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Diabetes and Pandemic

A Rise in New Type 1 Diabetes Cases Amidst the Coronavirus Pandemic

The coronavirus pandemic has hit many countries around the world very hard, with millions of people being diagnosed with COVID-19. At the same time, researchers have also found that new cases of type 1 diabetes (T1D) have also grown. Though there is no definitive link between COVID-19 and T1D, scientists do know that in some cases, the virus may contribute to increased beta cell damage. Diabetes occurs when insulin-producing beta cells in the pancreas are damaged or destroyed.

A small study in England found that the number of new cases of T1D at two of its five Pediatric Diabetes Network locations increased by 80 percent in April and May. Over the past five years, these two locations diagnosed an average of two and four new cases respectively during those two months, whereas this year, they have each diagnosed 10 new cases. Across the five sites, 30 children and teenagers (all under age 17) were diagnosed with T1D, and 21 of these individuals experienced diabetic ketoacidosis (DKA). Out of those 21 cases, 11 were considered severe, and 12 children experienced clinical shock resulting in four being admitted to pediatric intensive care units.

Although only two of the children tested positive for COVID-19 when admitted to the hospital, another 3 tested positive for antibodies meaning they had been previously exposed to the virus.

England is not the only country that has seen an increase in new T1D cases either. Studies in China and Italy both showed that since the pandemic started, they have seen more children than usual being diagnosed with T1D. There was no distinct tie between COVID-19 infections and diabetes in these countries either.

Additional research is needed to determine whether COVID-19 may play a role in T1D risk. There is still a lot about the virus that researchers do not know, and they are still exploring its short- and long-term effects on health. The Diabetes Research Connection (DRC), though not involved in this study, is committed to advancing research around type 1 diabetes and provides critical funding to early-career scientists. Learn more about current projects and how you can help by visiting https://diabetesresearchconnection.org.

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Infancy Diabetes Risk

Predicting Diabetes Risk in Infancy

Type 1 diabetes (T1D) is a chronic condition that often develops in early childhood, though it can present later in life for some. Researchers believe that it stems from a variety genetic and environmental risk factors. Oftentimes individuals do not realize they have T1D until they experience an episode of hyperglycemia or diabetic ketoacidosis. These are serious and potentially life-threatening conditions that must be treated immediately.

Recognizing risk factors early on can help doctors to be proactive and better manage children’s health to reduce complications. A recent study from The Environmental Determinants of Diabetes in the Young (TEDDY) involved 7,798 children from around the world who were identified as being at high risk of developing T1D. The study followed them for nine years, starting at birth, and assigned participants a risk score based on “genetics, clinical factors such as family history of diabetes, and their count of islet autoantibodies – biomarkers known to be implicated in type 1 diabetes.”

This approach improved newborn screenings and the ability to predict the development of T1D. In addition, it allowed doctors to educate families about the disease early on. By more accurately assessing risk, researchers can target clinical trials for preventing the disease to those children who may benefit most. Early detection also allows for improved treatment and management of the disease from the start, which may reduce complications.

Recognizing risk of type 1 diabetes and developing effective prevention strategies is essential. Researchers are continually advancing their knowledge and testing different therapies and approaches to slow or stop T1D. This is an exciting step forward in prevention and treatment efforts. The Diabetes Research Connection (DRC) is interested to see how this study could influence diabetes management.

Research across all stages of the disease is critical. The DRC empowers early-career scientists to pursue novel, peer-reviewed research studies focused on type 1 diabetes by providing key funding. One hundred percent of research funds go directly to the scientists. To learn more about current projects and how to help, visit https://diabetesresearchconnection.org.

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Pancreatic Islet Cells

Advances in Pancreatic Islet Cell Transplantation

Currently, the most effective method for managing type 1 diabetes is regularly testing blood sugar levels and administering insulin. However, this can be hard on patients and on their bodies, and it does not control type 1 diabetes (T1D) as well as the pancreas does naturally on its own. But in individuals with T1D, the immune system mistakenly attacks and destroys insulin-producing beta cells produced by the pancreas, which is why insulin injections are necessary.

Researchers have been testing methods of transplanting pancreatic islet cells into patients with T1D in an effort to replicate or restimulate the body’s natural process for managing blood sugar. One of the challenges that they have faced is keeping transplanted cells alive and functioning for more than a few days or possibly weeks. They often do not establish the proper vascularization or oxygenation necessary for survival. In some cases, they are once again attacked and destroyed by the immune system.

A recent study shows encouraging results when it comes to islet cell transplantation, however. Rather than transplanting the cells into or near the liver, scientists placed them under the skin. The islets were encapsulated in a collagen-based matrix that provided a layer of protection while also improving the amount of oxygen the cells received. Scientists are not entirely sure why this process works, but it has shown positive results in mouse models.

One hundred mice whose pancreases had been removed were transplanted with collagen-encased islet cells from mice, pigs, and humans. Results showed that the mice did not require insulin injections to control blood sugar levels for up to 100 days. It is important to note that tests in mouse models do not always translate exactly the same in human models. Scientists do not yet know if humans would experience the same response to this approach. More testing is needed.

