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During the seminal lecture “There is Plenty of Room at the Bottom” in 1959, the 1965-nobelist physicist Prof. Richard Feynman claimed that the manipulation of atoms by science would be possible. Sixty years later, with the development of the science of objects at the nanometer scale, referred to as nanoscience, Feynman's vision becomes a reality and is radically changing the world. The number of daily-life products containing nanotechnologies is more and more impressively growing. These nanoproducts include not only cosmetics, furniture, coatings for cars and sport materials, but also therapeutics, anesthetics, imaging agents, vaccines and nutritional supplements. Nanotechnologies are now expected to offer great new perspectives as well as helping in combating some of the world's deadliest diseases which cause a huge socio-economic burden worldwide.

This book gathers together 11 outstanding chapters, presenting the evidence offered by nanotechnologies to operate a disruptive medicine for tackling the prevalence, disabilities and mortality caused by diabetes, a disease that affects men, women, children and adolescents. Diabetes is a complex disease, including type 2 (T2D) and type 1 diabetes (T1D), together representing approximately 95% of total diagnosed cases. The current antidiabetic medicines for the treatment of T2D and T1D, are mostly non-curative and, over the long term, they fail to slow and/or prevent the long-term lack of glycemic control and the progression of the disease toward life-threatening diseases. The chapters, including “Optimizing the Current Type 2 Diabetes Antidiabetics with Nanotechnologies: Where do we Stand?” (Chapter 3), “Chemical Approaches for Beta-cell Biology” (Chapter 1) and “Amyloidosis Inhibition and Detection of Human Islet Amyloid Polypeptide with Nanomaterials” (Chapter 4) show that nanotechnology can not only improve the efficacy and safety of current antidiabetic drugs, but also provide a solution for engineering innovative curative antidiabetic drugs that will prevent the decline of pancreatic β-cells producing insulin, a key pathophysiological feature of T1D and T2D. Moreover, Chapter 5, entitled “Phytochemicals in the Management of Diabetes” reports a plethora of therapeutic candidates issued from plants that, if coupled to nanoparticles, might be a tremendous reservoir of future curative medicines. However, the search for innovative drugs requires high-throughput screening of hundreds of molecules, often achieved in non-human tissues. Chapter 7, entitled “Microfluidic and Organ-on-a-chip-based Technologies for Diabetes Therapy and Research” presents breakthroughs in 3D organ-on-chips (Ooc) microfluidic systems, made by nanomaterials, as fantastic support for human cell engineering by stem cells and for the culture of human tissues in an environmental medium that is very close to that of the human body. Ooc are anticipated to model human diabetes in a small dish and rapidly to ease the identification of the correct antidiabetic molecules for human therapy.

Nanotechnologies hold great promise in the transplantation of islets, the only curative treatment for T1D. This procedure is prescribed for patients with very unstable diabetes, severe hypoglycemia and without end-stage renal failure. Islet transplantation also enables the invasiveness and painful acts of glucose monitoring and insulin injections to be stopped. However, transplanted islets in the receipt can be rejected and/or progressively destroyed by immune cells attacks. In Chapter 8, “3D Bioprinting of Islets”, the authors review the possibilities offered by nanoparticles for generating macrocapsules for the encapsulation and protection of islets against inflammation and other adverse factors ensuing during transplantation.

Complementary to islet transplantation, the artificial pancreas (AP) is expected to radically change diabetes management for a majority of patients with T1D. AP is formed by a continuous glucose monitor (CGM) coupled to a program connected to the insulin infusion pump. The CGM sticks to skin, and regulates blood glucose variations in an autonomous loop without user intervention. Chapter 10 “Invasive and Implantable Glucose Sensors: Perspective for the Artificial Pancreas” describes the Aps manufactured so far, and details the important challenges tackled by nanotechnologies for popularizing such a system. One of these is the development of more sensitive glucose sensors using a new generation of nanomaterial-based artificial enzymes enabling more rapid monitoring of glucose, and thereby achieving a perfect connection between glucose measurement and insulin pump functioning.

Other major achievements made by nanotechnologies are highlighted in Chapter 6 entitled “Inhalation of Insulin for Diabetes Management”. This chapter deals with the release of a new generation of non-invasive, painless and easy mode of delivery of insulin, a hormone that is still mostly administrated via subcutaneous injection. In T1D, nanoparticle-based inhalation of insulin offers an unprecedented alternative for improving the comfort and compliance of patients, particularly those who have a needle phobia. The opportunity to adapt insulin therapy using inhaled insulin to a target patient is proof that nanotechnologies are contributing to make impactful advances into personalized diabetes medicine (PDM). Three chapters in this book illustrate this progress made by nanotechnologies in the set of PDM. In Chapter 9, entitled “In vivo Imaging of the Pancreas and Gut Hormone Receptors”, the authors report the development of innovative imaging agents that will enable imaging of pancreatic islet β-cells from patients with T1D and T2D. The best radiolabeled imaging probes and the imaging techniques for detecting and quantifying β-cells are presented in this chapter. Nanotechnologies could be revolutionary in aiding the non-invasive delivery of these imaging agents as it is achieved for inhaled insulin. Quantification of β-cells, thanks to their imaging, is an invaluable opportunity for clinicians to prescribe and/or alternate the right therapeutics, to the right person, at the right time, while knowing the residual β-cells mass and function at the diagnosis time and during treatment. Chapter 11, entitled “Artificial Intelligence for Diabetes-related Complications: The Eye as a Window to the Systemic Health” underlines the importance of artificial intelligence (AI) and machine learning in PDM. Using the interpretation of retinal imaging data as a powerful predictor of cardiovascular disease risk, this chapter underlines the huge potential of AI and machine learning for incorporating and computing several biomarkers for giving the best diagnosis and prescription in clinical practice. To this end, the search for potent biomarkers is needed. Finally, Chapter 2 on “Epigenomics of Type 2 Diabetes”, reports the progress made by epigenetics in identifying DNA biomarkers from blood cells, which could mirror the metabolic situation of several diseased organs and predict their improvement after therapy.

Nanotechnology for Diabetes Management is not only a book detailing the last progress made in nanotechnology for tackling diabetes and, thereby, stopping one of the fastest growing global health emergencies of the 21st century, it is also a seminal book that shows how much science can be disruptive, fruitful and groundbreaking when it is courageously and truly interdisciplinary.

Amar Abderrahmani

Sabine Szunerits

Abdelfattah El Ouaamari

Rabah Boukherroub

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