March 2018 - Diabetes Research Connection

Diabetes Research News
March 29, 2018

Improving PD-L1 Levels to Treat Type 1 Diabetes

A major obstacle that researchers face in treating type 1 diabetes (T1D) is the body’s own immune system. In individuals with T1D, the immune system destroys insulin-producing beta cells whether naturally occurring or introduced through novel therapeutic approaches. The use of anti-rejection drugs to protect newly injected or created cells can be hard to the body and contribute to undesirable side effects.

However, researchers at Boston Children’s Hospital are studying a new approach to treating – and potentially curing – T1D. They found that in individuals with T1D have a deficiency of PD-L1, a protein that helps prevent autoimmune reactions by binding to PD-1 receptors. By treating blood stem cells using gene therapy or a cocktail of small molecules, they were able to increase PD-L1 production. In turn, this helped to reverse hyperglycemia and better manage blood sugar levels.

In an experiment using mice with diabetes, “almost all the mice were cured of diabetes in the short term, and one-third maintained normal blood sugar levels for the duration of their lives.” In addition, the risk of adverse events is practically eliminated since the therapy uses the patients’ own cells. Though immunotherapies have been used before in an effort to treat T1D, they have not been targeted specifically for diabetes, whereas in this study, they are.

The research team has already met with the U.S. Food and Drug Administration for a pre-investigational new drug meeting regarding the combination of small-molecules used during the mouse trials in order to begin the approval process for human clinical trials.

This is an exciting step toward advancing treatment options for type 1 diabetes and potentially reversing the disease. More research is needed to determine how long the effects last and how often treatment would be needed.

The Diabetes Research Connection (DRC) is interested to see how the study progresses in the future and what it could mean for individuals living with type 1 diabetes. Though not involved with this particular project, the DRC supports early career scientists in pursuing novel research studies geared toward preventing, treating, and curing T1D, as well as improving quality of life for those living with the disease. Learn more about these researchers and their projects by visiting http://diabetesresearchconnection.org.

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Diabetes Research News
March 27, 2018

Exploring Beta Cell Regeneration in Treating Type 1 Diabetes

In individuals with type 1 diabetes (T1D), the body’s immune system mistakenly destroys insulin-producing beta cells necessary for managing blood sugar. Instead, patients must constantly monitor their own blood glucose levels and administer the proper dosage of insulin as necessary. In individuals without T1D, the pancreas does this automatically.

Some of the challenges that researchers have faced in trying to treat or cure T1D through cellular means is that the body may still reject these cells, there may be a shortage of donor cells, or the process of creating necessary beta cells can be complex. However, researchers at the Diabetes Research Institute at the University of Miami Miller School of Medicine may have found an effective way of using the body’s existing cell supply to generate insulin-producing beta cells.

The researchers identified the exact location in the body of progenitor cells with the ability to develop into beta cells. When stimulated by bone morphogenetic protein 7 (BMP-7), a naturally occurring growth factor, the pancreatic cells differentiated into the necessary beta cells. This discovery could lead to a significant supply of new beta cells within patients’ own bodies, eliminating the need for donor cells and curbing other immune-related challenges of treatment.

This process still requires more in-depth study, but it could lead the way to new regenerative medicine strategies that stimulate insulin production more naturally. The researchers are currently exploring options to reduce the need for lifelong anti-rejection drugs by enhancing immune tolerance of the newly created cells.

This study is another step toward advancing the treatment of T1D and providing patients with more options for care. The more scientists learn about the causes and effects of T1D, the more they can target approaches to treatment.

The Diabetes Research Connection (DRC) stays abreast of the latest developments in the field and encourages novel research projects by early-career scientists focused on T1D. The DRC raises funds through contributions by individuals, organizations, and foundations to support the advancement of these studies. Find out how you can get involved by visiting http://diabetesresearchconnection.org.

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Diabetes Research News
March 21, 2018

Could Implantable Glucose Sensors be a Viable Option for Monitoring Blood Sugar?

