Podcast: Implantable Chip To Cure Diabetes

In this episode, we explore the groundbreaking potential of an implantable device that promises a future without injections for diabetes control and we delve into the science, the impact on patients, and the promises it holds for a brighter future in diabetes care. 

EPISODE NOTES

(0:50) - An implantable device could enable injection-free control of diabetes

Transcript

What's up folks, if you have type 1 diabetes or you know someone that has type 1 diabetes, you know the pain that they go through every single day with finger pricking, with daily insulin injections and spoiler alert, it doesn't even do a good enough job to keep healthy blood sugar levels for these people. So, a team from MIT came up with a tiny device that they think can solve the problem. I think it's really interesting, so let's jump right on into it.

I'm Daniel, and I'm Farbod. And this is the NextByte Podcast. Every week, we explore interesting and impactful tech and engineering content from Wevolver.com and deliver it to you in bite sized episodes that are easy to understand, regardless of your background. 

Daniel: All right, what's up everyone? Like we said today, we're talking all about a world where diabetics no longer need to focus on daily insulin injections, blood sugar monitoring. This team from MIT is coming to the rescue with a tiny little device that can help turn that dream into a reality. But before we jump straight into talking about their device, let's kind of paint the picture.

Farbod: Let's do it.

Daniel: Type 1 diabetes is a chronic condition that messes with your pancreas, specifically the cells that make insulin. And insulin is a hormone that we're able to use to help metabolize sugar. Helps your body process your blood sugar. And having blood sugar that's too high or too low can have really, really poor effects on your body. This is something that if you have type 1 diabetes or type 2 diabetes, if you know someone with diabetes or you have diabetes yourself, you know that it's really, really challenging to deal with that. Many type 1 diabetes patients specifically, because they're the ones that have the insulin cells affected in the pancreas. They're the ones that spend a lot of their time pricking their finger to measure their blood sugar, using an insulin pump to inject additional insulin into their body. However, it's really, really challenging to match the actual natural insulin levels of a healthy pancreas. So, I didn't know this before we researched for this article, but apparently most people with type 1 diabetes, even when they have an insulin pump, even when they have these state-of-the-art devices that help inject this extra hormone into their body that they need to process blood sugar, I didn't know this, apparently most of them still have unhealthy blood sugar levels for most of their life. So even though technology is really, really good and it's gotten to a point where people with type 1 diabetes, this isn't necessarily a life-threatening illness for everyone every single day of their life, well that does provide a ton of different complications. I don't want to diminish the seriousness of the disease at all. Although we've gotten technology to a point where it isn't actively threatening your life on a daily basis. It still has a pretty low quality of life because your blood sugar still isn't optimal. We try our best with insulin pumps, but it overshoots your blood sugar, it undershoots your blood sugar. It's just not the same as having real cells inside your body that are actively responding to your blood sugar levels and then creating insulin as a response to that. So again, I didn't know this was such a problem, but apparently even our best technology right now to help address type 1 diabetes isn't good enough.

Farbod: Yeah, that was a big surprise to me as well because it, I mean, it makes sense. Your organ, the pancreas, when it's working as expected, it can detect a rise in blood sugar level and then respond to it in real time with the insulin to mellow it out. Now, back in the day, if you're just doing the manual insulin injections, it makes sense that you would overshoot or undershoot or whatever, but I figured with the insulin pumps, and like you said, the new tech, we would have a much better system of making sure that we're mimicking that real time response as much as possible, but it seems like that's not the case, right? And as far as I can tell based again, this is kind of a foreign field to me. I didn't do well in biology, medicine and stuff, but we've talked about tangential topics in the past. As far as I can tell the big step forward would be the ability to embed something in someone's body that matches that operation. But there have been limitations and the one that this paper talks about, is if you're gonna inject those cells into the body, you need oxygen. And that is not easy to do inside of the body.

Daniel: Well, there's actually like four different steps they took to get to a point where they said, we need oxygen. I wanna walk through all the different constraints.

Farbod: Let's do it.

