"I can't just grab my keys and leave the house.ÌýI have to make sure I have something with me in case my glucose levels go too low.ÌýI have to make sure that I have spare insulin pump consumables.ÌýThere's lots of parts of having type one diabetesÌýthatÌýisn't just what we eat."
Michelle'sÌýlived with type 1 diabetes for 31 years. SheÌýhas toÌýplan everything: what she eats, when she drives, whether she can try new foods. Sophie, diagnosed as a teenager, spent years hiding her condition, injecting herself inÌýsecret inÌýher school bathrooms.
For the millions living with type 1 diabetes, insulin is lifesaving. ButÌýit'sÌýalso relentless. Multiple daily injections, or a pump worn 24/7, and constant vigilance of everything fromÌýhow you exercise to how hot it is on a given day.Ìý
Professor Victoria Cogger is working on something scientists long thought impossible: smart insulin delivered orally as a single daily pill.
Victoria explains how oral delivery could make insulin management much easier,Ìýwhat'sÌýmade oral delivery so difficult thus far, and what exactly makes this new pill ‘smart.’
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý00:01
This podcast is recorded at the University of Sydney's Camperdown campus on the land of the Gadigal people of the Eora nation.ÌýThey'veÌýbeen discovering and sharing knowledge here for 10s of 1000s of years. I pay my respects to elders past andÌýpresent andÌýextend that respect to all Aboriginal and Torres Strait Islander people.
³§´Ç±è³ó¾±±ðÌýÌý00:27
My name is Sophie, soÌýI'veÌýbeen living with type one diabetesÌýfor aboutÌýnearly 20Ìýyears.ÌýSo,ÌýIÌýgotÌýdiagnosed when I was about 14~15.ÌýIt wasÌýdefinitely aÌýshock in those first years after my diagnosis.ÌýIt was a lot of secrecy and hiding of my condition. Everything was done in the toilet or in secrecy like measuring my glucose, injecting myself before a meal would all be done in a toilet where nobody really knew what I was doing.ÌýAs a teenager, you want to fit in,Ìýthat'sÌýthe main thing all teenagers want to do.ÌýAnd the moment you get the diagnosis, you know thatÌýyou'reÌýdifferent,Ìýyou'llÌýknow that your lifestyle will be different to others, and youÌýhave toÌýbe more careful.ÌýI think thatÌýwas why I hidÌýit, becauseÌýI felt uncomfortable being different.Ìý
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý01:46
For the millions of people living with type one diabetes, insulin isÌýliterallyÌýlifesaving. Since its discovery over a century ago,Ìýit'sÌýtransformed type one diabetes from a death sentence into something that can be managed with daily injections or insulin pumps worn 24 hours a day.ÌýBut saying it can be managed undersells just how involved life with diabetes can really be.ÌýSoÌýwhat if insulin could think for itself, and what if it could be taken just once daily, with no needles and no need to think about theÌýdose.ÌýProfessor VictoriaÌýCoggerÌýis working on a solution long thought impossible:Ìýsmart insulin delivered orally in the form of a single daily pill.ÌýI'mÌýMark Scott, and this is theÌýSolutionists.ÌýProfessor VictoriaÌýCogger has been the director of the Anzac Research Institute at ConcordÌýHospital, butÌýshe'sÌýthe newly appointed inaugural Executive Director of the SydneyÌýBiomedicalÌýAccelerator and theÌýco-founderÌýofÌýEndoÌýAxiom, a company developing oral insulin using nanotechnology.ÌýVictoria,Ìýwelcome.ÌýLet'sÌýclarify exactly whatÌýwe'reÌýtalking about here. What is diabetes andÌýwhat'sÌýthe difference between type one and type two?Ìý
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý03:10
Hi Mark,ÌýlovelyÌýto be here today. Type one diabetes is when our pancreasÌýis not able toÌýsecrete any insulin any longer. It is an autoimmune condition that usually affects children between the ages of about five andÌýfifteenÌýisÌýwhen most children are diagnosed. Type two diabetesÌýon the other handÌýis when our body becomes insensitive to the insulin thatÌýwe'reÌýproducing. It's not that our pancreas stops producing it entirely at the beginning, it's just that our body can no longer sense it in the way that it needs to and it causes similar impacts as type one diabetes, but it is actually a very different disease to type one diabetes.Ìý
