Tim Heise, Germany
Profil -Presenter of 1 Presentation
Smart insulins
Abstract
Abstract Body
"Smart" or glucose-responsive insulins (GRIs) that only act when blood glucose levels are high safely avoiding hypoglycaemia are considered as the "holy grail" of insulin therapy. First concepts for such an insulin had already been published in the 1970ies, but to date only one clinical trial with a GRI has been published and this development was stopped. On the hand, numerous publications and patent applications have presented concepts and designs of GRIs, often with proof-of-concept data in (mostly small) animals.
The presentation will explain the various challenges GRIs are facing including, but not limited to, a high affinity and selectivity of the glucose-sensing moiety, a very fast activation and inactivation of insulin to avoid both hyperglycaemia and hypoglycaemia, and toxicity and stability issues. The pros and cons of various developments trying to overcome these challenges will be discussed.
Finally, it will be discussed how GRIs might change insulin therapy. While the ideal GRI would allow coverage of both basal and prandial glucose needs, first developments might still need to be combined with other glucose-lowering agents.