Revolutionizing Type 1 Diabetes Treatment

A one-time treatment to eliminate the burden of a lifetime of challenges.

Harjot was 7 years old when he was diagnosed with type 1 diabetes, and his life hasn’t been the same since. From recesses cut short in school because he had to check his blood glucose levels and self administer his life saving insulin, to missed field trips with friends due to his parents’ fear, Harjot’s life revolves around his diabetes. He must take his condition into consideration for pretty much all of the choices he makes and his ability to live his life like all the other kids his age has been greatly hindered. The same is true with 436 million diabetic patients. This condition takes control of a patient’s life.

Taking a Closer Look at Type 1 Diabetes

Type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin. Insulin is a hormone that travels through the blood to your body’s cells. It allows the glucose from the food you eat to enter your cells. Once inside, the cells convert glucose into energy or store it to use later. Without insulin, cells are unable to use glucose as fuel and they will start malfunctioning. Insulin is created in pancreatic beta cells.

For someone with type 1, their immune system, specifically their white blood cells, mistake the pancreatic beta cells for foreign invaders and in an autoimmune response, white blood cells secrete auto antibodies that permanently damage the beta cells, rendering them unable to produce insulin.

In T1D, your beta cells are destroyed and produces little to no insulin

Without the hormone, glucose is unable to exit the bloodstream and becomes built up, resulting in hyperglycemia. There is also the potential of developing a dangerous condition called diabetic ketoacidosis. This happens when cells can’t use glucose for energy and must break down your fat and protein stores as alternative sources of energy. As fat breakdown continues, certain byproducts like ketone bodies accumulate in the blood, and if ketones build up too much, they pose a serious health risk.

Current Treatments

Currently in the market, the main treatment for this condition is lifelong insulin therapy. To administer the insulin the body needs that cannot be created by the pancreas, there are 2 main options, insulin pumps and needle and syringe. Both of these come with problems. One of them being the risk of taking inaccurate doses of insulin. The amount of insulin needed at a time is dependent on a variety of factors (ex. age, weight and diet), and it is up to the patient to determine what amount that is. However, this can be quite problematic.

If the patient were to administer too little insulin, there would be a large excess of glucose in their blood, leading to the potential of hyperglycemia — which can increase the risk of heart disease and stroke, kidney disease, vision problems, and nerve problems. On the other hand, if too much insulin is administered there is a risk of hypoglycemia.

Another issue with insulin needles and pumps is the sheer cost. A person who is diagnosed with type 1 diabetes must spend their life constantly buying the equipment they need. Whether that be the pump, a wide number of needles, strips to measure their blood glucose levels and a variety of other things. It was found that approximately $132 billion is spent annually on direct and indirect costs relating to diabetes. This financial burden is further exacerbated when it is taken into consideration that the average age of diagnosis for this condition is just 13 years old. From that point onwards, the patient must continue to put their money towards treatment.

These solutions to type 1 also contribute to limiting the quality of life of the patient. Having to constantly check their blood glucose levels and self administer their insulin is widely inconvenient and takes time away from the many other things they could be doing instead. This inconvenience may not seem significant, but it greatly impacts the patient’s life. Having to constantly think about their condition, waiting for the next moment when they will need treatment is an immense burden to carry for the entirety of someone’s life and is something no one deserves to have to deal with.

Introducing Metanoia

Metanoia has a revolutionary treatment for type 1 diabetes that will address all of the problems with one solution. We offer a one-time treatment to eliminate a lifetime of challenges. We guarantee our customers comfort, convenience, and well-being.

Step 1) Bioprinting an Artificial Pancreas

A patient’s bioprinted pancreas will be partly made from their own cells. Stem cells from the patient’s own body are used to convert them into beta cells (to produce insulin), as well as alpha cells ( to produce glucagon). The newly developed pancreatic islets are used as bio-ink. We also ensured that this bio-ink is feasible as it is compatible with the Cellink Bio X bioprinter, the most widely used one in the industry.

In addition, another bio-ink was created in order to bioprint blood vessels using the endothelial cells created from stem cells. By developing these 2 bio-inks, we’re able to ensure that blood flows into the pancreas, providing oxygen to the patient’s pancreatic islet cells and tissues in order to properly function.

After this, we can use the layer-by-layer technique, in which different 2D layers of cells are stacked on top of each other, until a 3D product is developed.

You may be wondering…

“what’s stopping the T-cells from once again killing off the newly produced pancreatic islets?”

Metanoia ensures this doesn’t happen again, by wrapping the produced beta and alpha cells with Alginate which is one of the most frequently used biomaterials in the field of cell microencapsulation. It has been demonstrated to be probably the best polymer for this purpose due to its biocompatibility, easy manipulation, gel forming capacity, non-immunogenicity and in vivo performance. It is a kind of polysaccharide refined from brown seaweeds. We would use this biomaterial as a membrane for our artificial pancreas to prevent the patient’s immune system from attacking it as foreign.

“what if there’s only a limited supply of insulin the artificial pancreas can hold?”

If for some reason the beta cells stop functioning, despite the cell encapsulation, Metanoia takes care of this by taking advantage of the patient’s stem cells once again. Stem cells are useful as we have a large amount of them in our body.

