Diabetes in the nano firing line

‘Smart insulin’ released within the body via microscopic drug couriers could spell the end for diabetes injections.

Story Kathy Marks
Illustration Justin Garnsworthy

The potential for nanoparticles – chemical structures smaller than breadcrumbs – to deliver drugs to specific cells or organs is opening lines of treatment for the debilitating disease diabetes.

Research led by Dr Christoph Hagemeyer is developing ‘smart insulin’ – nanoparticles carrying glucose-lowering insulin to the liver and pancreas that would activate as blood sugar levels rise. This would eliminate ‘guesswork’ and the multiple daily injections required by diabetics in their ongoing effort to maintain safe glucose levels.

“With type 1 diabetes, the disease is always at the back of your mind. It’s embedded in your life,” says Monash University’s Dr Hagemeyer. “If your glucose was being regulated automatically, you could almost forget about your diabetes. It would be life-changing.”

Diabetes is not only a disease but a way of life, requiring close monitoring of blood sugar levels and insulin injections half a dozen times a day. Meals, exercise, illness and stress can trigger dangerous highs and lows. Only a third of people with type 1 diabetes control blood sugar effectively.

That figure could rise substantially thanks to the smart insulin project led by Dr Hagemeyer, who runs the NanoBiotechnology Laboratory at the Australian Centre for Blood Diseases.

Dr Hagemeyer’s expertise includes engineering antibodies to create targeted drug-delivery systems. His aim is to formulate a glucose-sensing substance that could be packaged with pharmaceutical insulin.

People with type 1 diabetes live with the fear of hypoglycemia (low blood sugar), which can be life-threatening, or hyperglycemia (high blood sugar), which can cause kidney disease, eye disease and strokes. Smart insulin, which would minimise those risks, could also be used in the advanced stage of  type  2 diabetes.

The research could also produce a blueprint for other smart drugs that respond to biological signals. No such drug yet exists for any disease, says Dr Sanjoy Dutta, Assistant Vice-President of International Partnerships at New York’s Juvenile Diabetes Research Foundation.


Dr Christoph Hagemeyer and his co-investigators – University of Melbourne chemical engineer Professor Frank Caruso and Baker IDI Heart and Diabetes Institute clinicians Associate Professor Jonathan Shaw, Professor Mark Cooper and diabetes scientist Associate Professor Terri Allen – have been awarded a three-year, A$1.9 million (US$1.37 million) grant by the world’s largest diabetes charity, New York-based Juvenile Diabetes Research Foundation (JDRF), and Sanofi, a leading insulin manufacturer.

The spark for the project was a presentation on nanoparticles delivered by Professor Frank Caruso to Melbourne’s Baker IDI Heart and Diabetes Institute, where German-born and trained Dr Hagemeyer formerly worked. For him, diabetes is a new but immensely rewarding research field.

“Unless they have severe hypoglycemia, people don’t die from diabetes itself but from its consequences – heart attacks and strokes,” he says. “If you can control the diabetes, those risks go down dramatically.”

At a JDRF workshop, he was struck by the stories of two patient advocates, one of whom noted that potentially lethal insulin was the only drug requiring patients to “make dosing decisions every day, 24/7”.

Glucose-responsive insulin would remove that need, and require only one or two injections a day.

Smart insulin is the ‘Holy Grail’, Dr Dutta says. “While there are challenges ahead, we look forward to realising the dream of a glucose-responsive insulin that could potentially mimic naturally secreted insulin.”