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Scientists at Danish pharmaceutical company Novo Nordisk have developed a ‘smart’ insulin that responds to the spike and crash in blood sugar levels in real time. This can help to improve treatment options for people with diabetes. The research was published in the journal Nature. The scientists developed an insulin molecule with an “on-and-off switch” that automatically responds to sugar levels in the blood.

The synthesised modified molecule, called NNC2215, was tested in pigs and rats and was discovered to be as good as natural insulin in humans, according to a report in The Print. It is yet to be refined enough to be used in humans, however, initial findings are promising enough to be extremely similar to the expected observations in humans already.

Scientists believe that this insulin will help address the fluctuation of blood sugar levels and the challenge of matching insulin dosage to sugar levels. There have been previous attempts at engineering a smart molecule, but this is the first one that targets the sugar molecule glucose in the blood, instead of others like fructose.

David Sacks, a clinical chemist unaffiliated with the study, said, in a statement accompanying the research, “This is a very good study that was well designed—they did all the necessary experiments to validate that this works. It certainly provides encouragement that this approach is worth pursuing.”

Researcher Rita Slaaby and colleagues present a modified form of insulin with activity that varies according to the levels of glucose in the blood, according to a report in Medical Xpress. The molecule, named NNC2215, is equipped with a switch that can open and close in response to glucose.

Under high glucose concentrations, the switch opens, and the insulin becomes more active, removing glucose from the blood. When glucose levels decrease, the switch moves to a closed state, which prevents glucose uptake.

The NNC2215 molecule consists of two major parts in its structure, a ring-shaped structure called a macrocycle and a modified glucose molecule called glucoside. When the blood sugar levels drop, the glucoside activates and binds to the macrocycle, keeping the insulin molecule ‘closed’ in an inactive state.

However, when the blood sugar levels increase, the sugar molecules in the blood displace the glucoside and change the shape of the synthetic insulin molecule. This makes the “switch” turn on, thereby, helping in the release of insulin.

This modified insulin can help to prevent sudden sharp drops in blood sugar that tend to impact people with diabetes, especially during sleep. However, one of the major drawbacks of the study is that the blood sugar levels have to fluctuate to a very large degree and cause a steep rise for the molecule to activate.

The researchers are now working on bringing these levels down to smaller increases in glucose. The authors say that this insulin can help to improve both long- and short-term complications linked to diabetes.

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