a mobile device, making non-invasive
continuous monitoring a possibility.
Volume 4 | Issue 1 | January-March 2019
23
Sahana Shankar is a PhD candidate
in Structural and Molecular Biology at
Academia Sinica, Taiwan. When she
is not extracting protein, she loves to
travel, read and writes scicomm articles.
Her passion is to translate the science in
fascinating research papers in health and
medicine into common parlance. She
believes understanding the science behind
the world around us is indispensable
to our engagement with it. She has
contributed to Brainwave, a children’s
science magazine from the Amar Chitra
Katha family and Newslaundry, an
independent news portal.
With medical technology advancing fast,
we may be looking at a future with the
potential to decrease healthcare costs
worldwide to deal with diabetes in its
diagnosis, management and prevention.
The Mexican cave fish has been
established as a new model organism
for studying diabetes. It’s a blind fish
that lives deep in the sea with no access
to light and food for long periods
of time. It has evolved to survive
these harsh conditions by having
an insatiable appetite and insulin
receptors which do not respond in
the presence of high blood sugar. As a
result, the cavefish is severely diabetic
but can function normally. While
this physiological make-up is fatal to
humans, understanding the function of
the glucose regulation in cavefish may
be vital to develop novel therapies for
diabetes management and cure.
The DiRECT study from the Newcastle
University, UK with 300 diabetics aged
20-65 demonstrated that a severe
calorie-restricted diet can result in
remission of Type II in around 86% of
the patients. This is a very promising
result since there is a rapid increase
in obesity and Type II. A strict weight
loss intervention may be a means of
both prevention and cure of Type II
diabetes. Interestingly, Lorcaserin,
a weight loss drug was reported by
Harvard University to reduce the
incidence of diabetes and the risk
of hypoglycemia in patients being
treated for obesity. This is supported
by multiple recent findings from the
neurobiology community that obesity
results in activation of the microglia
cells in the brain and results in
impaired modulation of hormones and
increased glucose levels or resistance
to insulin and hence treating obesity
would also reduce the likelihood of an
array of metabolic disorders.
Wearable technology has translated
to better diagnostic and monitoring
devices for diabetes. We have had
home kits for monitoring blood
glucose levels since 1981, but almost
all variants require blood by pricking
the finger with a lancet. A proof-of-
concept study in South Korea of a
wearable glucose monitor in the form
of contact lenses has been successfully
tested in rabbits. The silicon lens has an
outward facing LED which is switched
off in response to high levels of glucose
in the tears as detected by a sensitive
nano-sized glucose monitor. While this
technology needs more work before
it can be available for humans, it is a
step in the direction of real-time, non-
invasive glucose monitoring. Another
variant of the wearable monitor is a
color-changing tattoo ink with liquid
biosensors developed by MIT and
Harvard Medical School which can
detect changes in the glucose levels, pH
or salt in the interstitial fluid between
the cells. This study is currently in
research mode with no plans for clinical
trials. However, the possibility of
using the human skin as an interactive
display for physiological monitoring is
extremely attractive for developing non-
invasive diabetes management products
as is the case with an armband that can
monitor the glucose in sweat via an
ionic sensor. The simple bioengineered
product from University of California,
Berkeley is primed for continuous
monitoring of not just glucose, but also
sodium, potassium, body temperature
and other physiological parameters
with a fully integrated electronic system
that can log and update the data into
Vaccines- Enteroviral infections are
known to cause Type I in newborns
by triggering an autoimmune response
against islet beta cells. At the University
of Finland, scientists have developed a
vaccine that can potentially eliminate
enteroviruses and thus prevent Type I.
Another common vaccine B.C.G. used
routinely against tuberculosis has been
used by doctors at the Massachusetts
General Hospital as a vaccine against
Type I. They have been successful in
a pilot clinical trial by reducing the
insulin dosage to one-third of the
patient’s initial requirement even after
5-10 years of the vaccination.