{"id":49441,"date":"2018-08-09T11:34:32","date_gmt":"2018-08-09T15:34:32","guid":{"rendered":"https:\/\/asweetlife.org\/?p=49441"},"modified":"2018-08-09T11:34:32","modified_gmt":"2018-08-09T15:34:32","slug":"the-promise-of-smart-glucagon-no-more-living-in-fear-of-hypos","status":"publish","type":"post","link":"https:\/\/asweetlife.org\/?p=49441","title":{"rendered":"The Promise of Smart Glucagon: No More Living in Fear of Hypos"},"content":{"rendered":"

Most people who follow developments in the diabetes world have probably heard about efforts to create smart insulin, which would sense when blood glucose levels are rising and respond accordingly. But what about the flip side of the coin, something that could respond when glucose levels are falling precipitously? Protomer Technologies, a biotechnology company based in Pasadena, California, is already working on developing smart insulin<\/a>. Now they\u2019re in the early stages of working on smart glucagon, which would quietly circulate in the body until activated by low glucose levels. In the spring, Protomer\u2019s concept won the T1D Exchange\u2019s Diabetes Innovation Challenge<\/a>, a competition to \u201cidentify, nurture and fast-track innovative scientific and clinical solutions for diabetes.\u201d (The competition drew sixty entries from around the world; other finalists included a company developing smart insoles that would help predict foot ulcers, and a bandage-thin \u201cpatch pump\u201d that could dispense insulin along with other medications.)<\/p>\n

Alborz Mahdavi, Protomer\u2019s founder and CEO, told me that his company decided to focus on smart glucagon for a couple of reasons: they felt that they had the right background and technical experience to tackle the problem, and they saw an important unmet need. In its current form, glucagon is a powder that must first be mixed with a sterile solution and then injected. If someone is alone and experiencing hypoglycemia severe enough to require glucagon, they\u2019re very unlikely to be able to formulate the glucagon themselves. This means they must be lucky enough to have someone there who knows how to formulate it and inject it.\u00a0\u00a0Smart glucagon, however, would activate within the body when\u2014and only when\u2014needed. Mahdavi points out that few companies are working in this space, partly because the glucagon market is tiny compared to the insulin market. \u201cBut honestly, money issues aside, we just thought about it and said, if this thing was available now, what kind of impact would it have? It\u2019s going to be huge. There are people who are dying, twenty and thirty year olds, dying from hypoglycemia. They go to sleep, have a hypoglycemic episode, and they never wake up. That\u2019s the worst result, but there are a lot of other really bad things that can happen too.\u201d<\/p>\n

After winning the Diabetes Innovation Challenge,\u00a0 Mahdavi talked with a close friend who was at the event, and had had a recent hypoglycemic episode that landed him in the hospital. \u00a0\u201cThis is a fifty-five-year-old industry veteran biotech guy who knows insulin inside and out. He\u2019s one of the most well educated people you can find in terms of type 1, and he\u2019s still having this issue,\u201d says Mahdavi. The worst thing about it, the friend told Mahdavi, is that he had absolutely no idea why it happened; he\u2019d gone to bed with an even blood sugar of 110, according to his CGM, and everything seemed fine. It was just one of those strange, unpredictable things that happens now and then with T1D. \u201cHe told me if this glucagon is actually developed, it could have a huge effect on the quality of life of type 1s, because everyone is living in fear of hypos. That shows up in so many different ways, including how aggressively people use their insulin.\u201d<\/p>\n

But any excitement about the idea has to be balanced by the fact that the concept is at a very early stage, with much to be figured out before it could even be tested at the pre-clinical level. Challenges include preclinical development of the molecule that both senses low blood glucose and switches on at the right moment; and playing with the molecule so it lasts for seven days with adequate strength throughout (their plan is to develop a version that would be injected once a week). Mahdavi points out other challenges too, including that glucagon is unstable and doesn\u2019t dissolve easily. All in all, he says, \u201cGlucagon is a really difficult molecule to work with.\u201d Yet this is exactly the sort of early-stage work that the Diabetes Innovation Challenge was set up to foster, Mahdavi says. \u201cI think the award is really meant to target concepts that are very promising, have high impact, and are in early stages of development.\u00a0This fits within that category.\u201d<\/p>\n

Right now, Mahdavi thinks there may be two other groups in the country working on the concept of smart glucagon. But he wouldn\u2019t be surprised\u2014and wouldn\u2019t mind\u2014if more groups join the hunt. \u201cEvery time we talk about what we\u2019re doing, a year or two later there are ten other groups working on it. But my view is, it just doesn\u2019t make sense to hide away what you\u2019re working on and not show it to people.\u00a0 It doesn\u2019t mean we won\u2019t patent it\u2014we\u2019ll patent the hell out of it\u2014but sometimes competition is beneficial too. At the end of the day, we are trying to solve a problem that many people are faced with and that is the most important goal.\u201d<\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

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