Type 1 diabetes (T1D) affects 1 in 10 of the 141 million people with diabetes worldwide. In this form of diabetes, the body’s immune system—for reasons still unknown—mistakenly targets specialized clusters of cells in the pancreas called the islets of Langerhans. Specifically, this immune malfunction destroys beta cells, which produce the hormone insulin—an essential factor in how we metabolize nutrients.

Without insulin to make glucose available to cells for fuel, glucose builds up in the blood, causing dangerous short-term symptoms and long-term damage to the vascular system.

Sooner or later, the disease shuts down insulin production completely. Well before then, though, people diagnosed with type 1 come to depend on injected insulin to control their blood sugar level. With today’s insulin therapies and a closely monitored diet plus exercise, a determined individual can control his or her blood sugar well enough to avoid most vascular decay. But the cost is high—financially and in freedom of lifestyle. The current options are a poor substitute for fully functioning islets.

Spending on diabetes research and treatment is soaring. According to the American Diabetes Association, the total costs of diagnosed diabetes amounted to $174 billion in 2007. The National Institutes of Health (NIH) alone budgeted $150 million for type 1 research in 2010; millions more came from private foundations. But because the disease is so complex and we don’t yet understand what triggers the autoimmune attack, a true cure remains frustratingly out of reach, even while methods of managing T1D gradually continue to improve.

Researchers are focusing on four main approaches:

• Developing drugs to control the immune malfunction that attacks islets and beta cells
• Developing drugs that can regenerate beta cells or keep them alive and functioning
• The “closed-loop” artificial pancreas, a system that automates insulin delivery through the skin via a pump attached to the body
• Transplanting healthy islets (obtained from various sources) into the body so that this “bioartificial pancreas” can produce insulin on its own

All of these approaches have potential, and all have major obstacles to reaching the goal of safely and effectively treating large numbers of people with type 1. For compelling reasons we’ll set forth, Hanuman Medical Foundation is committed to the last approach: developing a true bioartificial pancreas.