Nanobiotechnology- Nanofiber (NF) As A

Promising Approach For Type 2 Diabetes

Mellitus (DM) Management –By
Chibuike Macnelson
ABSTRACT

The successful application of nanobiotechnology in medicine has greatly changed the traditional way of
diagnosis and treating of disease. Modern delivery systems e.g., nanofiber (NF)-based systems fabricated
by natural and synthetic or both materials to deliver therapeutics agents and cells, could be an indicator of
a new era to avert DM complications. Recent progress in the field of diabetes research at its interface with
Nanofibers has received an immense attention of the world. As a result, the invention of Nanofibers in
1966, have left a lot of people astonished by its abilities ranging from tissue engineering to drug delivery
and also as a disease detecting material. Type 2 Diabetes mellitus (DM) is linked to both short-term and
long-term health problems therefore its detection at the very basic stage is of utmost importance because
its management will be a lot easier. Over the past three decades the incidence of type 2 diabetes has risen
dramatically in countries of all income levels and its management has progressed quite sluggishly.
Nanofibers could be used to cripple the rise of Type 2 Diabetes Mellitus (DM) in a many ways such as
creating ultra-sensitive glucose sensors, creating devices that can deliver insulin directly to the
bloodstream, creating smart textiles that can monitor the wearer’s health and provide feedback about their
blood sugar levels and finally promote healing and prevent infection in wounds.

Keywords – Nanobiotechnology; Nanofibers; Diabetes Mellitus (DM); Biosensors; Nanoporous

Materials; Nanoparticles; Nanotubes; Cell therapy; Tissue Engineering.

I. INTRODUCTION glucose in the blood to remain high. In people

[1] Type 2 Diabetes Mellitus (DM), the most
common type of diabetes, is a disease that
occurs when your blood glucose, also called
blood sugar, is too high. [2] Blood glucose is the
main source of energy of humans and comes
mainly from the food people consume. Insulin, a
hormone made by the pancreas, acts as a key to
let blood sugar into the cells of the body for use
as energy. [3] A person with type 2 DM is
known for having an insulin resistance –cells not
responding to insulin- which causes the levels of
with insulin resistance, the pancreas "sees" the
blood glucose level rising. The pancreas
responds by making extra insulin to maintain a
normal blood sugar. Over time, the body's
insulin resistance gets worse. In response the
pancreas makes more and more insulin. Finally,
the pancreas gets "exhausted". It cannot keep up
with the demand for more and more insulin and
as a result, it breaks down causing the blood
glucose levels start to rise. [4] In type 2 DM,
there are primarily two problems: the pancreas
does not produce enough insulin and cells
respond poorly to insulin and take in less sugar.
[5]A Person can develop type 2 DM at any age,
even during childhood. However, type 2 DM
occurs most often in middle-aged and older
people. People are more likely to
develop type 2 DM if you are age 45 or older,
have a family history of diabetes, or are
overweight or have obesity. WHO [6] shows
that in 2014 8.5% of adults aged 18 years and
older had diabetes. In 2019, diabetes was the
direct cause of 1.5 million deaths and 48% of
all deaths due to diabetes occurred before the
age of 70 years. Another 460,000 kidney
disease deaths were caused by diabetes.
Furthermore, diabetes is expected to become
the seventh largest cause of death worldwide
by 2030, Therefore, systems which improve
blood glucose monitoring, or “close the loop”
between glucose measurement and insulin
delivery, are highly desirable
FIG 1. [7] TRENDS IN INCIDENCE OF
DIAGNOSED DIABETES AMONG
ADULTS AGED 18 YEARS OR OLDER,
UNITED STATES, 2001–2019.
[8] Nano- and biotechnology are two modern
disciplines, which offer and promise a lot of
new developments for technological and
medical applications. Especially scientific
research at the interface between these two
disciplines (termed ‘nanobiotechnology’) can
lead to decisive technological breakthroughs
and innovative products. [9] Nanofibers and
their composites are an emerging carrier
system for delivering genes with desired
functions onto target sites. [10] Nanofibers are
one-dimensional nanomaterials of fiber shape
with a diameter in the range of tens to
hundreds of nanometers. Among the different
techniques for nanofiber production,
electrospinning, based on an electrostatic
driving force, offers continuous production of
highly pure nanofibers. Nanofibers have
numerous characteristics a few have been
explained below.
 HIGH SURFACE AREA – TO -
VOLUME RATIO:
When comparing the surface area of
Nanofibers to their volume, it has been
observed that Nanofibers have a large surface
area than their volume, enabling them to
capture and detect small molecules, such as
glucose effectively. In Type 2 DM
management, Biosensors – [11] a device that
measures biological or chemical reactions by
generating signals proportional to the
concentration of an analyte in the reaction -
are created primarily from Nanofibers because
they acts as a support for the biological
component, and their large surface area can
help to increase the sensitivity of the sensor.
 INTERCONNECTED
NANOPOROSITY:
Interconnected porosity is a network
of pores on a coating surface. It is a
property of some nanofibers that
describes the way that pores or holes
are connected to each other.
Nanofibers can be made with either
interconnected or non-interconnected
pores. Interconnected pores allow
fluids and gases to flow through the
nanofiber material, which can be
useful for applications such as tissue
engineering, drug delivery, and
filtration. Non-interconnected pores,
on the other hand, can be useful for
applications such as gas storage,
because they can trap and hold
molecules within the material.