Diabetes management has come a long way over the years. Some people have transitioned away from constant finger pricks and begun using continuous glucose monitoring (CGM) systems to track their blood sugar and alert them to episodes of hyperglycemia or hypoglycemia. However, not everyone has the same level of adherence to using this technology, so results can be inconsistent.

Researchers from Diablo Clinical Research recently conducted a study on the use of implantable, subcutaneous continuous glucose sensors for diabetes management. A small sensor was placed under the skin, and then a transmitter was positioned over top providing wireless power and transmission of data to a mobile app. The transmitter also vibrated to alert users of episodes of hyper- or hypoglycemia in addition to alerts being sent to the app.

There were 90 adults with type 1 and type 2 diabetes who participated in the nonrandomized, prospective, masked, single-arm study which lasted for 90 days. Sixty-one of the participants had type 1 diabetes. Individuals underwent accuracy assessment visits on days 1, 30, 60, and 90 to compare results of the implantable sensor versus a bedside glucose analyzer. In addition, some participants also partook in hyperglycemia and hypoglycemia challenges on days 30, 60, and 90. There were only eight participants who did not complete the study, and 12 reports of mild adverse events and two moderate adverse events.

Following the study, the results showed “more than 90% of continuous glucose monitoring system readings within 20% of reference values.” Furthermore, “the system correctly identified 93% of hypoglycemic events and 96% of hyperglycemic events by the reference glucose reader.” The implantable CGM system used was Eversense by Senseonics.

Additional clinical studies are necessary to further evaluate the safety and accuracy of the system and expand potential use to pediatric patients as well. However, preliminary results show high levels of safety and accuracy in this small study.

This is an exciting step toward providing individuals with T1D another option for managing diabetes allowing them to measure blood sugar levels more consistently and with less intervention. The Diabetes Research Connection (DRC) is interested to see how this study advances moving forward and what it may mean for diabetes management in the future. The DRC raises funds for early career scientists to perform peer-reviewed, novel research designed to prevent and cure type 1 diabetes, minimize its complications, and improve quality of life for those living with the disease. Click to learn more about current projects and provide support.

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Diabetes Research News
March 15, 2018

Could Viruses Play a Role in the Development of Type 1 Diabetes?

While researchers know that type 1 diabetes involves the destruction of insulin-producing beta cells or lack of production of insulin, they are still not clear on exactly what causes type 1 diabetes to develop. A great deal of time has been devoted to studying genetics and the role it may play in T1D risk. Now scientists are exploring a different avenue – the influence of viruses on diabetes risk.

A recent study led by Professor Ronald Kahn, chief academic officer at Joslin Diabetes Center, identified four viruses that can produce insulin-like hormones. These viruses were found to “produce peptides that are similar in whole or in part to 16 human hormones and regulatory proteins.” While these viruses are found in fish and amphibians, not humans, eating fish may expose the human body to the viruses and therefore have an effect.

Scientists synthesized these peptides and conducted experiments on mice and human cells to determine how they would respond. The viral insulin-like peptides (VILPs) acted like hormones, attached to human insulin receptors, and stimulated the same signaling pathways. In addition, mice were found to have lower levels of blood glucose after being exposed to the VILPs.

According to Kahn, these research findings could lead to new studies regarding type 1 diabetes and autoimmunity. The insulin-like hormones “could be an environmental trigger to start the autoimmune reaction in type 1 diabetes.” However, there is the possibility that they could work as a protective factor as well by desensitizing the immune response.

There are more than 300,000 viruses carried by mammals, but only about 7,500 have been sequenced so far, so there is the possibility that other viruses exist that may affect human cells and T1D risk as well. This study is just the start of understanding the role of microbes in human disease according to Dr. Emrah Altindis who also works at the Joslin Diabetes Center.

The depth and breadth of understanding regarding type 1 diabetes and various aspects of the disease is expanding every day. The Diabetes Research Connection is committed to supporting peer-reviewed, novel research studies that aim to improve diagnosis, treatment, and quality of life for individuals living with T1D. Through donations from individuals, companies, and foundations, the DRC provides funding to early career scientists to pursue innovative projects. Learn more about current projects and how to support these efforts by visiting http://diabetesresearchconnection.org.

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