Daniel: Not to get too much into the weeds, but I think it helps paint a really clear picture for everyone who's listening around what the technical challenges are and why we haven't been able to solve this to date. So, the first step they said is, okay, maybe we know that human, real human cells are better at metabolizing insulin than our pumps will ever be. So, let's try and get some cells from a cadaver from someone who's passed. Let's get some of their pancreas cells. They call them islet cells. The word stems from islet like a tiny island and it's like a little tiny island of cells inside your pancreas that's producing hormones. So, they take these islet cells from a cadaver, from someone who's passed, pretty grotesque. They take these cells from a dead person, they injected them inside the body and they said, okay, can this help us stabilize insulin levels? Yes, but the body thinks that it's a foreign organism and the immune system starts to attack it. So, you need to take these really invasive, immunosuppressive drugs that mess up the rest of your immune system. Is it worth it to maintain your blood sugar if the rest of your immune system is gone? Probably not. So, then they started looking, what if we did this from stem cells, from that person? Can we do it? No, the body still rejects it. We still need immunosuppressive drugs. So, then they say, whoa, what if we put these cells inside a flexible device so the immune system can't attack it, it doesn't know that there's a foreign object there. This device just circulates blood through it and then it passes it out. And as it's metabolizing the blood, it's metabolizing the blood sugar, et cetera. That's when they got to this point where they said, wow, we can do this, we can actually achieve this, but these cells living inside this tiny device protected from the immune system, they need oxygen to stay alive. They need more oxygen than the blood stream can provide them. So, then they're like, all right, cool. Let's make a flexible device with oxygen chambers, little oxygen tanks to help keep these cells alive. It worked, but they needed to reload this oxygen supply, which gets us to where we are today with this awesome team from MIT, they made a small implantable device. When I say small, it's like about the size of a quarter, I think, that contains these real-life insulin making cells. And I hope they're from stem cells instead of cadavers. I feel like that's, again, pretty grotesque, but I hope it's from stem cells. But these real human cells can produce insulin, but it also, this device also has its own oxygen production system to help keep these cells alive. So, you implant this tiny little device inside the body, attach it as a part of the bloodstream, et cetera, you've basically created a new organ within the body, which completely sustain itself. It's able to create insulin, it's able to create oxygen to keep these cells alive, and it helps humans, or could help humans in the future, they've only tested it in animals so far, could help humans to regulate their insulin without ever having to prick their fingers again to check their blood sugar without ever having to hook an insulin pump up to their body. To me, it sounds like a pretty incredible, you know, I think this would still also truly just count as a treatment for diabetes, but we're getting pretty, pretty close to what sounds like a cure for type 1 diabetes here if you're able to put this device inside your body and it handles all the insulin for you, right?

Farbod: Yeah. I mean, a lot of great information here. I did not know that eyelids came from the island analogy. So, kudos to you for looking into that. That is awesome.

Daniel: Yeah. Google is a powerful tool, my friend.

Farbod: Fair, fair. And yeah, man, I'm with you. It seems like, I feel like we've talked about insulin-something, diabetes-something in a semi recent episode, but I feel like the way biomedical engineering is going is almost being able to leverage biomimicry to, like you were saying, cure certain diseases. So, this is pretty exciting to see. And, what was so interesting to me is, I know we haven't gotten to the sauce yet, but I'm gonna hint at it. The technology that they use is actually kind of borrowed from what I would say is a hot topic in the automotive industry. And that was super interesting for me to see, because in my mind, they're like these two completely unrelated fields, but here they are leveraging the tech that is like potentially groundbreaking in both industries, just in completely different ways.

Daniel: Yeah, well, that's what I was gonna say is this isn't so much biomimicry as biohacking, I would say, right? So, they are using some piece of technology, right? And I'm gonna spill the beans here, related to hydrogen fuel cells, which we're thinking about using for electric vehicles, some borrowed technology from electric vehicles to help keep these real bio cells alive. So, they're not trying to reinvent these islet cells to produce insulin, they're actually using real islet cells. And then they're using this unrelated piece of technology from nearby, from an adjacent field, pulling that in and using it to keep these cells alive, to produce enough oxygen to keep those islet cells alive so that biology can just do its thing. But the hacking part of it is letting the body not know that this is going on. It doesn't think there's a foreign threat and these insulin cells or these islet cells rather, don't perceive a threat, they don't know. They just stay alive and they keep doing their thing. Keep going and going and going. And I think that's kind of like the hacking part of it. They've grafted someone else's islet cells into someone with type one diabetes to help solve the problem.