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý03:48
SoÌýthe vast majority ofÌýpeople living with diabetes are living with type two diabetes.ÌýSoÌýwhat are the common misconceptions about type one diabetes?ÌýIt'sÌýrelatively rare, is that right?Ìý
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý04:02
It'sÌýa much rarer disease, it usually is a childhood onset disease, andÌýit'sÌýnot something that can beÌýmodifiedÌýby lifestyle factors, in the same way that in type two diabetes you can haveÌýimpactÌýon that disease. Type one diabetes is an autoimmune disease.ÌýIt'sÌýyour pancreasÌýliterally eatsÌýitself, and the cells that produce the insulin are no longer present in your body. Your body simply cannot produce insulin any longer.ÌýIt'sÌýnot that you need to potentiallyÌýmodifyÌýyour diet or potentially do a little bit more exercise or change something else in your lifestyle. It is that your body simply does not have the capacity any longer to produce insulin, and this causes dangerously high blood sugar levels, which can create a condition known as diabetic ketoacidosis, which is very life threatening.Ìý
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý04:52
SoÌýyou'reÌýtrying to change the way that people manage their type one diabetes. How are people managing it now?ÌýWhat'sÌýthe common day to day life experience of someone with typeÌýone?
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý05:03
SoÌýtype one diabetes can only be managed by daily injections or pump infusion of insulin. So this involves the delivery of insulin into the body either via a needle into the subcutaneous fat, usually of the belly or the leg, and they deliver insulin that wayÌýfour, five, sixÌýtimes a day, so that their body can keep up with their requirements for the insulin, so that the sugar can get to where it needs to get in the body.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý05:32
SoÌýthis means, have I got this right, thatÌýyou'llÌýhave young people,Ìýyou'llÌýhave children who will needÌýfour,Ìýfive,ÌýsixÌýinjections a day of insulin to stay on top.
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý05:42
That'sÌýright.ÌýSoÌýfour, five, six, orÌýthey'reÌýon a pump thatÌýthey'reÌýconnected to 24 hours a day.Ìý
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý05:47
And what does the pump do?Ìý
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý05:48
SoÌýthe pump acts as an artificial pancreas, and throughÌýmonitoringÌýyour blood sugar levels, it then titratesÌýthe level of insulin that needs to be released into your body to try and keep your levels of blood glucose or blood sugar between aÌýrelatively normalÌýor safe level.ÌýAnd so basically, somebody who lives with type one diabetes needs to be on top of this all day, every day.
³§´Ç±è³ó¾±±ðÌýÌý06:16
I gotÌýtheÌýinsulin pump. That has beenÌýa big changeÌýto my condition.ÌýBefore, I was injecting myself at least four times a day or more, and because of theÌýnew technologyÌýthat has come through, youÌýdon'tÌýhave to prick yourself every day as well.ÌýObviouslyÌýyou have all these machines locked onto your body, likeÌýthey'reÌýstuck to your body, butÌýthere'sÌýa lot of technology that has helped toÌýkind ofÌýminimiseÌýthe blood pricks and the injections. And so obviously that has reallyÌýhelped, becauseÌýIÌýdon'tÌýreally have to go toÌýa toiletÌýand open a needle. And you know everybody has, everybody don't like seeing a needle in public, but having a pump, you just take up the machine and adjust the dose for your meal, and so it has become more easier to manage in the public definitely with the developmentÌýofÌýtechnology.
