Feb 13, 2015 — For patients with type 1 diabetes (T1D), the burden of constantly judging when and how much insulin to self-inject is bad enough. Even worse, a miscalculation or lapse in regimen can cause blood sugar levels to rise too high, potentially leading to heart disease and other long-term complications, or to plummet too low, which in the worst cases can result in coma or even death. Danny Chou, Ph.D., USTAR assistant professor of biochemistry, has helped develop a “smart” insulin that automatically adjusts blood sugar in mice with a diabetes-like condition. He discusses his research results and what it could mean for diabetes treatment in the future. Learn more about the research.


Interviewer: A new smart insulin could change diabetes treatment. Up next on The Scope.

Announcer: Examining the latest research and telling you about the latest breakthroughs. The Science and Research Show is on The Scope.

Interviewer: I'm talking with Dr. Danny Chou, USTAR assistant professor in biochemistry at the University of Utah. Dr. Chou, your discovery could really make a big difference in the lives of people with diabetes. Tell us about what you found.

Dr. Chou: So, we used a chemical approach to modify the native insulin molecule, and what we're trying to do is to have insulin that will be activated when the blood glucose level is high, so in the way that further regulate blood glucose level better for diabetic patients.

Interviewer: So, already, your work in mice would suggest that what you've developed is, I think, better than anything that's out there right now. Is that true?

Dr. Chou: Yes, because right now in the market, there are fast-acting insulins for meal-time use and there are long-acting insulins for basal level use. So basically there's no such insulin in the market right now that could provide any kind of glucose-regulated or glucose-responsive way.

Interviewer: And it seems like the results that you saw in mice were pretty striking. What did you see?

Dr. Chou: So what we see is that we could only do one single injection of this modified insulin, and then what we see is we could do three glucose tolerance test, which is kind of like a meal for the mice, and then we could see that one injection could be good for three different meals within a 13-hour span. So we really think this a very amazing and a very exciting result. But as we just mentioned, this right now is only in mice work and then we would try to see whether we could prove the safety of these insulins and one day we could put it into the clinical phase.

Interviewer: So, how long do you think it might take to get to the clinical phase?

Dr. Chou: So, we are thinking about a three-to-five year range.

Interviewer: For those of us who may not be familiar with living with diabetes, can you explain what some of the problems are that you're trying to address?

Dr. Chou: So, in the case of Type 1 diabetic patients, they do not have any insulin production inside their bodies. So, people with Type 1 diabetes, they have to totally rely on external source of insulin. And insulin is a drug that is not like you could put as much as possible and then you would still be okay. The thing is that you need to maintain your blood-glucose level in the normal range. So, when you inject too much insulin, that will give you a case of hypoglycemia, which will kind of cause dizziness, or in coma, or even death. So that's why people are afraid of injecting too much insulin inside a body.
However, if you do not inject enough insulin, that will give you a constant high-glucose levels, which is called hyperglycemia, and in the long run, that will lead to diabetic complications like kidney disease, eye blindness, or amputations. So, that's why we are trying to develop a special insulin in the way that its activity could be controlled by itself. So, basically, the activity is controlled by the blood-glucose levels inside your body. So, in that way, people with diabetes, they do not need to worry about the high or low glucose levels because the insulin itself is smart enough to control the glucose level inside a wide range.

Interviewer: You know, as it is, what you've developed is really incredible, but it sounds like you're also going to work on improving it.

Dr. Chou: Yes. So right now, I think we have already done a pretty good job in developing an insulin that could be used to reduce the high glucose level back to normal range during the meal time. But I think what we could still improve is in the hypoglycemic end. So what we try to do is we try to have the ideal insulin that the activity of insulin will be stopped or blocked when the glucose level is around, say, 80 milligram per [inaudible 00:04:33]. So, we will never need to worry about inducing hypoglycemia with this insulin injection.

Announcer: Interesting. Informative. And all in the name of better health. This is The Scope Health Sciences Radio.