Farbod: Yeah, yeah. And this device, so we've been talking about it, hydrogen fuel cells. The secret sauce here for getting the oxygen is this proton exchange membrane. I guess all you need to know about it as the audience is that there's water vapor in the body and this can extract it and split the hydrogen from the oxygen. The hydrogen gas just kind of dissipates, but the oxygen is what it takes and stores in its little tank to use whenever it needs it. So that's great. But then you have this next bit of, well, this is technically going to need some sort of power to go through this process.

Daniel: Well, that's the thing, right? This proton exchange membrane splitting water into hydrogen and oxygen.

Farbod: It's not free.

Daniel: I always forget if that's hydrolysis or electrolysis. I forget which way goes which, but whichever way this is, I think it's electrolysis.

Farbod: I think it's electrolysis.

Daniel: Requires electricity. So how are they achieving this, right? We said that it's completely implantable. You don't need to plug yourself in to be able to make this device work. How are they achieving it?

Farbod: That's a great question, because you would expect it to be hooked up to some sort of power source or a battery against usually what we've seen in embedded devices, right? Nope, wireless charging. Basically, what we use to charge our Apple watches, think of the same thing, it's a resonant inductive coupling. So, you have, I mean, it's gonna be on the inside of your body, but on the outside, you're gonna have a little pad that you can hook up to and charge this thing up. And that is how you can get those two volts fuel cells running for you and getting more oxygen out of your own body. But I don't know, again, going back to this episode that we did a while ago, right? I think you and I were talking about it before we started this episode. Was it 121?

Daniel: Episode 121.

Farbod: 121, it was from ETH Zurich. And they were actually using the excess glucose in the body to power a device. Just putting it out there, it could be a good solution for this device to work on that power system because you're already trying to balance out the glucose levels in the body. Why not take some of it and use it as energy for yourself?

Daniel: No, I agree. Not to cheapen the achievement here that this MIT team has….

Farbod: Not at all.

Daniel: Right, this is incredible. You've essentially found a way to replace these islet cells that are damaged or they're not working properly in someone that has diabetes inside their pancreas. You're able to get healthy islet cells actually living and surviving inside the body. No more injections, no more finger pricking. That's a big deal. It's a major improvement in quality of life for someone who's used to finger pricking, who's used to doing insulin injections, etc. Or carrying around like a hefty insulin pump that's attached to their body. All that sounds like a pain to instead just have this tiny little device. Again, I think when they tested it in rats, it was about the size of a quarter. They said to have enough production for humans would be about the sizes of a slice of gum. If you can think about it, it's still pretty thin, small. Get this slice of gum. You know, one time you go through the procedure to get implanted in you. And then for the rest of your life, this is able to produce enough insulin to maintain healthy blood sugar levels, more healthy than your current insulin pump can do. That's already a huge improvement. Even if, you know, sometimes when you're sleeping at night, you need to hook up this wireless charger to make sure the device stays alive. That's a big deal on its own. But again, talking about this team from ETH Zurich, episode 121, they came up with a way to help metabolize excess blood sugar to keep a small wearable alive. And you never needed to plug this charger in. I think this could be awesome because one, obviously it removes the nuisance of having to charge, but also the whole goal here is this, someone with type 1 diabetes has too much blood sugar, has too much blood, or has too much sugar in their blood this could actually potentially help reduce the size of the device because you wouldn't need as many islet cells to help metabolize the excess insulin if part of the device was also a fuel cell that's metabolizing extra glucose to create electricity to keep everything alive. So definitely interesting. I'd love to see these two teams collaborate and make something because then truly I feel like we could get to something where we say like, if you have type 1 diabetes, this device can solve it.

Farbod: One and done.

Daniel: Yeah. No questions asked. I think it's pretty exciting. One of the other things I wanted to mention for people who want further listening, in episode 19, it's a long time ago.

Farbod: What a throwback.