²Ñ¾±³¦³ó±ð±ô±ô±ðÌýÌý07:13
My name is Michelle, and I have lived with type one diabetes now for 31 years, and I was diagnosed on the 14th of November 1994 which ironically wasÌýactually WorldÌýDiabetes Day. I was aÌýpre-teen, and then I went through it as a teenager.ÌýYou know, being a teenager is hard enough without also having a condition where youÌýhave toÌýgive yourself medication, youÌýhave toÌýgive it attention, and you constantlyÌýhave toÌýplan what you are doing.ÌýIt wasÌývery littleÌýspontaneity, andÌýso thatÌýthat was always quite tricky. I guess one of the things that people misunderstand about diabetes management is often thatÌýit'sÌýjust about food,Ìý²¹²Ô»åÌýit'sÌýjust about yourÌýmedication, andÌýthere'sÌýactually aÌýlot of other factors that affect our glucose levelsÌýthroughÌýthe day.ÌýSoÌýyou know, ifÌýI'mÌýfeeling a bit stressed one day, or ifÌýI'mÌýfeeling nervous aboutÌýsomething, andÌýmy glucose levels can rise because of that. IfÌýI'veÌýdone some exercise, then my glucose levels can go high from that exercise, and sometimes they go low from exercise, depending on what type of exercise I do. And if I want to drive the car, IÌýhave toÌýsee what my glucose level is to make sure thatÌýI'mÌýat a safe levelÌýthatÌýI can drive my car.ÌýYou'reÌýconstantly planning your next move andÌýto leaveÌýthe house, IÌýhave toÌýmake sure I have something with meÌýin case my glucose levels go too low.ÌýIÌýhave toÌýmake sure that I have spare insulin pump consumables.ÌýSo,Ìýthere'sÌýlots of parts of having type one diabetes whichÌýisn'tÌýjust what we eat.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý09:20
SoÌýtell us about the workÌýyou'reÌýdoing now.ÌýYou'reÌýstill working onÌýinsulin, butÌýthinkingÌýthroughÌýhow it can be delivered differently.
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý09:28
So one of the things, and there are no two ways about it, injectable insulin isÌýlifesaving, and the people that discovered it and were able to separate it out of the,Ìýyou know, originallyÌýpig pancreasesÌýjust over 100 years ago, really they won the Nobel Prize, they deserve everyÌýbit of that Nobel Prize. But the thing is, isÌýthat when we take insulin, weÌýhave toÌýinject it, and the way we inject insulin does not mimic the way in which insulin is normally secreted byÌýthe body. And instead ofÌýgoing inÌýdirectly into our bloodstream, it goes into our subcutaneous fat, and then it travels around the body before it gets to its target tissues. And that isÌýreally notÌýa very effectiveÌýway of deliveringÌýinsulin, andÌýcreates lots of side effects known as iatrogenic impact.ÌýAnd these side effectsÌýactually canÌýbeÌýreally counterproductiveÌýto managing body weight, managing insulin sensitivity, managing infections,Ìýall ofÌýthose sorts of things.ÌýAndÌýso,Ìýcreating a different method of delivery is something thatÌýbecameÌývery importantÌýto our team.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý10:37
SoÌýwhat have you begun to focus on?Ìý
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý10:41
So, we reallyÌýstartedÌýto look at how we could orally deliver insulin, and we really started to try to understand how we could take something that is only able to be ingested or taken into the body via injection.ÌýWe wanted to try and see if we could make it orally bioavailable.ÌýSoÌýit'sÌýone thing to get something into your body,Ìýit'sÌýanother thing to make it available to your body, and that is what we have focused on.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý11:05
And would oral insulin be that much more efficient?
