Savvy Updates, 5/17/21: Bigfoot Biomedical Smart Cap, T1D and Microbiome, Smallest Injectable Chip, New Rx Bottle Design, Rethinking Carb-Insulin Model, Neuropeptide Y, 3-D Printed Vitamins, and Breathing Oxygen

FDA clears novel smart cap for insulin pens was posted on Healio.com/endocrinology, 10 May 2021. The FDA granted 510(k) clearance for a first-of-its-kind connected smart cap for insulin pens, recommending insulin doses for people with diabetes prescribed multiple daily injection therapy, according to press release.

Biomedical), which features smart caps that are integrated with Abbott’s FreeStyle Libre 2 system, translates continuously monitored glucose data into on-demand insulin dose recommendations displayed on the pen-cap screen for ease of use, according to the company. The system also includes real-time hypoglycemia alerts and is compatible with all major U.S. brands of rapid- and long-acting disposable insulin pens.

The Bigfoot Unity system has three primary components — proprietary smart pen caps for both rapid- and long-acting insulin, a mobile app and integrated FreeStyle Libre 2 integrated continuous glucose monitor (iCGM) sensor — that fit into the person’s dose decision process when they need it throughout the day, according to the release.

Diet, T1D, and the Microbiome was shared by Jenna Feeley for TheSugarScience.org, 30 April 2021. I can barely keep up with all the research on the gut microbiome and T1D. It matters what you eat!!!

Research continually shows that diet plays an integral role in modulating the microbiome. Because the microbiome has a profound impact on many systems within the body, monitoring and adjusting dietary habits to fit individual patient needs is central to maintaining health and wellbeing. This is even more important for those who are living with or are susceptible to autoimmune conditions, as the microbiome plays an important role in immune regulation.

Short Chain Fatty Acids Protect Against T1D: Lactate and butyrate, which are Short Chain Fatty Acids (SCFAs), seem to play a protective effect in T1D development. Decreased levels of lactate and butyrate producing bacteria have been linked to pancreatic beta cell autoimmunity. Bacteria metabolize nondigestible carbohydrates such as those found in fruits and vegetables in order to produce SCFAs. Therefore, it is important that T1D susceptible patients consume a diet high in nondigestible carbohydrates to ensure healthy levels of SCFAs.

Bacteroides & Beta Cell Autoimmunity: The Bacteroides species of bacteria are pathogenic and commonly found in clinical infections. Increased levels of Bacteroides species can lead to beta cell autoimmunity and a dysbiotic state that may leave patients susceptible to T1D development. Higher levels of Bacteroides have been observed in those who consume high levels of saturated fat and animal protein. Alternatively, the protein casein, a protein found in milk, was found to have a protective impact against beta cell autoimmunity in patients who are susceptible to T1D development. Lastly, a gluten free diet may protect against autoimmune disorder development by increasing the Akkermansia species and decreasing Bifidobacterium, Tannerella, and Barnesiella species.

Ketogenic Diet, the Microbiome, & T1D: Ketogenic diets have been utilized by T1D patients in order to tighten blood glucose control; decreased carbohydrate load helps to reduce insulin needs and blood glucose fluctuations. Ketogenic diets may also modulate the immune system by altering microbiome contents. In mice, it was found that decreased levels of Bifidobacteria (from a ketogenic diet) leads to a reduction of Th17 cells which subsequently reduces immune activation. Therefore, decreasing the Bifidobacteria species through a ketogenic diet would be beneficial for T1D patients as it would decrease unnecessary immune activation.

The takeaway: The diet plays an important role in maintaining health; however, with our new understanding of the microbiome and its far-reaching effects on overall health, our diet may be impacting us more than we previously thought. For T1D patients, diet impacts both the immune system (i.e. autoimmune attack against beta cells) in addition to daily blood sugar management. It is therefore imperative that T1D patients find a way of eating that supports their individual needs and promotes overall health. This may also be applied to those who are susceptible to T1D development as balancing the microbiome could potentially protect against autoimmune diseases.

Read much more research from TheSugarScience.org: Microbiome and T1D

The Smallest-Ever Injectable Chip Hints at a New Cybernetic Medicine was reported by Brad Bergan for InterestingEngineering.com, 12 May 2021. It’s the size of a dust mite!

Electronics are getting imperceptibly small, opening new avenues for medical technology to place advanced monitoring and treatment devices inside our bodies. And Columbia University engineers just demonstrated a new and revolutionary version of this, creating the world’s smallest single-chip system ever developed, according to a recent study published in the journal Science Advances. The implant created by the engineers at Columbia is record-breakingly small, but it’s also breaking new ground in simply existing as a wholly functional, electronic circuit whose total volume is less than 0.1 cubic millimeter. In other words, it’s the size of a dust mite, not to mention far more compact than the world’s smallest computer. And, the tiny new chip can be implanted via a hypodermic needle to measure internal body temperature, and potentially much more.

