For people living with type 1 diabetes, the risk of hypoglycemia — dangerously low blood sugar — is a constant concern. While insulin helps manage high blood sugar, a sudden drop can lead to confusion, seizures, or even death. Now, researchers at MIT have developed a small, implantable device that could dramatically improve emergency response in these situations. This innovation, a wireless-triggered reservoir that releases glucagon, offers a promising new approach to managing hypoglycemia and could provide peace of mind to patients and caregivers alike.

This implantable device, about the size of a quarter, sits just beneath the skin and holds a powdered form of glucagon, the hormone used to raise blood sugar levels. When triggered, either manually or automatically through a sensor, it releases a dose of the hormone to counteract hypoglycemia. The potential applications are especially meaningful for diabetic children or individuals who may not recognize the early symptoms of low blood sugar. I found this detail striking — the idea that a child could be protected from a silent, life-threatening drop in blood sugar during sleep is both powerful and deeply reassuring.

Daniel Anderson, a professor in MIT's Department of Chemical Engineering and senior author of the study, described the device as “a small, emergency-event device that can be placed under the skin, where it is ready to act if the patient's blood sugar drops too low.” He emphasized that the goal was to create a system that is always ready to intervene, reducing the fear that many patients and their families live with daily.

One of the key features of this emergency diabetes device is its integration with existing glucose-monitoring technology. Many patients already use continuous glucose monitors (CGMs) to track their blood sugar levels. The MIT team designed the implant so it could interface with these sensors. If blood sugar drops below a certain threshold, the device could be automatically triggered to release glucagon, eliminating the need for the person to recognize symptoms or take action themselves.

At the heart of the device is a 3D-printed polymer reservoir sealed with a shape-memory alloy made from nickel-titanium. When heated to 40 degrees Celsius, the alloy changes shape, opening the reservoir and releasing the powdered glucagon. The heating mechanism is powered by a wireless signal, which activates a small electrical current. This system allows for precise, on-demand drug delivery without the need for bulky external equipment.

Because glucagon in liquid form is unstable over time, the researchers opted for a powdered version, which remains viable much longer. This makes the device more practical for long-term implantation. Each unit can store one or four doses, offering flexibility depending on the patient’s needs and the device’s intended lifespan.

In preclinical trials with diabetic mice, the device effectively stabilized blood sugar levels within 10 minutes of activation. The researchers also tested it with epinephrine, used to treat severe allergic reactions and cardiac arrest, and observed elevated bloodstream levels and increased heart rate shortly after release. These results suggest the technology could be adapted for other emergency medications, broadening its potential impact beyond diabetes management.

Lead author Siddharth Krishnan, now an assistant professor at Stanford University, noted the versatility of the system. “One of the key features of this type of digital drug delivery system is that you can have it talk to sensors,” he said. The ability to integrate with existing monitoring systems could make the device a seamless addition to current diabetes care routines.

Importantly, the team also considered the body’s natural response to implanted devices. Over time, scar tissue can form around foreign objects, potentially interfering with their function. However, the study found that even after fibrotic tissue developed around the implant, the device still successfully released its contents when triggered. This suggests the system could remain functional over extended periods, although researchers are still determining the optimal lifespan — possibly a year or longer — before replacement is necessary.

The implications of this technology are significant. For those managing type 1 diabetes, especially children or individuals with impaired hypoglycemia awareness, this device could serve as a life-saving safety net. It also represents a step forward in the broader field of digital drug delivery, where smart implants respond to real-time physiological data to administer treatment precisely when needed.

The team is preparing for additional animal studies and aims to begin clinical trials within the next three years. If successful, this innovation could redefine how emergency medications are delivered, not just for diabetes but for a range of acute medical conditions.

As Robert Langer, a co-author of the paper and MIT professor, remarked, “It’s really exciting to see our team accomplish this, which I hope will someday help diabetic patients and could more broadly provide a new paradigm for delivering any emergency medicine.”

This research was supported by the Leona M. and Harry B. Helmsley Charitable Trust, the National Institutes of Health, a JDRF postdoctoral fellowship, and the National Institute of Biomedical Imaging and Bioengineering.

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