FIG2. [12] AN IMAGE SHOWING THE
INTERCONNECTED
NANOPOROSITY OF NANOFIBERS.
b. AS A WOUND HEALING AGENT:
 HIGH MASS TRANSPORT
PROPERTIES:
Nanofibers allow rapid mass transport
because of the large number of surface
sites available for molecules to interact
with, and the interconnected pores allow
for easy flow of molecules through the
material. This makes nanofibers ideal for
applications such as filtration and tissue
engineering, where the movement of
molecules and fluids is critical.
 STRUCTURED PROPERTIES:
Nanofibers can be designed to have specific c.
mechanical and chemical properties. The d.
result of this is that an insulin-releasing
nanofibers that responds to changes in
glucose levels and potentially mimics the
function of a healthy pancreas can be
engineered.
II. APPLICATIONS OF NANOFIBERS
Nanofibers have a wide range of applications
in general health but for purpose of context, its
application to diabetes mellitus is explained
below.
a. AS SCAFFOLDS FOR TISSUE
ENGINEERING:
Scaffolds for tissue engineering are three-
dimensional structures primarily made of
polymeric biomaterials like nanofibers used to
support and guide the growth of a new tissue.
[13] Millions of patients worldwide who suffer
from Type 2 DM is majorly as a result of the
failures of the pancreas to produce enough
insulin. These patients will greatly benefit
from advanced tissue regeneration
technologies, which can promote restoration of
the pancreas because nanofiber tissue-
engineered scaffolds are considered as a
satisfactory solution to aid the health and
quality of life for millions of patients
worldwide with end-stage organ failure or
tissue loss. Nanofiber scaffolds can be
designed to promote cell attachment, growth,
and differentiation, and can be loaded with
growth factors or drugs to further enhance
tissue regeneration.
Diabetic Wound (DW) remains a major clinical
challenge due to impaired healing process
composed of multifactorial which resulted from
peripheral neuropathy, impaired vascular
function, impaired angiogenesis, and/or chronic
inflammation as well as microbial infection in
chronic wounds. [14] Nanofiber membranes
(NFMs) have high porosity and a large specific
surface area, which provide a suitable
environment for the complex and dynamic wound
healing process and a large number of sites for
carrying wound healing factors. Nanofiber
dressing can help promote the healing of wounds
such as foot ulcers for Diabetic Mellitus patients.
CREATION OF BIOARTIFICIAL LIVERS:
[15] Bioartificial liver (BAL) is a bioreactor
charged with liver cells that is connected
externally to the circulation. [16] It is a novel
device that has shown to reduce the severity of
liver diseases. DM can have a significant
effect on the liver which is the most affected
organ by DM. Some cases of DM destroys the
liver completely and hence a transplant is
needed. However, broader application of liver
transplantation is limited by demand for
lifelong immunosuppression, shortage of
organ donors, relative high morbidity, and
high cost. Nanofibers can be used to create
Bioartificial livers which serves as an
alternative support systems to treat liver
diseases of which Type 2 Diabetes Mellitus is
included.
 d. CREATION OF SMART
TEXTILES:
[17] A smart textile is one which can sense
changes in the environment and respond by
modifying one or more of its parameters to
perform a function. They are devices that have
been embedded with electronic devices such
as sensors, microprocessors, and actuators.[18]
Most patients fail to adhere to a strict dosing
schedule due to invasive drug administration,
off-target toxicities, or medical conditions.
However, this problem is taken care of by this
smart devices. For example, they can be worn
comfortably on the body and do not require
frequent blood draws or finger pricks and the
data from the sensor can be transmitted
wirelessly to a device such as a Smartphone,
which can then provide the wearer with
feedback about their blood sugar levels and
enable them know what decisions to make.
e. DELIVERY OF DRUG AND