Typically, small electronics feature radio frequency (RF) modules capable of transmitting and receiving electromagnetic signals, this method generates wavelengths too large to originate from devices as small as the new one. Alternatively, ultrasound wavelengths are far smaller at specific frequencies because the speed of sound is a lot slower than the speed of light at which all electromagnetic waves move. Consequently, the Colombia team of engineers integrated a piezoelectric transducer capable of functioning like an “antenna” for wireless communication and powering using ultrasound waves.

Such tiny chips could also be implanted in the human body, and then communicate measured information and data wirelessly through ultrasound. As the device stands, it can only measure body temperature, but it could eventually also monitor respiratory function, glucose levels, and blood pressure. “We wanted to see how far we could push the limits on how small a functioning chip we could make,” said Ken Shepard, leader of the Columbia study, in a report from New Atlas. “This is a new idea of ‘chip as system’ — this is a chip that alone, with nothing else, is a complete functioning electronic system.”

The classic prescription bottle just got a compostable redesign was reported by Lilly Smith for FastCompany.com, 4 May 2021.

Prescription pill bottles—you know the ones, made out of see-through orange plastic with a white plastic locking cap—are ubiquitous. But they’re also ubiquitous in landfills, because they’re notoriously hard to recycle. Now, a team of designers has created a free alternative that can go into your compost bin when your prescription runs out.

To solve the problem, designers at Saatchi & Saatchi Wellness, a branding agency that focuses on the health sector, partnered with Israeli social design collective Tikkun Olam Makers (TOM) to design an alternative: a compostable, biodegradable pill bottle made out of paper. It’s the winner of the art and design category in Fast Company’s 2021 World Changing Ideas Awards.

This paper alternative is designed to have a short life cycle. In fact, you can put it in the compost when you’re done with it and it will decompose, says Scott Carlton, creative director at Saatchi & Saatchi Wellness. That’s because it’s designed with paper, adhesives, and a water-resistant coating that are all biodegradable. The design also complies with FDA regulations for child resistance.

Scientists propose a rethink of the role of carbs in obesity … an interesting new look at the carbohydrate-insulin model … was written by James Kingsland for MedicalNewsToday.com, 8 May 2021.

A popular theory asserts that carbohydrates in food cause a spike in insulin, which promotes fat storage and increases appetite, leading to overeating. However, recent research suggests that this “carbohydrate-insulin model” may be an oversimplification. In an article in the journal Science, researchers argue that while low carb, high fat diets can help some people lose weight, a more nuanced model is needed to explain how they work. They write that insulin levels between meals, and the hormone’s effect on multiple organs, are more important for balancing the body’s energy budget.

For decades, the causes of obesity — and the most effective way to lose weight — have been the subject of fierce debate among scientists and healthcare professionals. According to one theory, known as the “carbohydrate-insulin model,” food and drink that contain large amounts of carbohydrates cause a spike in circulating insulin levels. The hormone drives fat cells, or “adipocytes,” to store the excess calories, which reduces the availability of these energy sources for the rest of the body. This, in turn, increases hunger and slows metabolism, which leads to weight gain over time. Dietitians often cite the carbohydrate-insulin model to explain the success of high fat, low carbohydrate diets such as the ketogenic diet. Unlike carbohydrates, dietary fat does not cause a spike in insulin levels immediately after a meal.

On the other side of the debate, the energy balance model makes less of a distinction between fat and carbohydrates. This model focuses instead on the balance between total calorie intake through eating and drinking, and total calorie expenditure through physical activity. According to this model, if calorie intake exceeds expenditure, the result will be weight gain over time. But if expenditure exceeds intake, the eventual outcome will be weight loss.

Writing in the journal Science, two scientists argue that the carbohydrate-insulin model is overly simplistic. John Speakman, from the University of Aberdeen in the United Kingdom, and Kevin Hall, of the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, MD, do not dispute the success of high fat, low carb diets for some individuals. They also acknowledge that insulin plays an important role in body fat regulation. But they question whether the effect of insulin on adipocytes after eating food high in carbohydrates is solely responsible for weight gain.

They write: “We propose that the role of insulin in obesity may be better understood by considering its action on multiple organs that is driven by factors mostly independent of carbohydrate intake. Reconsidering the role of insulin may improve our understanding of the causes of obesity and its treatment.”

New drug turns ‘energy-storing’ fat into ‘energy-burning’ fat was reported by James Kingsland for MedicalNewsToday.com, 13 May 2021.

In response to starvation, a nerve signaling molecule called neuropeptide Y (NPY) boosts food intake and reduces energy output. A new study in mice suggests that a drug that blocks a receptor for NPY increases heat generation in fat tissue. In animals fed a high-fat diet, the drug reduced weight gain by around 40%. The drug does not appear to cross the blood-brain barrier, so unlike other weight loss drugs, it is unlikely to adversely affect mood.