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý11:09
Absolutely.ÌýSo oral insulin, when we take something via our mouth, it goes straight into our bloodstream, from our gut and directly to our liver.ÌýWhen our pancreas secretes insulin in people that are not living with diabetes, it goes straight into our bloodstream from our pancreas,Ìýstraight to our liver.ÌýSoÌýin some ways they mimic each other. When we take it subcutaneously, it goes everywhereÌý
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý11:34
on the circuit
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý11:35
and then it comes to our liver.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý11:36
And again, the dangersÌýof itÌýgoing on that indirect circuit through to our liverÌýhasÌýreal physical consequences.Ìý
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý11:44
Absolutely.ÌýSo one of the big problems with insulin therapy is people that start it immediately put on weight,Ìýbecause they're fat and they're just their normal you know, adipose tissue and their muscles start to be exposed to levels of insulin that someone that's not living with type one diabetes are not exposed to.ÌýAnd those levels cause excess fatÌýdeposition becauseÌýinsulin causes fat uptake into your fat deposits,Ìýand alsoÌýcan cause fat deposits into your muscle, which isÌýreally notÌýsomething that is great to live with.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý12:16
People have been injecting insulin for 100 years. What stood in the way of us developing an oral solution?
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý12:23
Absolutely, so lots of people have tried, and, you know,Ìýwe'reÌývery aware that many people have tried before us.ÌýAnd basically, ourÌýbody isÌýreally cleverÌýand has evolved all sorts of mechanisms to stop proteins, of which insulin is one, from getting into our body intact. AndÌýthat'sÌýbecauseÌýthat'sÌýone of the ways in which we preventÌýinfectionÌýand we prevent toxicity from, you know, things that we pick up off the floor, and all those sorts of things.ÌýOur body breaks it down in our stomach with high acids and enzymes and all those sorts of things which break down proteins into their core components. The reason insulinÌýcan'tÌýget in is because ofÌýall ofÌýthose factors. AndÌýsoÌýwhat weÌýhave neededÌýto do is invent a way to make sure we can protect the insulin from our body's innate mechanisms, to protect it fromÌýusÌýingesting whole protein.Ìý
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý13:10
SoÌýtheÌýstomach would normally attack the insulin before the benefits could beÌýaccrued?
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý13:15
Absolutely.ÌýYou would not get a whole molecule of insulin into your bloodstream. You just get bits of it. AndÌýsoÌýwhatÌýwe'veÌýdone isÌýwe'veÌýcreated a way to get the whole molecule in and make sure that it can still work when it gets into your bloodstream.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý13:29
So how are youÌýgoingÌýabout that?
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý13:31
It'sÌýbeenÌýa really interestingÌýprocess, becauseÌýit'sÌýpushed us into areas that we are not, youÌýknow,ÌýthatÌýwe'reÌýnot innate nano technologists.Ìý
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý13:40
AndÌýwhat'sÌýa nanotechnology?Ìý
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý13:41
Sure.ÌýSoÌýnanotechnology is really an area of science or an area of physics and chemistry whereÌýwe'reÌýlooking at molecules and designing molecules that are sub 100ÌýnanometersÌýin size.ÌýSoÌýto give you some context, 100ÌýnanometersÌýis about the width of about a third of the width of a human hair.ÌýSoÌýwe'reÌýtalking about very, very, very tiny molecules. And the reason they are so interesting is because they allow us to circumvent some of the properties that our bodyÌýhas toÌýprotect itself.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý14:16
Is thatÌýdue to the fact thatÌýit is so small?Ìý
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý14:19
PartlyÌýit'sÌýso small, butÌýit'sÌýalso because of some of the innate properties of theÌýparticular nanoÌýtechnologies you might like to use.ÌýWe useÌýa quantumÌýnanotechnology, which means our dots can behave either as a wave or as a particle, and this is howÌýwe'reÌýable to getÌýthrough intoÌýthe body.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý14:36
Now, that sounds complicated-
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý14:38
It is.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý14:39Ìý
But explain it to us a bit more. So,Ìýthe molecule that carries the insulin, tiny,ÌýtinyÌýdelivered into the stomach, and then using these quantum capabilities allows it to bypass the protective mechanism.
