Two new Danish inventions may be the basis for a new intervention for people with type 1 diabetes. One is a mechanical artificial pancreas developed in a research alliance between Steno Diabetes Center Copenhagen and the Technical University of Denmark. The other is a stable, soluble glucagon preparation under development at the Danish firm Zealand Pharma.

‘We want to combine the two inventions, and we believe this can result in a better quality of life for patients, by improving glucose control, lowering the risk of developing diabetic complications and reducing the incidence of low blood glucose’, says doctor Ajenthen Ranjan PhD.

He works at Steno Diabetes Center Copenhagen, and for the next few years he will be working to find out whether the theory holds up.

He is one of a large research group from Harvard Medical School and Massachusetts General Hospital in the USA, the Technical University of Denmark, the University of Copenhagen, Zealand Pharma A/S and Herlev Hospital. He has just secured funding for his postdoctoral studies: the Danish Diabetes Academy has awarded him a grant of 1.2 million Danish kroner to enable him to devote two years to the task.

Too little exercise and too many calories

Semi-automatic insulin pumps and glucose sensors already exist, and they have changed type 1 diabetes patients’ lives for the better. But many are still taking too little exercise, partly because they are afraid of insulin shock. Others take in too many calories when they eat to keep their blood sugar up, which can lead to overweight.

The Danish-led research team believes the solution may lie in the combination of the two new inventions: first, the mechanical artificial pancreas, DiaCon, developed by Steno and the University of Southern Denmark, which automatically adjusts the insulin supply to match the insulin need, without user intervention. The other piece of news is that stable, soluble glucagon preparations are on the way, raising the possibility of long-term treatment. Glucagon is currently available only as a powder that must be dissolved immediately before use, and the solution lasts only a few hours. Danish firm Zealand Pharma is one of the companies that have made advances with this new, stable and soluble glucagon.

Low-dose glucagon effective

In his postdoc work, Ajenthen Ranjan, 32, is continuing the course he set out on when doing his PhD. Then, he investigated the possibility of using low-dose glucagon as an alternative to carbohydrates in the treatment of mild low blood glucose. It turned out that low-dose glucagon was effective, and that the effect depended on diet, activity level and insulin level, among other factors.

In this new project, he will study the possibility of including glucagon in manual and automatic insulin treatment, as glucagon can act as a safety measure in the event of low blood glucose, and can prevent it. It will be tested in a four-week study outside the hospital, with study participants injecting themselves with low-dose glucagon in the event of low blood glucose. Automatic insulin-glucagon treatment will be tested in the hospital, where participants will spend 33 hours fitted with DiaCon’s artificial pancreas, which uses a glucose sensor to automatically adjust the supply of pump-administered insulin and glucagon. Both studies will perform a comparison with the use of Dasiglucagon, the stable form of glucagon from Zealand Pharma, says Ajenthen Ranjan.

Ajenthen Ranjan’s primary supervisor is consultant, DMSc Kirsten Nørgaard of Steno Diabetes Center Copenhagen.

‘At the Danish Diabetes Academy, we think it is important that young researchers work both with universities and with hospitals, that they work internationally and with the life science industry. It is rare for this to happen at such an eminent level at this early stage of a researcher’s career, so we are looking forward to following their work.’

FACTS

The Danish Diabetes Academy was founded in 2012 and is supported by the Novo Nordisk Foundation and the Danish universities and university hospitals. Its objective is to strengthen Danish diabetes research and treatment by helping to train the diabetes researchers and practitioners of the future.

CONTACT
Ajenthen Ranjan
Email: ajenthen.ranjan@regionh.dk
Tel. +45 23 74 27 66

Danish Diabetes Academy
Managing Director Tore Christiansen
tore.christiansen@rsyd.dk
Tel. +45 29646764