Daniel: We talked about injectable microchips for monitoring temperature inside the body. I think that these two teams could learn a little something from that team from episode 19 as well on miniaturizing the size of the device. I don't know about you, but when we got from the size of a quarter, which sounds like a little bit, it's not completely unscary to me, I would say like, it's not super happy. It's still a little bit scary, but it's not that scary for me to think like, you're gonna inject or implant something about the size of a quarter of my body. Getting to about the size of a slice of gum is large enough that you have to be careful that you're not doing it near any joints or like any muscles. It still feels, you know, in the grand scheme of things, it's pretty small, but it still feels a little bit bigger than I'd feel being comfortable with. I wonder if there's any technological innovations that can borrow from this team that was able to shrink temperature sensors small enough that they fit inside a needle. I wonder if there's anything that they can borrow there. And maybe we have a bunch of little tiny bots of cells floating around in the body in the bloodstream that aren't implanted in a certain area. And they just flow through the bloodstream and these microchips have islet cells in there and they have this fuel cell technology that metabolizes sugar to help keep the islet cells alive. I don't know if that's a potential future. To me, this sounds like the ultimate panacea, right? You can get a vaccine or, you know, I don't know if there's a trigger word for anyone, get a vaccine that ultimately treats, you get a shot and it treats type one diabetes, which would be incredible.

Farbod: Yeah. Like you said, not trying to bring down anyone or the research work that they've done. It's just for us, we digest so many different topics and over time, you start to see a convergence of potential solutions, and it's fun to talk about them. So, I feel like that's one of the best parts about this podcast, where we see elements that we think would go well with other research topics, and some of their parts could be greater than what they are. Sustainable products.

Daniel: Not to toot our own horn here, but for folks who listen to the podcast and kind of get this slice of technology, we're constantly, you should see for both of my text messages, we probably send back and forth. I don't know, a ratio of four or five articles every week for every one that we record. We're trying to find the latest and greatest. We're trying to find the most interesting, the most impactful technology. And it's so crazy to feel that even after we do all that, we only take the top 10% or the top 20% of articles that we can find. Even once the cream rises to the top, we're still seeing a lot of synergy between the topics that we cover. I think that's one way that we feel like we're really connected with the technology scene, but also for people who listen to this, or if you have friends who are contemplating listening to this, this is a pretty convenient way to stay on top of different technology trends in the world. Again, I don't think we're remarkable by any means. I think this is just you and I doing cool things as a friend. And now we've got a cool community that are on along the ride with us. But it always like brings a smile to my face when I start to see these different technology trends. Start to link up and we're talking about, episode 19, episode 121, and now we're recording, I think it's episode 144 or something like that. Right. To see these technology trends link up over years and years of podcast episodes, we're not incredible at the technology is, but this is a convenient way to stay in touch with it.

Farbod: Yeah, and as a testament to the type of topics that we covered and how you can build that, again, foundational knowledge to be able to, you know, if your goal is to pursue something here or become an expert in this field, we're having those conversations. We're not experts by any means, but we're trying to understand what's out there and how it relates to each other. With that said, I think you need to do a TLDR because this was a solid article.

Daniel: I agree man. So, let's wrap this up here. Again, everyone, let's imagine a world where diabetics no longer need daily insulin injections. MIT engineers are turning that dream into reality. If you don't know type 1 diabetes affects insulin making cells inside the pancreas, those are called islet cells. Many people with type one diabetes need injections daily to maintain proper insulin levels. However, they're still not able to match the natural regular insulin regulation that healthy pancreas had. So essentially if you've got type one diabetes, you're not only doing finger pricking, you're not only getting injections. At the end of the day, your blood sugar levels still aren't healthy. So, some MIT engineers took up the task. They created a tiny little device about the size of a slice of gum that produces insulin inside the body using real islet cells that help diabetes patients maintain healthy blood sugar levels without any daily injections. They stole hydrogen technology from electric cars to keep these living cells alive inside the human body. This can help people with type one diabetes produce their own insulin, maintain healthy blood sugar levels, and they will never ever need to prick their finger or get another injection ever again.

Farbod: Money. Like always.

Daniel: Thanks, my dude.

Farbod: All right. Anything else we got to talk about or is this the end?

Daniel: I think that's it.

Farbod: All right, everyone. Thank you so much for listening. As always, we'll catch you in the next one.

Daniel: Peace.

As always, you can find these and other interesting & impactful engineering articles on Wevolver.com.

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The Next Byte: We're two engineers on a mission to simplify complex science & technology, making it easy to understand. In each episode of our show, we dive into world-changing tech (such as AI, robotics, 3D printing, IoT, & much more), all while keeping it entertaining & engaging along the way.