April 2020 - Diabetes Research Connection

Diabetes Research News
April 29, 2020

Advancements in Type 1 Diabetes Management Technology

One of the challenges – and frustrations – of living with type 1 diabetes (T1D) is multiple finger sticks each day to test blood sugar levels. Individuals want to ensure that they are staying on top of blood sugar in order to administer insulin or glucose as needed. Even continuous glucose monitors require a tiny needle stick in order to monitor blood sugar levels.

In a recent study, researchers share advancements using laser technology, rather than blood samples, in order to measure glucose concentration. The device they developed uses Raman spectroscopy, which shines near-infrared light on the skin to determine its chemical composition. This includes reading the signal given off by glucose located in the interstitial fluid that surrounds skin cells.

The near-infrared light only has the ability to penetrate a few millimeters into the skin, so researchers needed to find a reliable way to measure glucose from this reading. Initially, they were comparing the chemical composition of the tissue with blood samples taken simultaneously to determine glucose levels. However, there was too much unpredictability since movement of the patient or changes in the environment could alter results. In addition, it required a great deal of calibration.

The Laser Biomedical Research Center at MIT has spent more than 20 years working on developing a glucose sensor using Raman spectroscopy, and they have made a lot of advancements over the years. The latest device has evolved from indirect measurement of glucose concentrations, like those mentioned above, to direct measurement. Researchers found that by using a small fiber to collect the Raman signal after shining the near-infrared light at a 60-degree angle, they could filter out unwanted signals from other solid components in the skin. Testing the device on pigs, they were able to get an accurate glucose reading for up to an hour, and it only required about 15 minutes of calibration.

One drawback to the current technology is that the device is approximately the size of a desktop printer, meaning it is not easily portable. With a slightly smaller system, individuals could have a testing device at home or at work where they could place their finger on a sensor and Raman spectroscopy would be used to check blood sugar. Eventually, researchers would like to create a wearable monitor that would act as a continuous glucose monitor but without any needles.

After more than two decades, researchers are finally getting closer to their goal of creating a laser-based glucose sensor that can be used for everyday monitoring. It is encouraging to see advancements that seek to take some of the pain and inconvenience out of blood sugar monitoring by eliminating the need for so many needles.

Diabetes Research Connection (DRC) is excited to see how this technology continues to advance and what it may mean for the future of continuous glucose monitoring and diabetes management. Researchers around the world are focused on improving the prevention, treatment, and management of type 1 diabetes. The DRC supports these efforts by providing up to $75K in funding to early-career scientists pursuing novel research for T1D. Learn more by visiting https://diabetesresearchconnection.org.

Learn More +

DRC & Research News
April 24, 2020

Three Words that Changed My Life Forever…Type 1 Diabetes

National Tell a Story Day

I will never forget April 30, 2003, the day my life changed forever. My mom picked me up from school and asked, “How many times did you pee today, Hannah?” It’s a question she’s been asking frequently. I thought I might get in trouble if I told her the truth, so I said only twice.

We drove away and suddenly I could tell we were driving in the direction of my pediatrician’s office, not home. When I noticed my dad’s car in the parking lot, I knew it was not a routine visit, something was off. I was rushed inside, weight taken, vitals checked and then the dreaded blood test.

After some time passed, the doctor came in and told us to sit down. He started speaking to my parents about how all the signs; my drastic weight loss, the number of times I went to the bathroom and the amount of liquids I consumed daily confirmed what my parents already thought, I have type 1 diabetes (T1D).

I was diagnosed with T1D 17 years ago at the age of 7. My childhood was spent counting carbs, making sure I had all my supplies every time I left the house, worrying about ketoacidosis, low blood sugar and having to go to the hospital.

After my diagnosis, life was hard. I was not allowed to go on field trips, kids teased me and said I had “cooties” (the simple term for contagious) and I could not enjoy food or life the same way I did before. It was not until that summer that things started getting better.

My dad found a camp for kids with T1D and booked a weekend family trip. The first thing I did when I got there was learn how to give myself insulin shots. I wasn’t scared; I was excited to gain some control back. My parents found other parents who were worried about this new predicament as well and talked about tips for management and how to cope.

I never really had hope growing up that there would be a cure during my lifetime…until now!

As the Development Assistant at the Diabetes Research Connection (DRC), I see first-hand the innovative research being funded and it gives me hope.

Now, I have hope that this disease WILL be eliminated, and I WILL be alive when the cure is discovered.

