Why is it in the news?

• Scientists have achieved a significant breakthrough in creating “smart” insulin, often termed the “holy grail” of diabetes treatment.
• This innovative insulin responds in real time to fluctuations in blood sugar levels, addressing the urgent need for effective treatments as diabetes affects over half a billion people globally and is responsible for nearly seven million deaths each year.

More about the news

• Diabetes has two primary types, both linked to the body’s ability to produce and respond to insulin, the hormone that converts blood sugar into energy.
• Type 1 diabetes usually begins in childhood and occurs when the pancreas fails to produce adequate insulin. Conversely, Type 2 diabetes results from the body’s cells becoming resistant to insulin, necessitating greater amounts than the pancreas can provide.
• Both types are managed with synthetic insulin, which poses challenges due to the variability of blood glucose levels. Overdosage can lead to dangerously low blood sugar, making constant monitoring and dose adjustments essential for patients.
• For decades, scientists have sought to develop glucose-sensitive insulin therapies. The most advanced systems so far involve storing insulin in the body, which is released based on blood sugar levels detected by external sensors.
• However, the latest study, published in Nature, features an international team from Denmark, the UK, Czechia, and the University of Bristol who have engineered the insulin molecule itself, incorporating an “on-and-off switch” that automatically reacts to changes in blood glucose levels.
• The newly developed insulin, called NNC2215, consists of two components: a ring-shaped structure and a glucoside molecule resembling glucose.
• When blood sugar levels are low, the glucoside binds to the ring, keeping the insulin inactive to prevent further lowering of blood sugar. As glucose levels rise, the glucoside is replaced by glucose, triggering a shape change that activates the insulin, allowing it to reduce blood sugar to safer levels.
• The Director of Research at Diabetes UK noted that this advancement could ease the ongoing challenge of managing blood sugar levels and improve the physical and mental well-being of millions who depend on insulin therapy.
• Currently, a major challenge with NNC2215 is that its activation is not gradual; it requires a significant glucose spike, leading to a sudden surge of insulin in the system.
• Researchers are working to refine the molecule for a more gradual activation, enabling insulin levels to rise slowly and safely.