Adults have on average 50,000 to 200,000 stem cells in their body, which we can use to our advantage. We can easily take out the required amount of the patient’s stem cells by removing some blood temporarily, isolating and collecting the stem cells, then inserting the blood back into the body. Stem cells also have the ability to go through a process called symmetrical division, in which they’re able to increase the number of stem cells in their pool by dividing into 2 more.

This explains why we chose to use stem cells as they are the more sustainable solution compared to other alternatives. For example, 3D printing stem cells or getting a transplant from another patient, would increase chances of cell rejection. Metanoia ensures that we think of a long-term solution for our patients, and tackle potential issues early on!

Where will the Pancreas Be Placed?

The ideal place to implant the artificial pancreas would be at one of the many subcutaneous sites within the body. This is because of the significant amount of fatty tissue present in these areas just below the skin. The subcutaneous route allows drugs such as insulin and heparin to be absorbed slowly over a period of time. The 2 best options would be the front and outer sides of the thighs and the abdomen, except for a 2 inch area around the navel.

Possible locations the pancreas can be placed

Possible Challenges

However, these subcutaneous sites are somewhat far from the nearest blood vessels, posing a potential problem in getting the blood vessels to grow from the artificial pancreas.

Metanoia’s Approach

In that case, we would first test if the subcutaneous sites would work, and if not we would do the implementation into the omentum, which is a large flat adipose tissue layer that encases the stomach. This site would be good as we can wrap the artificial pancreas in this tissue layer and it will be localized so it can be retrieved easily if necessary.

Step 2) Nanosensors for Real-Time Blood Glucose Monitoring

It is crucial that diabetic patients have the power to know what is happening in their own bodies, at all times. Metanoia gives our users the ability to gain this power by implanting a stent embedded with nanosensors. The nanosensors are specifically designed to monitor glucose levels, by specifically monitoring changes to the patient’s blood pH levels.

As the concentration of glucose changes, the pH levels change, caused by competitive binding. The breakdown of glucose caused by glucose oxidase (GOx), decreases the pH levels by releasing hydrogen ions, which generates negative charges by producing the gluconate ion.

By embedding these nanosensors to a stent, users are able to easily get accurate and real-time values of their glucose levels. Additionally, by mounting nanosensors specifically, we take advantage of their small sizes to avoid potential issues getting in the way of regular blood flow.

A closer look at where the sensors will be embedded in the stent

This nanosensor embedded stent will be placed anywhere in the 3 inch long hepatic portal vein. This blood vessel is responsible for carrying glucose rich blood from the small intestine to the liver after eating a meal. Thus, we are able to get the most accurate glucose readings as the change in pH is easily identified in this location.

A closer look at where the portal vein is located

How Metanoia Overcomes the Problem of Powering Devices:

For several years now, implanting bio-sensors was not considered a sustainable solution, as there were many drawbacks.

These drawbacks include:

  • bandwidth issues with wireless connection solutions
  • inconvenience with inserting batteries as eventually the battery would run out of power
  • surgeons having to open up a patient’s body multiple times a year to replace the battery.

However, Metanoia combats this issue by utilizing in-vivo networking (IVN)

Step 3) Monitor Glucose Levels On your Smart-device through In-vivo Networking

In-vivo networking is the latest and revolutionizing technology, which creates a system of devices to communicate wirelessly. It is able to wirelessly power small devices implanted deep into our bodies, and send the data retrieved to devices outside the human body.

When the IVN transmits wireless signals, which is sent through the body, it extends to the tiny implanted nanosensors in the body. The sensors then harvests energy from the signals sent, which is then used to communicate. This technology doesn’t rely on batteries, but instead it can wirelessly power them up and communicate with them from a distance.

“However, when wireless signals are sent through the body, they lose a lot of their energy”

IVN overcomes this hurdle by using the multi-antenna technique which involves using sophisticated signal generation in order for the signals to combine constructively towards the sensors. This allows the IVN to power the sensors, so they’re able to continuously sense, and then communicate to devices outside of the body. IVN has the ability to power up the sensors, through multiple layers of tissues, and is truly a promising technology of the future.

Impact

Our solution does not require patients to make payments for the entirety of their lives. One single cost, and they never have to pay for anything again. Being able to give people this freedom lifts the financial weight that comes with this condition. As well, this solution provides a new opportunity for patients to live their lives to the fullest. No more constant monitoring, no more stopping to self administer their insulin.

The average cost of type 1 diabetes (includes the insulin, needles, strips, meter, cartridges, poker pen, insulin disposal, alcohol swabs, and many more indirect costs) costs a patient $1,396/month. Knowing that the average age to get T1D in children is at the age of 13, they would’ve spend $117, 264 by the age of 20. This is a huge number, and the cost for T1D patients to survive needs to be lowered.

Metanoia’s implantation of both the artificial pancreas + nanosensors would cost the patient, between $27,000 — $29,000. A one-time surgery, to eliminate all the costs and unconvenience that comes along with type 1 diabetes.

This solution will effectively relieve the burden of overseeing their own treatment off the shoulders of patients. Metanoia has the ability to make sure that other kids like Harjot have a better quality of live, and letting them live their lives worry-free.

We’d like to thank:

Dr. Alice A Tomei, Professor Nayef, Abbira Nadarajah, and Heya Desai for helping us with this project.

Thank you for reading our article! Feel free to check us out to learn more about what we do here at Metanoia!

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