Coffee may soon replace insulin injections in diabetic patients

The lives of more than 400 million patients suffering from Type II diabetes worldwide may witness a drastic yet positive change. Scientists at ETH Zurich in Switzerland have recently devised and tested a synthetic gene circuit responding to concentrations of caffeine in beverages. This revolutionary implant may render insulin shots obsolete as patients would be able to regulate their blood glucose simply by drinking coffee. Their findings have been published in the journal Nature Communications. This cutting-edge therapy is seen as having the potential to wholly and seamlessly reform the treatment and management of diabetes as coffee is the most consumed beverage in the world and thus, controlling blood sugar level would be outright easy.

In the United Kingdom (U.K.), 95 million cups of coffee are consumed daily. Comparatively, it is estimated that 4.6 million people suffer from diabetes, including those having Type II diabetes but who do not know it since they have not been diagnosed. 12.3 million people are also at an increased risk of this type of diabetes. The cost of diabetes to the National Health Service (NHS) is over £1.5m per hour or 10% of the NHS budget for England and Wales. In total, an estimated £14 billion is spent yearly on treating diabetes and its complications, with the cost of treating complications representing the larger share.

A simple caffeinated therapy integrated with lifestyle

Type II diabetes is a lifelong serious condition where insulin produced by the pancreas is not enough or does not work properly. Current health management in diabetic patients requires monitoring and responding to the increase in blood glucose following food intake. People with Type II diabetes generally have to take insulin injections to bring their blood glucose down to safe level. This can be a painful and inconvenient part of a lifelong therapy.

The therapy developed by the scientists was designed to be a simple one that can be seamlessly integrated with lifestyle. The team, hence, decided to fine-tune the treatment by using caffeine as a trigger since it is “non-toxic, inexpensive, and only present in specific beverages.” As a result, patients would no longer have to take additional chemicals or insulin and it would also be easier to make them comply with treatment regimens since coffee forms part of a routine cultural habit. The scientists strongly believe that therapies based on such routine habits can be seamlessly incorporated into people’s lifestyle, giving rise to a new generation of personalised medicine.

This progressive therapy is based on synthetic biology whereby human cells are engineered to sense caffeine and proportionately produce glucagon-like peptide 1 (to stimulate insulin secretion), according to Martin Fussenegger, professor at the Department of Biosystems Science and Engineering at ETH Zurich. The team carried out tests with by implanting these designer cells that are encapsulated in beads of half a millimetre. Protected from the immune system, they remain connected to the bloodstream and release glucagon-like peptide 1 once they sense caffeine. Various sources and doses of caffeine were used for the laboratory tests, including commercial brands of beverages. The experiments resulted in substantial improvement in glucose control. The implant could last from six months to a year before replacement. The ingenious development could alleviate some of the pain and inconvenience of having to endure one to multiple insulin shots per day both in Type I and Type II diabetes.

Coffee itself has been scientifically proven to reduce risks of diabetes

According to the Institute for Scientific Information on Coffee, various epidemiological studies suggest that consuming three to four cups of coffee daily can curtail the risk of developing Type II diabetes by approximately 25% compared to consuming none or less than two cups per day. The research comprised of 457,922 individuals and 21,897 newly-diagnosed cases of Type II diabetes from eight different countries. The team also noted that there exists a dose response, that is, every additional cup of coffee consumed per day (up to six to eight cups per day) was associated with a 5-10% lower risk of developing Type II diabetes.

This inverse association with coffee consumption is also buttressed by additional epidemiological studies and reviews from different countries.  For instance, a 10-year follow-up study from Greece underlined the significance of long-term habitual coffee drinking against diabetes onset. Further dose response studies have also culminated to the same results. A 2014 study proved that participants who increased coffee intake by more than one cup per day over a 4-year period had 11% lower risk of developing Type II diabetes, while those who decreased coffee consumption by one cup per day had 17% higher risk of developing Type II diabetes. These studies have additionally suggested that the effect was stronger for women than men.

Other coffee constituents play a key role in managing glucose

Caffeine is the main constituent in coffee but the beverage also consists of hundreds of other bioactive components. These coffee constituents, namely antioxidants such as chlorogenic acid and trigonelline, have shown to reduce early glucose and insulin levels at 15 minutes in oral glucose tolerance tests (OGTT).  These findings tally with data of a French study reporting the strongest association for coffee consumed at lunchtime. A 2017 review, as well as an analytical study of a key biomarker for diabetes, equally suggests that polyphenols found in coffee may have anti-diabetic effects.

Scientists believe that the various constituents in coffee may positively contribute to the total antioxidant load of a diet, and may subsequently help to limit oxidative stress. This, in turn, may limit the development of Type II diabetes. This potential role for coffee in reducing oxidative stress is interesting, although this hypothesis has not yet been verified. Other studies have proven that coffee has the potential to partly inhibit postprandial hyperglycaemia and, therefore, thwart the occurrence of Type II diabetes. The study was a cross-sectional multi-ethnic study conducted on 954 non-diabetic adults, and it was concluded that caffeinated coffee is positively related to insulin sensitivity.

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