Nanomedicine to fight diabetes

Nanomedicine: a sweet spot in fighting diabetes

Even if diabetes is no longer the acute life-threatening condition it was before the exogenous insulin treatment was discovered, it is still the fifth most common cause of death in the UK. Moreover, diabetes is a disease which deeply affects patients’ quality of life and can even lead to severe secondary illnesses such as blindness and neuropathies. Nowadays two trends related to diabetes are observable:

  1. A dramatic increase in the number of patients with Type II diabetes mellitus (T2DM), a lifestyle- and obesity-related dysfunction of glucose regulation
  2. The disease increasingly occurs in earlier ages, often during adolescence or even childhood, while in the past it affected mainly the elderly

Type I diabetes (T1DM), or juvenile diabetes, is due to the autoimmune-induced complete destruction of insulin-producing beta-cells in the pancreas. The only treatments available require lifelong injections of exogenous insulin several times per day. On the contrary, early stage T2DM can be treated by changes in diet, by increasing physical exercise, and by drugs delaying the glucose uptake in blood. The multiple injection of insulin in late T2DM (after exhaustion/destruction of the beta cells) and in T1DM affects patients’ quality of life as it is lifelong, invasive, painful and hence particularly difficult for small children. Moreover, it does not allow complete control over the glucose level, which is the worst case leads to neurologic or vascular disorders. For several decades, the main research focus in the fight against diabetes has centred around the development of improved non-invasive monitoring and insulin administration, as well as the transplantation of pancreatic islets without immune suppression in T1DM-affected children.

How small can make a big difference

Nanomedicine – the use of nanotechnologies to solve medical problems – can provide promising advances to improve the quality of life of diabetes patients. Working at the nanoscale with structures that are usually 10-100 times smaller than a body’s cell but only little larger than molecules makes possible the treatment of the origin of diabetes at the molecular level.

For instance, research projects studying the delivery of insulin in the form of nanoparticles into the nose, or into lungs as a spray, or through the gastrointestinal tract as a pill, are underway. In each case, non-invasive and painless application routes have been opened by the use of nanoparticles. Furthermore, tests are currently being conducted on nanomaterials engineered with a glucose responsive coating; these can act as an insulin depot once injected under the skin.

Nano-based innovative sensor systems are also under investigation, with the goal of improving non-invasive or less invasive monitoring of glucose level in the blood. In this regard, an even more advanced approach is a glucose-sensitive tattoo.

Moreover, new immune protective nano-coatings are able to prolong the survival of transplanted pancreatic islets and protect them against the autoantibodies in T1DM patients. This approach targeting T1DM patients would allow them to experience a life without immune-suppressive drugs.

The urgency of new strategies to fight diabetes, which becomes a pandemic disease and leads to a significant shorter life expectancy (10 years in T2DM, >20 years for T1DM), and to high costs for health systems, is undeniable. Novel approaches using advanced nanotechnologies can tackle this societal challenge and will therefore be one of the major research topics in Horizon 2020, the forthcoming EU Framework Programme.

Article published by Dr Silke Krol, PhD from the Fondazione IRCCS Neurologic Institute ‘Carlo Besta’ in Milan and member of the European Technology Platform on Nanomedicine in the International Innovation publication (TechFocus, Issue 117)