How Can Exosomes Become an Alternative Therapy for Diabetes?

When Sugar Becomes a Threat: Why Should We Be Concerned About Diabetes?

Diabetes isn’t just another disease—it’s a serious global challenge, with the number of cases expected to rise over time. In 2021, the International Diabetes Federation (IDF) reported 527 million adults aged 20–79 suffering from diabetes, meaning that 1 in 10 people has diabetes, a figure that has grown by 16% (about 74 million people)since the IDF’s previous estimate in 2019. The number is projected to rise to 643 million by 2030 and 784 million by 2045.

The modern lifestyle, filled with high-sugar diets and a lack of physical activity or healthy habits, puts millions at risk of developing diabetes without them realizing it—especially those who are overweight or obese. Diabetes occurs when the body is unable to use insulin properly or does not produce enough insulin, causing blood sugar levels to spike. . If insulin is not produced normally, it disrupts blood sugar circulation. If left uncontrolled, diabetes can lead to severe complications such as heart disease, kidney failure, nerve disorders, and even permanent blindness.

SciWord of the day!

Insulin

Insulin is a hormone in the body that helps transport sugar from the blood into cells to be converted into energy. If the body cannot produce insulin properly, sugar builds up in the blood and can cause health problems like diabetes.

In medicine, insulin is essential for people with diabetes. Those with type 1 diabetes rely on artificial insulin because their bodies cannot produce it at all. Some people with type 2 diabetes may also need it if their bodies have trouble using insulin effectively. Artificial insulin is made in laboratories and serves as a substitute for natural insulin to help regulate blood sugar levels. 

Fun fact: Insulin works like a "key" that unlocks cells so sugar can enter and be used as energy!

Discovered by: Frederick Banting and Charles Best (1921)

However, there is good news—scientific advancements continue to progress, and new hope has emerged in the fight against diabetes. This hope comes in the form of therapy using exosomes—tiny particles with remarkable potential in combating diabetes.

Exosomes: A New Hope

Exosomes are tiny particles produced by nearly all cells in the body, including stem cells. They contain RNA, microRNA, proteins, and lipids that can alter the function of target cells, either by repairing damaged cells or optimizing bodily functions.

Essentially, exosomes act as "couriers" or "messages" between cells, enabling communication that helps target cells heal and function more efficiently. In recent years, scientists have discovered that exosomes are effective in treating diabetes and show great promise as a therapeutic tool for the disease.

How Can Exosomes Help Diabetes Patients?

Since exosomes play a crucial role in "cellular communication," they can assist diabetes patients in various ways through what is known as "biological mechanisms." One of these mechanisms involves exosomes protecting and repairing pancreatic cells, particularly pancreatic β-cells, which are responsible for insulin production. Damage or death of β-cells is a primary cause of diabetes since, without these cells, the body cannot produce enough insulin.

Exosomes carry "packages" containing regenerative molecules or molecules that interact to inhibit certain proteins, such as p38, to prevent β-cell apoptosis (cell death) and accelerate their repair, ensuring that the pancreas continues producing insulin normally. Additionally, the "communication" facilitated by exosomes enhances insulin sensitivity, allowing blood glucose to be absorbed quickly and preventing glucose buildup in the bloodstream.

Moreover, exosomes contribute to maintaining fat metabolism. The relationship between insulin sensitivity and fat metabolism is proportional—when insulin functions properly and its sensitivity increases, fat metabolism runs smoothly, preventing fat accumulation. Conversely, impaired fat metabolism leads to fat buildup in specific tissues, reducing insulin sensitivity and hindering fat distribution for energy production.

The Future of Diabetes Treatment

Compared to stem cell therapy—another regenerative treatment—exosomes are considered to have fewer side effects. Unlike stem cells, exosomes do not trigger immunogenic reactions (immune responses) or side effects such as tumor growth. Therefore, exosomes, as a new regenerative therapy, offer a better alternative solution to diabetes, potentially addressing the root cause of the disease and providing an effective, long-term treatment.

Referensi

Ashrafizadeh, M., Kumar, A., Aref, A. R., Zarrabi, A., & Mostafavi, E. (2022). Exosomes as Promising Nanostructures in Diabetes Mellitus: From Insulin Sensitivity to Ameliorating Diabetic Complications. International Journal of Nanomedicine, Volume 17, 1229–1253. https://doi.org/10.2147/IJN.S350250

Magliano DJ, & Boyko EJ. (2021). IDF Diabetes Atlas 10th edition scientific committee. IDF DIABETES ATLAS [Internet].

Satyadev, N., Rivera, M. I., Nikolov, N. K., & Fakoya, A. O. J. (2023). Exosomes as biomarkers and therapy in type 2 diabetes mellitus and associated complications. Frontiers in Physiology, 14. https://doi.org/10.3389/fphys.2023.1241096