:
           | > vein
           | 
           | Artery - not a lot of O2 in veins.
           | 
           | But other than nitpicking defensively, I agree those good
           | points. I'd still like to see what any actual bio-whatever
           | engineers have to say.
        
           | nonplus wrote:
           | Also a layman (but t1d), I believe what you are saying is
           | correct/Insulin is injected into fatty tissue, and I presume
           | this implant would go in fatty tissue. Getting to a vein
           | sounds like a much higher risk.
        
       | XorNot wrote:
       | This is the coolest bit of biotech I've seen lately because the
       | approach feels very complete: custom cells so the device is self-
       | regenerative, and an encapsulation system so it's protected from
       | the immune system.
       | 
       | It does make you wonder what else could be done: i.e. could we
       | implant some cells which produce antivenom?
        
         | chpatrick wrote:
         | Or drugs like in Culture.
        
           | inhumantsar wrote:
           | Out of all the wild future tech in those books, a universally
           | accessible easily controllable gland capable of pumping out
           | whatever molecules the body could use, from hormones to party
           | drugs, still stands out as the single most beneficial thing
           | possible.
        
             | CommitSyn wrote:
             | As a kid I had an idea for a pill that would do that. I had
             | no idea how it would work if course, but I thought one day
             | in the future we could have a pill that you took that
             | detected issues with the body and produced the needed drugs
             | to fix it, so nobody needs to take a bunch of pills or the
             | wrong pills. I'll have to read it.
        
       | onetokeoverthe wrote:
       | [dead]
        
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