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý14:57
That'sÌýright.ÌýSoÌýthatÌý²¹²Ô»åÌýa protectiveÌýcoating, which we can comeÌýtoÌýbut the nano particle can behave like a wave or a particle, we attach the insulin to it, and it still stays, so our dots are only about sevenÌýnanometersÌýin size, and then when we add the insulin to it and encapsulate it, we keep them below the 100ÌýnanometerÌýsize, and so they continue to be able to act in that way that allows them to basically slip through the cells and into our bloodstream.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý15:26
SoÌýthat'sÌýtheÌýsweet spotÌýis the 100. And ifÌýit'sÌýsmaller than that,Ìýit'sÌýlikeÌýit'sÌýmore likely to be able to make its way throughÌý
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý15:33
That'sÌýexactly right.Ìý
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý15:34
How on earthÌýdo youÌýload upÌýa molecule onto something so small?
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý15:38
Yeah,Ìýit'sÌýa good question, and involves very clever chemists, butÌýreallyÌýwe have aÌýlinker molecules, and we also use electrostatic or negative positive charge. It really comes down to things as simple as that positive negative, just like a battery, we join themÌýtogetherÌýand they match up, and they allow us to attach the insulin to the molecule, and then we can keep them together.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý16:00
This feels a long way away from your core medical experience, first up.
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý16:06
Absolutely and the work really has only been possible because of our collaborations with very clever people at theÌýNanocentreÌýhere,ÌýZdenkaÌýKuncicÌýfor example, myÌýco-inventors, DavidÌýLacuda, who is a clinician and has significant experience in treating diabetes,Ìýand also Dr Nick Hunt, who is the otherÌýco-inventorÌýof the molecule.ÌýWe have really had to push into areas that we knewÌýwhat we wanted to do,Ìýwe needed help to work out how exactly to do it, and we've been very fortunate to collaborate with people that have been really willing to go on that journey with us.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý16:41
It'sÌýa great exampleÌýof multidisciplinary teams taking on the great global challenges. They talk about your pill as being a smart insulin pill.ÌýSoÌýit'sÌýnot just tiny,Ìýin what ways would it be smart?
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý16:55
SoÌýit'sÌýclever, and this really was Nick's leap of faithÌýfor us.ÌýIt's clever because we're able to coat it in a way that the coating which partly protects it from the enzymes that I spoke about before in the stomach and gastrointestinal tract, it coats it in a way that means that the insulin cannot be released unless the enzymesÌýto break down the coatingÌýare able to operate, and they can only operate in high glucose environments.ÌýSoÌýwhen the body has low blood glucose or low body sugar, the insulin is hidden andÌýit'sÌýnot bioavailable. AndÌýsoÌýin doing thatÌýwe make it smart, because the insulin can onlyÌýimpactÌýthe body in the same way that the pancreas works.ÌýThe insulinÌýis only active when there's sugar in the blood. In low sugar environments, the insulin just stays tightly wrapped up in its little package.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý17:50
SoÌýif I go back to the current treatment, which is all about the pump and the measuring and then delivering the necessary dose, the medication itself only works if the condition is set that the body really needs it.
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý18:03
That'sÌýexactly right.ÌýSoÌýthe enzymes can only work if the body needsÌýit.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý18:09
Sounds incredibly exciting. Tell us about the journey from taking smart ideas in the lab on a process of development wherebyÌýyou'veÌýgot theÌýdrug, andÌýthen trials of the drug andÌýpossibly changingÌýthe worldÌýas a consequence ofÌýthis.