~ Written by Hannah Gebauer

Learn More +

Diabetes Research News
April 23, 2020

Exploring the Impact of Environment on Type 1 Diabetes Risk

While researchers know that type 1 diabetes is caused by the destruction of insulin-producing beta cells, what they are still uncertain about are the exact causes of this process. They know that genetics play a role, yet there is not a single gene responsible for the disease; there are several genes that are believed to contribute. Furthermore, they are not convinced that the disease is entirely genetic, and have reason to believe that environmental factors are to blame as well. But once again, there is not a single environmental risk that has a significantly greater impact than others.

A recent study examined several environmental risk factors such as “air pollution, diet, childhood obesity, the duration of breastfeeding, the introduction of cow’s milk, infections, and many others” and yet researchers still do not have any definitive answers. What they do know is that the incidence of type 1 diabetes has increased over the past 30 years by 3 percent year over year, and this change is too significant to be caused by genetics alone.

Using a variety of modeling, they evaluated the impact of specific environmental factors over time. But the simulated data did not pinpoint one factor that stood out above the others and had a stronger impact on diabetes risk. It is likely that a combination of environmental factors is at play in conjunction with genetic risk. More research is needed to further investigate potential risks and protective factors when it comes to type 1 diabetes.

These findings may inspire other researchers to dig more deeply into environmental factors and their impact on disease development and progression. Diabetes Research Connection (DRC), though not involved with this study, provides critical funding for early-career scientists to pursue novel research studies related to type 1 diabetes to enhance understanding as well as prevention, treatment, and management of the disease. The goal is ultimately to find a cure. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org.

Learn More +

Diabetes Research News
April 21, 2020

Making Insulin More Affordable During Coronavirus Pandemic

The coronavirus crisis has turned life upside down for people around the world. As tighter restrictions are put in place and more businesses are forced to close or cut hours, it is taking a serious toll on the economy and individuals’ finances. Millions of people have filed for unemployment and lost employer-provided health insurance.

This can be an especially scary time for people with chronic diseases such as type 1 diabetes who require continued medical care, supplies, and medications to manage their condition. Lack of income or insurance means that some people can no longer afford insulin. They may begin rationing what they have left, which can be incredibly dangerous and lead to diabetic ketoacidosis, which can be fatal.

The cost of insulin in the United States has skyrocketed in recent years, but in an effort to support those with diabetes during this difficult time, pharmaceutical company Eli Lilly recently announced a $35 monthly cap on out-of-pocket insulin costs. Almost all of Lilly’s insulins are included, and the cap applies to individuals both with and without insurance. However, according to Lilly, “patients with government insurance such as Medicaid, Medicare, Medicare Part D, or any State Patient or Pharmaceutical Assistance Program are not eligible for the scheme.”

With so many Americans facing financial hardships right now, this is a step toward reducing some of the stress for those with diabetes regarding how to pay for insulin in order to keep themselves healthy. Insulin is not optional when it comes to type 1 diabetes – it is a life-sustaining medicine. Other drug makers such as Sanofi and Novo Nordisk have also lowered the cost of insulin during this time.

Diabetes Research Connection (DRC) is glad to see that individuals with type 1 diabetes are getting some support during these challenging times so that they can continue to afford the insulin they need. Until a cure for diabetes can be found, affordable insulin is a necessity. The DRC continues to work toward finding a cure as well as improving treatment options. Click to learn more about current projects and provide support.

Learn More +

Diabetes Research News
April 21, 2020

Investigating a New Form of Diabetes Management – a Smart Patch

The traditional method of managing type 1 diabetes is testing blood sugar levels, then dosing and administering the correct amount of insulin to keep blood sugar within the target range. This is done over and over again throughout the day, each and every day. Researchers are constantly seeking improved methods of managing the disease that are less patient intensive.

Over the years, scientists have created continuous glucose monitors, insulin pumps, artificial pancreases, and other systems to assist with managing type 1 diabetes (T1D). Each device has its pros and cons depending on the patient and their situation. Patients must find what works best for their needs.

A recent study is investigating yet another treatment option: a smart insulin patch. This small patch contains tiny microneedles with glucose-sensing polymer. When blood sugar begins to rise, the polymer is activated and releases doses of insulin. As blood-glucose levels return to normal, it stops administering insulin.

This technology removes the burden of constantly testing blood by patients and handles the testing and administration on its own. The needles penetrate the skin just far enough to be effective without causing much more than a pinprick of pain. The current model is designed to manage blood sugar levels for up to 24 hours and has been tested on mice and pigs. After 24 hours, the patch would need to be replaced with a fresh one.

Researchers are in the process of obtaining approval to begin human trials for the smart insulin patch. Although it may be several years before this technology could potentially be brought to market, it is a step in the right direction toward creating a more effective, efficient way of managing T1D. Researchers also believe that it may help reduce risk of insulin overdoses which can lead to hypoglycemia.