Over the years, various drugs that suppress the appetite by acting directly on neurotransmitter systems in the brain have been withdrawn from the market due to adverse effects, particularly involving mood and the function of the heart. “Most current prescribed treatments are aimed at reducing food intake by targeting the central nervous system,” says Dr. Yanchuan Shi, who leads the neuroendocrinology group at the Garvan Institute of Medical Research, in Sydney, Australia. “However, these can have significant psychiatric or cardiovascular side effects, which have resulted in over 80% of these medications being withdrawn from the market,” she notes. Dr. Shi and colleagues wanted to test a new way of reducing weight gain without affecting the central nervous system. Their research has been published in Nature Communications.

The team focused on a nerve signaling molecule called NPY. It helps many animals, including mice and humans, survive conditions in which food shortages are commonplace. NPY increases food intake and conserves energy stores by reducing heat generation in a type of fat tissue called brown adipose tissue. In an environment where people have ready access to food and do not get sufficient exercise, however, NPY may make it particularly difficult to lose weight. Dr. Shi, Prof. Herzog, and colleagues investigated the effects of a drug called BIBO3304 on mice and human fat cells from people with obesity. The drug blocks a type of cell receptor for NPY called Y1 that is found in fat tissue and other tissues in the body. Crucially, BIBO3304 cannot cross the blood-brain barrier, so it is unlikely to adversely affect mood.

ADDED BENEFITS: In addition to reducing weight gain in mice, the authors discovered that blocking Y1 has several knock-on effects, including improving glucose metabolism. As Y1 contracts blood vessels, blocking Y1 with BIBO3304 may widen blood vessels, a process called vasodilation, which lowers blood pressure. The researchers had previously shown that BIBO3304 also stimulates bone cell growth, which could help maintain bone density, preventing osteoporosis in older people.

This company 3D-prints your favorite vitamins into a single gummy was posted by Talib Visram for FastCompany.com, 11 May 2021.

Melissa Snover started a customized vitamin company, Nourished, to fit “extremely high-impact nutrition into an enjoyable medium, to take on a daily basis.” When supplement-takers subscribe to Nourished, they can choose their “totally bespoke” collection of vitamins, which are then 3D-printed, using a patented process, into separate and precise vitamin layers, creating a single, vegan, sugar-free gummy. Those daily portions are then boxed up and shipped to customers in three-month supplies.

Most customers who use Nourished—there were about 15,000 boxes shipped in March—start by taking an algorithm-powered quiz on the website, which asks questions about allergies, use of glasses or contacts, consumption of processed food, and exercise and sleep habits. The answers generate a recommendation for the best combination of seven vitamins, minerals, or superfoods that are vital for helping bodies deal with different conditions, whether their properties are anti-aging, anti-inflammation, or pro-energy.

Snover started out 3D-printing candy gummies, without the vitamins, in 2015, and created a patented 3D food printer that was approved by both the Food and Drug Administration and the U.K.’s Food Standards Agency. That venture, the Magic Candy Factory, allowed for such precise and pretty confectionary as the gummy Eiffel Tower, made with the same vegan gel and customized flavor model that Nourished uses, but adding the health and wellness impacts. Nourished launched in January 2020 in the U.K., and in November 2020 in the U.S., under the parent health tech company that Snover founded in 2019, Remedy Health, which has just announced its Series A funding of $11 million.

And for fun, if you have read all the way down to the bottom here … Pigs and Rodents Can Breathe Through Their Butts in Emergencies was shared by Loukia Papadopoulos for InterestingEngineering.com, 15 May 2021.

You have probably heard the expression: when pigs can fly. Well, pigs can’t fly just yet but what they can do is breathe through their butts according to a new study. Rodents and pigs have the ability to use their intestines for respiration, finds a study published in the journal Med.

“Artificial respiratory support plays a vital role in the clinical management of respiratory failure due to severe illnesses such as pneumonia or acute respiratory distress syndrome,” senior study author Takanori Takebe of the Tokyo Medical and Dental University and the Cincinnati Children’s Hospital Medical Center said in a press release. The researchers tested these animals’ ability to breathe through their anuses by engineering an intestinal gas ventilation system to administer pure oxygen through the rectum of mice. Their study demonstrated that without the system no mice survived 11 minutes of extremely low-oxygen conditions. However, with intestinal gas ventilation, 75% of mice survived 50 minutes of normally lethal low-oxygen conditions. Now, the scientists are hoping their new system could be applied to humans particularly during the pandemic.

Of course, the human respiratory system is far more complex than that of a rodent or a pig. It’s also unclear how the researchers plan to apply it to humans.