Biosimulation and Drug Development

The World Health Organization estimates that more than 300 million people in 2025 will suffer from diabetes, mainly type 2 diabetes, and primarily in industrialized countries. This places an economic burden on the health care system and the society. On one hand, the expenses to glucose control and patient education are large but, on the other hand, the expenses for treating the complications are enormous. 

the development of new medicines is expensive, and the expenses are increasing year after year. Most of the expenses go to clinical trials that demonstrate that the medicine is both effective and safe and with newer and more effective medicines, the safety issue becomes more and more acute. What helps one patient may be dangerous for another. The result is that the industry is beginning to discuss individualized medicine, where both the type of medicine and the treatment regime, dose and timing, are personalized. 

Regarding diabetes, there now appears to be a spectrum of patients where the metabolism is altered in different aspects and in different combinations. This makes it much more difficult to develop a general dmg and treatment regime for all patients. However, with a better understanding of the many diabetic variants, a much more effective and safe medicine can be developed for a particular patient type. 

A characteristic problem with diabetes is the large span of time-scales involved. Metabolic experiments usually last a few hours and only address one particular pathway. The nutrient traffic involves time-scales of hours to days or weeks, but the development of late complications takes years or decades. It is therefore important to analyze the experimental results and place them in a greater context to see which effect a modification of the pathway in question will have on the overall progression of the disease. 

To reveal this by conventional experiments or trials is almost impossible. However, a biosimulation model, or a set of models, can describe even very complex, interacting pathways and control systems quantitatively and give an estimate of the effect. Moreover, the models can indicate where and how a given metabolic disorder best can be corrected. 

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