Nanomedicine – A cure for Type 2 diabetes?

by Jaison Jeevanandam and Dr Stephanie Chan

Almost everyone is familiar with the word ‘diabetes’ as it is one of the most widespread diseases among humans.

A recent report released by the World Health Organisation (WHO) on World Health Day 2016 stated that 422 million adults are living with diabetes, mainly in developing countries. This statistic is alarming that means about 8.5 per cent of the world’s population is suffering from diabetes, a significant increase from 4.7 per cent in 1980.

Diabetes is classified as Type 1 (lack of insulin secretion) or Type 2 (secreted insulin cannot be utilised by cells). Type 1 is mainly due to genetic makeup and is hereditary while Type 2 is mainly due to population shift in diet and exercise.

Type 2 diabetes is rapidly increasing among Malaysians. The National Health and Morbidity Survey (NHMS) reported that in 1983, 6.3 per cent of Malaysian adults above the age of 30 had Type 2 diabetes, increasing to 20.8 per cent in 2011.

Another report from the International Diabetes Federation (IDF) states that 3.3 million of Type 2 diabetic cases were found in Malaysia in 2015. The report also presents a shocking prediction that the number of diabetic cases will continue to increase up to 215 million in 2040.

A recent report published by the Malaysian Health Ministry states that 18 per cent or more than 5 million Malaysians are overweight or obese, a health condition that may lead to Type 2 diabetes.

Generally, insulin therapy is prescribed for Type 2 diabetic patients to control the disease’s metabolic complications. Insulin therapy is complex in nature and requires strong commitment from patients. Insulin syringes, pumps, pens, cartridges are used to administer insulin supplements into patients depending on their quantity and frequency.

The most prescribed insulin regimens in Malaysia are ‘premixed’ ones such as NovoMix®30, Mixtard®30 and Humalog Mix®25 as well as ‘basal’ insulin regimen such as Lantus®, Humulin N® and Levemir®. Different insulin regimens are widely available in the pharmaceutical market and are used depending on the severity.

Although these insulin regimens can control the sternness of the disease, the side effects are high. Patients who require frequent administration of insulin are found to develop side effects such as hypoglycemia, weight gain, allergy, urticarial and anaphylaxis.
Moreover, the cost of insulin regimen is high. For example, one of the most popular ‘premixed’ insulin regimen in Malaysia, NovoMix®30, costs about USD18. As the number of patients increases, the cost and stock production of these regimens will also increase not only in Malaysia but also throughout the world.

These negative aspects of insulin therapy has spurred researchers to find an alternative cure to this chronic illness. In recent years, the pharmaceutical industry has transformed conventional drugs to nano-formulations as they provide excellent results in treating diseases.
The word ‘nano’ comes from the Greek word ‘nanos’ which means dwarf. Particles which are smaller than micron range (10-9m) and possess more interesting properties than their bulk counterparts are called ‘nanoparticles’. These nanoparticles serve as drugs or drug-carrying formulations called ‘nanomedicines’ and are found to possess the ability to treat diseases better than conventional drugs.

Currently, there are about 43 FDA (Food and Drug Administration) approved drug formulations that are promoted as nanopharmaceuticals. For diabetic treatments, carbon nanotubes, quantum dots, artificial pancreas, nanopumps and polymeric nanoparticles like Chitosan, Polyacrylamide and Pluronic F-127 are nanomedicines that are under clinical trials to be used in insulin delivery and as glucose sensors.

The significant feature in nanomedicine is its high surface to volume ratio. Due to this phenomenon, nanomedicines can reach the target site easily and less quantity is sufficient for the treatment of diseases compared to conventional drugs.

An ongoing research project by Curtin Sarawak aims to formulate an effective nanomedicine for Type 2 diabetic treatment. It is being carried out by research student Jaison Jeevanandam under the supervision of Professor Michael Danquah and Dr. Stephanie Chan Yen San.

The project focuses on the formulation of a potential nanomaterial to activate enzymes which are responsible in allowing insulin transportation into the cell. As insulin resistance is observed in Type 2 diabetic patients whose bodies are able to secrete insulin, activating the enzyme to induce reserve insulin resistance could make it possible to convert diabetic cells into normal cells.

The most interesting aspect of this project is the use of plant leaves for the preparation of the enzyme-activating nanomedicine. Bayam (green spinach) and bayam merah (red spinach) that can be found locally in Sarawak are used for the nanomedicine preparation.
According to the research team, the success of the project will highly benefit the nanopharmaceutical industry and particularly Type 2 diabetes patients.

Jaison Jevanandam is a postgraduate student and Dr Stephanie Chan a senior lecturer of petroleum engineering in Curtin Sarawak’s Faculty of Engineering and Science. They can be contacted by e-mail to jaison.jeevanandam@curtin.postgrad.edu.myand chanyensan@curtin.edu.myrespectively.

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