Though not involved with this study, Diabetes Research Connection (DRC) is excited to see what happens in the future if the patch is approved for human trials. It has the potential to become one more tool for individuals with T1D to use to manage the disease and enhance their quality of life. The DRC is committed to supporting research regarding T1D and providing funding to early career scientists for novel, peer-reviewed studies. Click to learn more about current projects and provide support.

Learn More +

Diabetes Research News
April 16, 2020

Improving Vascularization in Pancreatic Islet Transplants

One of the approaches scientists have been exploring for the treatment of type 1 diabetes is pancreatic islet cell transplants. By introducing these cells into the body, they are often able to maintain better glycemic control and support insulin production. However, there are many challenges that come with this type of treatment. It is essential to protect transplanted islet cells from immune system attack while also promoting sustainability. Cells tend to lose function over time and poor vascularization is often a contributing factor.

In a recent study, scientists have found a way to improve vascularization and therefore function of transplanted human pancreatic islets in diabetic mice. In addition to encapsulating islet cells, they also included human umbilical cord perivascular mesenchymal stromal cells or HUCPVCs. The HUCPVCs had a positive effect on graft function and suppressed T cell responses. In both immunocompetent and immunodeficient diabetic mice, glycemic control was maintained for up to 16 weeks when cells were transplanted via a kidney capsule, and for up to six weeks or seven weeks respectively when administered via a hepatic portal route. Furthermore, with the addition of HUCPVCs to the transplanted islet mass, rejection was delayed and the graft showed some proregenerative properties.

These findings may improve the future of human islet allotransplantation as a viable option for long-term treatment of type 1 diabetes. Scientists are constantly exploring ways to reduce rejection and the need for prolonged immunosuppression while maintaining better glycemic control. This study opens doors for more advanced research on the use of HUCPVCs in islet transplantation as well as related therapies.

Diabetes Research Connection is committed to supporting research for type 1 diabetes by providing early-career scientists with essential funding to keep projects moving forward. Learn more about current studies and how to donate to these efforts by visiting https://diabetesresearchconnection.org.

Learn More +

Diabetes Research News
April 14, 2020

Advances in Therapeutic Treatment for Type 1 Diabetes without Immune Suppression

One approach that researchers have been exploring to treat type 1 diabetes is cell therapy. By introducing new insulin-producing beta cells or other types of cells, scientists strive to support the body in once again producing its own insulin. A common challenge with this technique is that it often has limited results as the body once again attacks the cells, or they slowly lose function on their own. In addition, cell therapy typically requires immune suppression which can put individuals at risk for other complications.

However, in a recent study, researchers tested a new method of transplanting therapeutic cells by using a retrievable device with a silicone reservoir. The cells are further protected by a porous polymeric membrane that allows macrophages to enter the device without destroying the transplanted cells, or that prevents them from entering at all.

When tested in immunocompetent mice, the device supported normoglycemia for more than 75 days without the need for immunosuppression. The transplanted cells were able to effectively produce erythropoietin, which in turn improves oxygen supply to the body, and also generates insulin to manage blood sugar levels.

This is a notable step forward in improving cell therapy for the treatment of type 1 diabetes. More research and testing are required to determine how this process translates into human models. Researchers have been trying to limit or eliminate the need for immune suppression while transplanting healthy pancreatic, islet, and stem cells into the body to control blood glucose levels.

Dan Anderson, Ph.D., a member of the Diabetes Research Connection (DRC) Scientific Review Committee, is the senior author of the article published regarding these findings. DRC is excited to see where these advances may lead and what it could mean for the future of cell transplantation techniques and cell therapy for type 1 diabetes. The organization provides critical funding for a wide range of projects related to improving diagnosis, treatment, and prevention of the disease. Learn more about current studies and how to support these efforts by visiting https://diabetesresearchconnection.org.

Learn More +

Diabetes Research News
April 9, 2020

Differentiating Between Childhood-Onset and Adult-Onset Type 1 Diabetes

Although many cases of type 1 diabetes (T1D) emerge in childhood because it is an autoimmune disorder unrelated to diet or exercise, there are some individuals who develop T1D in adulthood. This condition is referred to as latent autoimmune diabetes in adults, or LADA. LADA shares characteristics with both type 1 and type 2 diabetes, but it is more closely related to type 1.

Researchers estimate that around 10 percent of individuals diagnosed with T2D actually have LADA. This is discovered when patients do not respond as expected to common T2D treatment. Just like with T1D, their body’s immune system mistakenly attacks and destroys insulin-producing beta cells that are essential for blood sugar regulation.