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý18:29
MarkÌýit'sÌýbeen a phenomenal process, it has been a learning curve like nothing elseÌýI'veÌýknown in my life, and it has been a wonderful ride. WeÌýagain,Ìýneeded to lean into areas of complete discomfort and interact in ways with companies, in ways with investors.ÌýWe’veÌýreally had to work across the basicÌýdiscovery side, pushing into clinical experience andÌýall ofÌýthose sorts of things.ÌýSoÌýthrough collaboration, we were able to understand what the problems are with insulin delivery.ÌýSoÌýall ofÌýthat sort of thing was incredibly important, and then basically, we needed to go and learn how to pitch our ideas to people that were potentially going to help us get them out of the lab and into the clinic.ÌýWe'veÌýhad to learn about manufacturing,Ìýwe'veÌýhad to learn about regulatory affairs,Ìýwe'veÌýhad to learn aboutÌýall ofÌýthose sorts of things. But luckily,Ìýwe'veÌýbeen supportedÌýto doÌýthat here, and that has been somethingÌýthat'sÌýbeenÌýreally important. The other thing that really helped us was partnering with the business school was incredibly important. AndÌýalsoÌýwe wereÌývery fortunateÌýto receive a philanthropic bequest that really helped supercharge this project.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý19:38
One of the thingsÌýyou'veÌýdemonstratedÌýis the power of business partnershipsÌýin this work. TellÌýus a bit aboutÌýProtoÌýAxiom andÌýEndoÌýAxiom.
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý19:45
SoÌýProto is a biotech accelerator here in Sydney.ÌýIt'sÌýaÌýfairly newÌýcompany, and Anthony Liveris came into the market to disrupt and try and help to accelerate biotechnological advancesÌýthat are coming out of universities.ÌýAnd so he really came in with some venture capital, and has raised funds and done series raises and all of those sorts of things, so that he can start to help to license intellectual property out of universities and medical research institutes into the corporate space so that they can start to get the support and traction and business development that they need. Obviously, you need to do clinicalÌýtrials,Ìýthey'reÌývery expensive. You need to doÌýall ofÌýthe regulatory things that I spoke about,Ìýall ofÌýthat stuff needsÌýknowÌýhow and needs support. But all of that costs money, and so really, the partnering withÌýProto so that we could spin out with the University of Sydney and the Sydney Local Health District to formÌýEndoÌýAxiom is what is pushing forward our oral insulin into the clinical trials that are that are currently getting ready to get underway.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý20:53
And how long will that takeÌýthat clinical trialsÌýprocess?Ìý
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý20:56
So theÌýclinical trial will take six months, the first clinical trial, and then after that, we'll move into phase two, and that will take another two to three years, and then the phase three,Ìýthat's when it starts to go worldwide andÌýstarts to be sort of incorporated into clinical practice, but in an experimental way.ÌýSoÌýwe'reÌýstill a few years off thisÌýhitting, you know, the shelves as such, butÌýwe'reÌýwell and truly on the path, and for me, that is a moment of huge fulfillment.
²Ñ¾±³¦³ó±ð±ô±ô±ðÌýÌý21:29
I think the biggest thing would be if I could just sit down and eat some food and not have to think about it 15 minutes before and not have to count my carbohydrate foods in my meal and worry that I might have calculated it wrong.ÌýIt'sÌýone of those things that makes me not always want to try different foods, because IÌýdon'tÌýwant to have to deal with it afterwards. I think for me, having something which means that I can just eat something without having to count the carbohydrates in it, and without having to worry about the repercussions on it afterwards.Ìý
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý22:23
Now,Ìýyou'reÌýnot just a scientist in thisÌýspace,Ìýyou'reÌýa caregiver to someone living with type one diabetes. But that cameÌýlater,Ìýyou started the work first, tell us this story.
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý22:34
Yeah, so my son wasÌýten, and we had already finished the oral insulin formulation, the one that is going into people, and we just finished it, and he was not very well. And it was throughÌýCOVID,Ìýso you know it was, as we all know, the medical system was so under strain, and he got terribly, terribly unwell one Christmas, and I didn't know what was wrong with him, and I thought he had a virus. He was rushed to hospital, and I by the timing, I had no idea what was wrong with him, even though I work in this field and had so muchÌýexperience.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý23:09Ìý
SoÌýyouÌýdidn'tÌýthink thisÌýisÌýdiabetes?
