Managing diabetes with nanomedicine: challenges and opportunities

Abstract

Nanotechnology-based approaches hold substantial potential for improving the care of patients with diabetes. Nanoparticles are being developed as imaging contrast agents to assist in the early diagnosis of type 1 diabetes. Glucose nanosensors are being incorporated in implantable devices that enable more accurate and patient-friendly real-time tracking of blood glucose levels, and are also providing the basis for glucose-responsive nanoparticles that better mimic the body’s physiological needs for insulin. Finally, nanotechnology is being used in non-invasive approaches to insulin delivery and to engineer more effective vaccine, cell and gene therapies for type 1 diabetes. Here, we analyse the current state of these approaches and discuss key issues for their translation to clinical practice.

Microneedle-array patches loaded with hypoxia-sensitive vesicles provide fast glucose-responsive insulin delivery

“…Instead of using enzymatically induced pH changes (3,8), for the first time to our knowledge, we have taken advantage of the local generation of hypoxia due to the consumption of oxygen in the enzymatic reaction as a trigger for rapid insulin release in response to hyperglycemia. To achieve hypoxia-responsive transduction, 2-nitroimidazole (NI), a hydrophobic component that has often been applied in cancer imaging due to its high sensitivity to the hypoxic condition in tumor sites, was used (24,25).…”

“…However, such pH decrease-dependent methods are often compromised by slow responsiveness, especially in a buffered physiological environment (8). Taken together, challenges remain to demonstrate a method that would combine (i) fast responsiveness with pharmacokinetics similar to normal pancreatic activity, (ii) ease of administration, and (iii) biocompatibility without long-term side effects (3).…”

“…The traditional care for people with diabetes often requires monitoring of blood glucose and insulin injections to maintain normoglycemia (5). However, such self-administration is associated with pain and often inadequate glucose control (6)(7)(8). Poor glucose control accounts for a high risk for complications of diabetes, including limb amputation, blindness, and kidney failure.…”

“…Current closed-loop systems combine a glucose-monitoring module and a sensor-triggered insulin releasing module (6, 7). There are closed-loop electronic/ mechanical devices that use a continuous glucose-monitoring sensor calibrated by the patient and an external insulin infusion pump (8). However, challenges associated with such devices, such as guaranteeing accurate signal feedback and preventing biofouling, still persist.…”

Transgene and islet cell delivery systems using nano-sized carriers for the treatment of diabetes mellitus

“…However, hypoxic conditions in intramuscular and subcutaneous spaces have been reported to reduce the survival of transplanted islet cells [94–96]. To overcome this problem, artificially modified islet cells transplanted into intramuscular and subcutaneous spaces have been studied.…”