Diabetes Research
Diabetes Research: The Search For The Silver Bullet
Beginning and Ending in Diabetes Research?
Before 1921 it was known that there was a link between the Islets of Langerhans in the pancreas, its secretions and diabetes. In that year, a Canadian surgeon, Frederick Banting thought he could derive a sufficiently pure extract from the Islets of Langerhans in appropriately prepared dogs. When this was done he produced isletin (now known as insulin). This was tested on dogs rendered diabetic and blood sugars were kept within bounds by use of the extract.
Later in 1921 there were further researches which confirmed the earlier success. Extraction of isletin took about six weeks. The use of fetal calf pancreas accelerated the process. In December 1921, work was done on purification of the extract. In January 1922, a young diabetic was treated with isletin, which was further refined and administered for a second time with complete success. In a highly dramatic demonstration of the effectiveness of this diabetes research, a whole ward of dying diabetic children was injected with the purified extract with immediate, coma-reversing effect.
More Diabetes Research
The drug firm Eli Lilly and Co. made a major breakthrough in refining the extract and produced large amounts of purified insulin, which was soon marketed. So it continued until the late 1970s when Genentech produced synthetic ‘human’ insulin in the lab. Eli Lilly and Genentech entered into partnership and in 1982 synthesised human insulin branded Humulin went on sale. Most insulin now in use is bio-synthetic ‘human’ insulin or its analogs. Insulin analogs have been developed to have the same effect on blood sugar levels as ‘normal’ human insulin but with characteristics tailored for quicker take-up (such as insulin lispro) or extended release (such as insulin glargine). The former is effective in about 15 minutes and the latter, while avoiding the peaks and troughs in regular insulin levels, remains effective up to 18 to 24 hours.
Further Diabetes Research
Research discovered a hormone (exendin-4), in the saliva and tail of the Gila Monster, which was close to human glucagon-like peptide 1, (GLP-1). GLP-1 regulates the metabolism of glucose and the secretion of insulin. Eli Lilly and Co. and Amylin Pharmaceuticals manufacture and market a sythesised version of the hormone named Exenatide and branded Byetta. It is claimed that Exenatide enhances the secretion of glucose-dependent insulin by beta-cells in the pancreas, while also suppressing abnormally high glucagon secretion, slowing gastric emptying, reducing liver fat and promoting weight loss. Although still being studied, Exenatide has been approved for Type II diabetics who have not responded sufficiently well to ‘traditional’ therapies with metformin, sulfonylurea, thiazolidinediones, or a combination of metformin and sulfonylurea or thiazolidinediones.
Other Diabetes Reseach
Research continues into the impact of diet and exercise on diabetes. The reversal of George W Bush’s stem cell research policy opens the way for promising research into diabetes. Researchers are genetically engineering cell function to protect insulin-producing islet cells and direct stem cells to become islet cells. Islet cells have been transplanted in other diabetes research programs.
Future Diabetes Research
Synthesised insulin is now made using genetic engineering techniques, (recombinant DNA technology). Researchers have introduced the gene for human insulin into safflower, with a view to growing insulin at considerably reduced cost.
As indicated in our introductory article, Diabetes, insulin cannot be orally ingested as it does not survive intact the gastrointestinal tract. This issue has been the subject of considerable diabetes research, and human clinical trials have recently been undertaken. Successful trials would be commercially exploited in a matter of a few years.
Until then, insulin will continue to be taken by subcutaneous injection via disposable syringe, insulin pump, or insulin pen.
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