Up to this point, autoantibody screening was the primary way of differentiating between LADA, T1D, and T2D, but this can be an expensive process. However, a recent study found that there may be genetic differences between these conditions that are significant enough to serve as a more affordable yet still reliable way of diagnosing diabetes type.

With T1D, when researchers examined the major histocompatibility complex (MHC) and “control for T1D genetic variants in one part of the MHC, other variants associated with T1D appear in another part of the MHC.” When they conducted the same test on LADA patients, the results were not the same. In controlling for T1D genetic variants, there was no association in another part of the MHC. Furthermore, they saw the same differences in outcomes when a sensitivity test was conducted.

These genetic differences may help medical professionals more accurately diagnose individuals with LADA and provide more effective treatment sooner. Additional research is necessary to determine whether these findings hold true across multiple ethnicities.

It is these types of studies that help other scientists advance their own research regarding type 1 diabetes in order to improve diagnosis, treatment, and management of the disease. Diabetes Research Connection (DRC) provides critical funding for early-career scientists pursuing novel research studies on T1D. To learn more or support current projects, visit https://diabetesresearchconnection.org.

Learn More +

Diabetes Research News
April 8, 2020

Exploring Challenges with Hybrid Closed-Loop Insulin Delivery Systems

There are many different options for managing diabetes from manually checking blood sugar and administering insulin to using a hybrid-closed loop insulin delivery system that does the work automatically with some human input. This type of insulin delivery system, also referred to as an artificial pancreas, was designed to improve diabetes management and blood sugar control without as much demand on patients.

However, a recent study found that nearly one-third of children and young adults stopped using the hybrid closed-loop system within six months. Some of them even discontinued use of a continuous glucose monitoring (CGM) system. The study involved 92 participants with type 1 diabetes who had an average age of 16. Each participant began using the Medtronic 670G system in manual mode for two weeks before switching to auto mode. They received follow-up training via phone within one month after starting auto mode, then were seen in a clinic every three months during the next six months.

The Medtronic 670G system uses CGM data to automatically control basal insulin delivery. This can help manage changes in blood sugar more quickly and administer the correct amount of insulin without patient input. If boluses are needed, however, the individual must enter their carb count and blood glucose number manually.

Researchers found that use of auto mode continued to decrease over the 6-month trial period, dropping from 65.5% during the first month to 51.2% by the sixth month. In total, 28 youth stopped using the hybrid closed-loop system within the first six months, and 21 of those 28 stopped using CGM as well. This raises the question as to whether CGM use posed some barriers to success and continued use of the hybrid closed-loop system.

The study did show that while participants used the artificial pancreas, their time spent within range for blood glucose improved from 50.7% to 56.9%, and their HbA1c levels decreased from 8.7% to 8.4%.

Understanding the strengths and challenges of artificial pancreas use in children and young adults can help researchers to make improvements and adjust systems for better results and continued use. Hybrid closed-loop therapy is just one option for managing type 1 diabetes, and it is important for individuals to find what works best for their situation.

Diabetes Research Connection is committed to providing early-career scientists with the funding necessary to support research designed to prevent, cure, and better manage type 1 diabetes. Funding is critical to continue advancing understanding and therapies for the disease. Click to learn more about current projects and provide support.

Learn More +

Diabetes Research News
April 2, 2020

Increasing Protective Factors to Reduce Risk of Type 1 Diabetes

Despite decades of research, scientists have yet to develop a cure for type 1 diabetes since it is a complex disease that is impacted by and interacts with many processes within the body. However, they have made significant advancements in understanding and managing the disease. Now, more focus is being put on preventing the development of type 1 diabetes.

In a recent study, researchers at the Pacific Northwest National Laboratory found that by increasing levels of growth differentiation factor 15 (GDF15) in non-obese diabetic mice, they were able to reduce the risk of developing type 1 diabetes by more than 50 percent. Although there are more than 387 pancreatic proteins in the body associated with T1D, the researchers discovered that GDF15 was significantly depleted in pancreatic beta cells of individuals with T1D.

By increasing GDF15 levels in the non-obese diabetic mice, it helped to protect islet cells from immune system attack. Researchers are seeking to determine whether this may be used to create more effective therapies for the treatment and prevention of the disease in humans. While more research is needed, it is a step in the right direction.

Diabetes Research Connection (DRC) is following these findings to see how they impact future diabetes research and treatment options. It is these types of studies that open doors for advancements in the field and an increased understanding of the disease. The DRC supports early-career scientists in pursuing novel, peer-reviewed research studies focused on the prevention, treatment, and management of T1D and eventually finding a cure. To learn more about current projects and support these efforts, visit https://diabetesresearchconnection.org.

Learn More +