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý23:12Ìý
Not at the beginning.ÌýAnd when I look back,ÌýI'mÌýaghast, because I think,Ìýhow on earthÌýdid I miss that? But I rushed him toÌýhospital, and when I gotÌýtoÌýemergency, I said to them, my son either has type oneÌýdiabetesÌýor he has a brainÌýtumor. And they said, well,Ìýlet'sÌýcheck the type one diagnosis first. And his blood sugar levels wereÌýthirtyÌýsomething, which normally there should be five. And he was, youÌýknow,Ìýhe was very, very acutely unwell, and the team that helped him, you know,Ìýsort of helpedÌýus support him in those first few daysÌýwereÌýphenomenal.Ìý
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý23:50
I canÌýimagine this just creating this massive, complex, almost psychic reaction from you. I mean, devastated as a mother that your child is so sick, relieved at a diagnosis, but of all the diagnoses for him to have, it being the area that you've committed your professional life to, how did you come to terms with that?
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý24:12
It was a big head wrestle for quite a while. I was very worriedÌýfor a long timeÌýI'dÌýbrought something home from the lab and done something to him, and that was something, you know, and it took his endocrinologist and everything to say, you know,ÌýthisÌýdidn'tÌýhappen like that. You know, calm down.ÌýIt'sÌýgotÌýnothing to do with you. But I think what it did for me and the project and I think the way I then worked with our team was it made it something that I was able to say this is going to make a tangent. It took it from something that was abstract to something that you really started to understand what it is like for someone that is having to live with multiple daily injections or a pump, and you see how it changes fundamentally the activities of daily living.ÌýYouÌýhave toÌýthink, what are weÌýeating, what are we doing today, what are we, you know, what do we need packed in the car?ÌýYou know, particularly when he was little. And you know,Ìýhe'sÌýnot so littleÌýnow,Ìýhe'sÌýgiant. But you know, he loves football, he loves his sport and all you know, and he really does change the way you think about it, and who's going to be with him today when he's playing sport, who's going to make sure he's got his juice in his bag, his things in his bag.ÌýWhat'sÌýat school for him to make sure that he is going to be okay if he has an event at school?Ìý
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý25:29
Yeah.ÌýSoÌýit brought youÌýkind of deepÌýempathy and insight into patients and, I suppose, into carers and to families.ÌýDid it change any of your researchÌýas a consequence ofÌýthat?
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý25:41
Absolutely. It changed it to something that I knew needed to be addressedÌýand hopefully we can create a technology that not just delivers insulin, that can solve this problem for other proteins as well.ÌýSoÌýallÌýprotein-basedÌýdrugs need to be injected. And this sort of technologyÌýit'sÌýlikeÌýwe'veÌýdesigned a new suitcase forÌýthe protein. And if we canÌýimpactÌýother diseases in this way, I can only, you know, hope that we can change the lives of other people as well.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý26:12
SoÌýif you crack this delivery mechanism, what are some of the other diseases that might be helped through this?
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý26:19
SoÌýthere are lots of diseases that need injections, things like children that have stunted growth or limited growth require human growth hormone injections. There are other diseases that the GLP ones, theÌýOzempic'sÌýand all theirÌýprotein-basedÌýdrugs?Ìý
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý26:32Ìý
Right,ÌýsoÌýyou can take a tablet for that?
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý26:34Ìý
Absolutely,Ìýrather than an injection. It also makes it cheaper, because youÌýdon'tÌýhave a lot of the issues that are related with injectable drugs.ÌýWe'veÌýspoken about the issues to the person, but alsoÌýprotein-basedÌýdrugs need to be refrigerated. They need to be cold-stored, you know, transported. They have limited shelf lives. This has majorÌýsocio-economicÌýimpacts.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý26:57
So,Ìýno pressure Victoria, but the biggest buildingÌýwe'veÌýever built here in the 176 years of the University of Sydney, is the new SydneyÌýBiomedicalÌýAccelerator, andÌýyou'veÌýjust been appointed the inaugural director of that that new complex for us. Tell us about the opportunities that you think the biomedical accelerator could bring to the treatment of patients and the development of new drugs and diagnostic tools.