INSULIN:
[19] The Insulin is a 5.8 kDa protein which
plays an important role in regulating
metabolism and enhancement of cell growth.
Nanofibers can be used to create nanofiber
delivery systems which can be used to deliver
insulin and drugs. The delivery systems are
loaded with drugs and insulin which are
released in a controlled manner by
incorporating the drug or insulin into the
nanofiber matrix itself, which can then release
the drug or insulin in response to a specific
trigger, such as changes in temperature or pH.
f. AS A GLUCOSE MONITOR:
[20] Blood glucose in particular remains a
difficult but high-value analyte to monitor
continuously. [21] Commercial glucose
sensors are based on puncture tests, which
should be performed up to 7 times a day.
Unfortunately, the pain, risk of infections and
discomfort caused by punctures in each
glucose measurement cause patients to only
measure their glucose level a few times or as
needed. As a result of these, nanofibers have
been deployed in the production of devices
that can monitor glucose. The two Nanofiber
sensors that perform this function are:
Nanofiber-based Electrochemical Sensors and
Optical Glucose Sensors. [22] Nanofiber-based
electrochemical sensors are commonly
designed with a large active surface area for
the detection of electrocatalytic activity,
surface adsorption, or both modalities. These
sensors work by measuring the change in
electrical current that occurs when glucose
reacts with the surface of the sensors. Optical
glucose sensors are sensors based on surface
plasmon resonance work by shining a light on
a nanofiber surface that has been coated with a
thin layer of gold. When glucose molecules
bind to the gold surface, the light is reflected
in a different way, and this change can be
detected by the sensor. In other words they are
sensors that detect glucose levels using light.
The applications discussed above are to be
incorporated with the experience of medical
practitioners for proper Type 2 DM
Management.
FIG 3 [23] A SMARTPHONE-BASED
ELECTROCHEMICAL GLUCOSE
MONITORING SYSTEM. (A) PORTABLE
SMART TOOTHBRUSH FOR GLUCOSE
DETECTION IN SALIVA. (B)
PORTABLE BLOOD GLUCOSE DEVICE
NAMED IBGSTAR.(C) WEARABLE
SALIVA GLUCOSE MONITORING
WITH SMARTPHONE-BASED
ELECTROCHEMICAL SYSTEM. (D)
WEARABLE SWEAT GLUCOSE
ANALYSIS WITH BATTERY-FREE,
WIRELESS AND FLEXIBLE
ELECTROCHEMICAL PLATFORM.(E)
IMPLANTABLE FREE STYLE LIBRE
FLASH GLUCOSE MONITORING
SYSTEM BASED ON INTERSTITIAL
FLUID PRODUCED BY ABBOTT.(F)
IMPLANTABLE MICROELECTRODE
FOR PERITONEAL GLUCOSE
MONITORING.(G) STRUCTURE OF A
TRIBOELECTRIC NANOGENERATOR.
(H) SCHEMATIC DIAGRAM OF A
FLEXIBLE ASYMMETRIC
SUPERCAPACITOR
III. CONCLUSION
Nowadays, diabetes mellitus (DM) acts as a
colossal problem and life-threatening disease
for humanity health by globally escalating
prevalence. DM is recognized by glucose level
dysregulation in blood result from defects in
insulin secretion by pancreas (type 1 DM)
and/or impair the response of body to insulin
(type 2 DM) In 2019, all over the world, 463
million people suffered from DM, with 4.2
million deaths yearly and it is estimated to
strike about 700 million by 2045. World
Health Organization (WHO) expressed that
DM will turn into the seventh greatest reason
for mortality in 2030 Nanofibers (NF) will
pave way for a dramatic reduction in Type 2
Diabetes Mellitus globally and with proper
usage and administration, Type 2 DM can
reduce by up to 30% over the next 20 years
and bring the management of Type 2 DM to its
Maximum because of the bio-friendly nature
of Nanofibers (NF).
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4. https://www.mayoclinic.org/
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5. National Institute of Diabetes and
Digestive and Kidney Diseases
(NIDDK) “Who is more likely to
develop to develop type 2
diabetes?”.
6. www.who.int “Diabetes”.
7. Fig1: Centers for Disease Control
and prevention “Trends in
incidence of diagnosed diabetes
among adults aged 18 years or
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