What are the scientific and technical challenges that hinder the development of a universally accessible and engineered intervention for type 1 diabetes?

T1D is an incurable autoimmune disease that damages insulin-producing cells and causes high glucose and complications. Current treatments are suboptimal and have drawbacks. Developing a universal and engineered intervention faces challenges in understanding, predicting, modulating, engineering, delivering, sensing, translating, and managing T1D

T1D is a lifelong disease where the immune system destroys the cells that make insulin, leading to high blood sugar and health problems. Existing treatments require insulin injections or pumps, but they are not ideal and have limitations. To create a better intervention, we need to overcome many scientific and technical hurdles in different aspects of T1D.

I am dismayed by the apparent lack of responses to this topic, which suggests that type 1 diabetes is not well understood and is deliberately ignored by the public and the media. I suspect that this is a result of the influence of the insulin companies, who have a vested interest in maintaining their profits and suppressing alternative treatments. This is a serious issue that deserves more attention and research, not silence and indifference.

AMK said:

I am dismayed by the apparent lack of responses to this topic

Not just "apparent", but real! However, I only occasionally go beyond the BS 7671 discussions.

I would say that the issue of maintaining a reasonably safe blood glucose range between hypoglycaemia and ketoacidosis has been helped greatly by engineering approaches such as insulin pumps and devices such as Libre, but an equally important issue is the prevention of complications such as retinopathy, and cardiovascular and renal disease.

I am not sure that I would call islet cell transplantation an "engineering" solution.

Hello Chris, thanks for the reply. Just picking up on retinopathy,  medical lasers to seal or destroy the faulty blood vessels that affect vision, (laser photocoagulation) was a groundbreaking treatment for diabetic retinopathy that emerged in the late 1960s and early 1970s, when lasers were first used for eye-related applications.

But this treatment can result in loss of side vision, difficulty seeing at night, reduced ability to distinguish colors, and swelling of the central part of the retina.

So why do we still depend on a treatment from the sixties?

How about artificial groups of cells that can produce insulin. These artificial groups of cells are like tiny balls that have cells inside them that act like the ones in the pancreas. And then use these artificial groups of cells to replace the ones that are not working well in people with diabetes. This way, we might be able to help more people with diabetes, because we don’t have to wait for someone to donate their pancreas, and we might be able to avoid the problems that happen when the body rejects the new cells.

AMK said:

So why do we still depend on a treatment from the sixties?

I don't think that electrickery has changed a lot over the past 100 years.

The operation of my newest car (2021) is little different from my oldest one (1930).

The laws of physics have not changed, but I am staggered by the quality of photos taken by modern telephones (not cameras!) so perhaps modern laser treatment of the retina has also become more precise?

Problem with pancreas transplantation is that somebody has to die first.

If we could inject, let's say, cells which can produce insulin; and if they could survive like seeds planted in the soil, how would their output be controlled?

I am not sure that engineering is the right discipline here even though it has obviously contributed greatly in e.g. joint replacement surgery. (The surgery is the easy bit!)

Problem with pancreas transplantation is that somebody has to die first.

If we could inject, let's say, cells which can produce insulin; and if they could survive like seeds planted in the soil, how would their output be controlled?

I am not sure that engineering is the right discipline here even though it has obviously contributed greatly in e.g. joint replacement surgery. (The surgery is the easy bit!)