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý27:23
So for me, and I think the University of Sydney and the Sydney Local Health District and the people of New South Wales, the SydneyÌýBiomedicalÌýAccelerator is going to transform the way in which we as a university and a local health district can both treat the patients that we have and design new treatments for the patients in the years to come. We are taking a relationshipÌýthat'sÌýbeen in place for I thinkÌýit'sÌý140Ìýsomething-Ìý
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý27:51
140 years.
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý27:52
140 years. We are taking aÌýrelationshipÌýand we are solidifying our partnership by committing to working side by side in a synergistic way that willÌýimpactÌýdiscovery,ÌýbiomedicalÌýdiscovery, and take it straight to the clinic for the people of New South Wales and the world.ÌýIÌýcan'tÌýunderestimate how exciting this is for the University of Sydney and the Local Health District. It is something that we have long dreamed of,Ìýit'sÌýsomething that few other places have achieved, andÌýwe'reÌýon the precipice of it,Ìýit'sÌýremarkable.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý28:30
And it strikes me that this development may have been a long time coming, butÌýit'sÌýarriving just at the right time. The impact of quantum, the impact of nanotechnology, the impact of AI means thatÌýall ofÌýthese tools that are now available to our brilliant scientists and wonderful clinicians just gives them a repertoire that they can draw on, which should really help with discovery and translation.
³Õ¾±³¦³Ù´Ç°ù¾±²¹Ìý°ä´Ç²µ²µ±ð°ùÌýÌý28:55
Oh, absolutely.ÌýI think thereÌýare points in history where you can seeÌýthere’reÌýgreat leaps are possible because something has changed in the ecosystem, you know, whether it is AI or the single patient digital health record or things like that.ÌýWe areÌýnow committing to saying we are going to use these technologies for the good of these patientsÌý²¹²Ô»åÌýalso, I think, you know, for the fulfillment of our scientists and clinicians, and IÌýdon'tÌýthink that can be underestimated. The people that are delivering this work are committed to making the world a better place, and we are inviting them to do that.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý29:34
AndÌýwe'reÌýthrilledÌýyou'reÌýtaking on that leadershipÌýrole,Ìýthat's Professor VictoriaÌýCogger.ÌýShe'sÌýthe newly appointed inaugural Executive Director of the SydneyÌýBiomedicalÌýSccelerator. And if you want to learn more about how diabetes researchers are leading us into the future of medicine, listen to our episode with Professor David James,Ìýwho'sÌýworking on precision medicine.
¶Ù²¹±¹¾±»åÌý´³²¹³¾±ð²õÌýÌý29:57
What I would like to see is ifÌýwe could do a test on people right at the get go, and that test would tell us you should be taking drugÌýY, so that you immediately take a prescribed drugÌýY, save all those problems, and you save the potential dangerous adverse effects from taking four medications instead of one.
²Ñ²¹°ù°ìÌý³§³¦´Ç³Ù³ÙÌýÌý30:22
You can listen to that episode of theÌýSolutionists right now and make sureÌýyou'reÌýfollowing theÌýshowÌýso youÌýdon'tÌýmiss an episode.ÌýTheÌýSolutionists is a podcast from the University of Sydney, produced byÌýDeadsetÌýStudios.Ìý
The Solutionists is a podcast from the University of Sydney, produced byÌý. Keep up to date withÌýThe SolutionistsÌýby following @sydney_uniÌýonÌýÌý²¹²Ô»åÌý, and @sydney.edu.au onÌý.
This episode was produced by Liam Riordan withÌýsoundÌýdesign by Jeremy Wilmot. Supervising producer is Sarah Dabro. Executive editors are Kellie Riordan, Jen Peterson-Ward, and Mark Scott.ÌýStrategistÌýis Ann Chesterman.
This podcast was recorded on the land of the Gadigal people of the Eora nation. For thousands of years, across innumerable generations, knowledge has been taught,ÌýsharedÌýand exchanged here. We pay respect to elders past and present and extend that respect to all Aboriginal and Torres Strait Islander people.
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