When one thinks of diabetes, insulin automatically comes to mind, an important hormone for the human metabolism. But what is its function and, above all, what side effects does insulin have?

Besides lowering glucose being the main task for insulin, there’s more to it. While usually unnoticed, in type 1 diabetes, where insulin is missing, these side-functions become evident:

1. Cognitive function, learning, memory

Insulin has a key role in the hippocampus, a brain region that is highly involved in learning, memory and cognitive performance. Besides that it has regulating connections to the limbic system, where emotions, motivation, motor-action control and social behavior is controlled. An absence of insulin (and therefore glucose) leads to difficulties in memory, cognitive function and irritability. The higher the insulin sensitivity, the higher the cognitive performance indicators. [1]

2. Hunger and satiety

Physiologically, after a meal containing carbohydrates, insulin levels rise. As insulin passes the blood-brain-barrier, it acts as a strong feedback signal on satiety-centers (specifically, POMC-Neurons) in the hypothalamus. An absence of or resistance to this signal, as in T1/T2 diabetes, is interpreted by the brain as a shortage in nutrients and energy, thus leading to more appetite and initiating food seeking behavior. [2]

3. Tissue growth

Insulin is one of the most important anabolic, growth hormones. Especially muscles and bones, but also skin, hair and nails depend on the presence, and the right amount of insulin to grow. [3]

4. Fertility

Insulin acts on the female reproductive tract by regulating the production of estrogen and testosterone in hormone-producing cells on ovaries. High insulin levels can lead to high testosterone production, leading to symptoms of PCOS (irregular periods, masculine hair growth, acne). Also contributing to excess estrogen production, sore breasts, fibroids and heavy menses are typically associated with high levels of insulin. Conversely, the absence of insulin (as in T1D) is interpreted as a shortage in food-supply and in order to preserve energy, specific brain centers stop the production of cycle-regulating hormones, leading to irregular periods and infertility. [4][5][6]

Thanks so much for reading and we’ll provide you with the next episode of this series soon!

[1] Capucho AM, Chegão A, Martins FO, Vicente Miranda H, Conde SV. Dysmetabolism and Neurodegeneration: Trick or Treat? Nutrients. 2022; 14(7):1425. https://doi.org/10.3390/nu14071425

[2] S.M. Anika, T.R. Houpt, K.A. Houpt, Insulin as a satiety hormone, Physiology & Behavior, Volume 25, Issue 1,1980,Pages 21-23, ISSN 0031-9384, https://doi.org/10.1016/0031-9384(80)90175-4.

[3] Insulin and bone health in young adults: The mediator role of lean mass Torres-Costoso A, Pozuelo-Carrascosa DP, Álvarez-Bueno C, Ferri-Morales A, Miota Ibarra J, et al. (2017) Insulin and bone health in young adults: The mediator role of lean mass. PLOS ONE 12(3): e0173874. https://doi.org/10.1371/journal.pone.0173874

[4] Fica S, Albu A, Constantin M, Dobri GA. Insulin resistance and fertility in polycystic ovary syndrome. J Med Life. 2008 Oct-Dec;1(4):415-22. PMID: 20108521; PMCID: PMC3018970.

[5] Hill JW, Elmquist JK, Elias CF. Hypothalamic pathways linking energy balance and reproduction. Am J Physiol Endocrinol Metab. 2008 May;294(5):E827-32. doi: 10.1152/ajpendo.00670.2007. Epub 2008 Feb 19. PMID: 18285524; PMCID: PMC5724360.

[6] George B. Karkanias, Jose C. Morales, Chang-Sheng Li, Deficits in Reproductive Behavior in Diabetic Female Rats Are Due to Hypoinsulinemia Rather Than Hyperglycemia, Hormones and Behavior, Volume 32, Issue 1, 1997,Pages 19-29, ISSN 0018-506X,

Quality & HR

• We have continued to grow – all open positions were successfully filled, that means 9 new team members were recruited in 2022.
• We implemented a document management system. Also, we implemented and certified the relevant processes for the DCB Management System according to ISO 9001. The audit went great and they reported zero findings!

Innovation & Business Development

• Oh yes, we did innovate and develop our business in 2022! The team evaluated >200 ideas, proposals, and applications. Several dozen projects/startups were supported by DCB: With expertise, access to our network, facilities, and funding.
• The DCB Open Innovation Challenge was again a huge success! 66 applications from 22 different countries helped grow the vibrant DiabetesTech community and resulted in the six final projects from Denmark, France, Australia, Germany and the U.S. Our highlight, the DCB Start-Up Night & Award Ceremony took place on 30 November, where the jury selected the two winners: Ole Kjerkegaard Nielsen with GO-Pen ApS from Denmark (Category Diabetes Devices) and Pascal Grimm with Una Health from Germany (Category Digital Diabetes).

Clinical & Data

• First clinical study terminated: Our first clinical study has been conducted at the Universitätsklinik für Diabetologie, Endokrinologie, Ernährungsmedizin& Metabolismus (UDEM), Berne, Switzerland and Institut für Diabetes-Technologie (IfDT), Ulm, Germany. For this study, for an insulin pump manufacturer, we were responsible for the whole clinical process from clinical study plan writing, EC submission, material supply, site monitoring, data cleaning and analyzing to the study report writing.
• The secure web-based EDC system, REDCap, deployed: With the support of iSolutions and the IT department of the Institute of Social and Preventive Medicine of the University of Bern, REDCap, a secure web-based EDC system, has been deployed into a Cloud Environment (PaaS). DCB will use REDCap for the collection of data from various clinical trials and medical registries.
• Clinical / Data teams grew: Five new employees, Stefanie Hossmann, Constance Bischoff, Dr. Stefanie Hofer, Dominique Rubi and Aritz Lizoain joined DCB and brought their expertise, experience and good mood to the Clinical and Data Teams.
• 3 internships successfully finished:

Laura Burlando conducted a systematic review on the effect of the menstrual cycle on diabetes management for her master’s in eHealth at the University of Lucerne.

Aritz Lizoain performed data analysis of in-vitro glucose measurements and contributed to the development of a continuous glucose monitoring sensor to complete his master’s in statistics at the University of Neuchâtel.

Katja Kilcher did a qualitative research project with regards to global regulations and requirements for electronic Consent processes.

• FibreGum starts for recruitment: The clinical study FibreGum, under the supervising of Prof. Maria Luisa Balmer, started for recruitment at the Children Clinic Berne. The study will assess the effect of an additive in a chewing gum on body weight loss. 105 adolescents and young adults, treated at the weight management department, will be included over 2 years.

Associated research group of Prof. Dr. phil. Lilian Witthauer

• The samlab (sensing & monitoring lab) has successful initiated the moonwalk pilot study where they investigate the relationship beween nocturnal hypogycemia symptoms and sleep
• The samlab has built up their optical lab and in now ready to perform cutting edge research

Thank you, dear readers for your loyalty and interest throughout the year! We will continue to provide you with new series, inside stories and regular updates in 2023. All the best and till soon!?