But it is a step in the right direction toward improving diabetes management and stimulating a more natural and effective process. Though not involved with this particular study, the Diabetes Research Connection (DRC) is committed to advancing understanding and treatment of the disease by providing critical funding to early career scientists. One hundred percent of donations go directly to researchers and their projects. Learn more and find out how to help by visiting https://diabetesresearchconnection.org.

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Determining the Impact of COVID-19 and Diabetes on One Another

Determining the Impact of COVID-19 and Diabetes on One Another

As the COVID-19 pandemic rages on, scientists from around the world have been conducting studies and analyzing data to better understand how the virus impacts humans and what may make some people more susceptible to severe infection or complications than others. While there is still a lot about the virus that scientists don’t yet understand, there have been some interesting findings from current data, including regarding diabetes and COVID-19.

In general, researchers know that individuals with comorbidities such as obesity, diabetes, cardiovascular disease (CVD), and chronic kidney disease (CKD) tend to have higher risk of developing complications and requiring hospital or ICU admission and mechanical ventilator use. They also tend to have a greater risk of mortality.

There have been a lot of interesting findings emerging regarding race and ethnicity when it comes to COVID-19. Hispanic, Black, and American Indian populations have been disproportionately affected by the virus, but it is still unclear why these disparities exist. Furthermore, although these populations have higher rates of contracting the virus, they do not demonstrate higher risk of severe infection requiring mechanical ventilation or resulting in mortality. Obesity, diabetes, and CVD do exist within these groups, which are general comorbidities across the general population, not specific to race or ethnicity.

When it comes to diabetes, many of the studies that have been conducted so far have not demonstrated a significant difference in terms of diabetes type and outcomes. Individuals with type 1 and type 2 diabetes both face risk of complications and poorer outcomes. Having poor glycemic control can increase risk of mortality, and it was shown to induce hyperglycemia in both patients with and without pre-existing diabetes.

Scientists have also found many overlaps between COVID-19 and diabetes. For example, having comorbidities puts individuals at greater risk of complications, and due to the nature of diabetes, patients who are diabetic tend to struggle with obesity, CVD, CKD and hypertension, which are all risk factors for COVID-19 complications. It can be a vicious cycle. Unfortunately, there have not been many large studies regarding pediatric patients with diabetes and COVID-19, but the studies that exist show that obesity, diabetes, and congenital heart disease all put pediatric patients at greater risk.

Researchers are taking a closer look at the role of viral infection load on cell death, inflammatory cytokine production, and immune response as well, especially as it relates to diabetes. COVID-19 is believed to increase cytokine levels, which in turn can increase risk of multi-organ failure, hyperglycemia, and tissue injury. Diabetes also leads to inflammation, poor glycemic control, and multi-tissue injury. These similarities between conditions can exacerbate complications in individuals with both diabetes and COVID-19. Plus, some studies have shown that COVID-19 may actually trigger new onset type 1 diabetes as a result of damage to beta cells.

Since COVID-19 has only been around for less than a year, it is difficult for scientists to accurately predict any long-term effects. However, they believe that it could aggravate pre-existing CVD or induce new cardiac pathology that may have lasting effects. In addition, due to the overlapping pathology of COVID-19, diabetes, and pre-existing comorbidities, that may put patients with diabetes at greater risk of complications in the future, even after recovery from active infection.

The Diabetes Research Connection (DRC) is committed to supporting research not just for diabetes and COVID-19, but for type 1 diabetes in general. The organization ensures that researchers receive necessary funding to carry out their projects and make meaningful contributions to the body of work that exists around T1D. These studies can help to improve diagnosis, treatment, and management of the disease, as well as improve quality of life and reduce risk of complications. To learn more about current projects and how to help, visit https://diabetesresearchconnection.org.

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Reducing the Need for Systemic Immunosuppression for Islet Grafts

Reducing the Need for Systemic Immunosuppression for Islet Grafts

One of the approaches scientists have been testing for reversing or better controlling type 1 diabetes is the use of allogeneic pancreatic islet transplants. By reintroducing healthy insulin-producing islets, they aim to support the body in naturally regulating and stimulating insulin production to manage blood glucose levels.

A major challenge to this technique, however, is the immune system’s rejection of the graft following transplantation. As with organ transplants, scientists were forced to suppress the immune response in order to keep cells from attacking and destroying the islets. But immunosuppression is not a long-term solution for islet graft transplantation because the potential risks and health effects can outweigh the benefits.

In a recent study, scientists explored the possibility of controlling a localized immune response rather than a systemic one. They designed a synthetic platform that contains microgel made of biomaterials that can deliver checkpoint proteins to regulate cell death.  They used a chemeric streptavidin/programmed cell death-1 (SA-PD-L1) protein. In addition to this protein, they added a short, two-week administration of rapamycin to help the body adjust to the transplant while curbing rejection risk. This approach enabled sustained survival of allogeneic islet grafts without the need for chronic systemic immunosuppression.

These results demonstrate the potential benefits of using synthetic microgels in combination with immunomodulatory ligands and specific antibodies to manage immune response to allogeneic pancreatic islet grafts. While additional research is needed, this is a step toward improving therapeutic modalities for treating or potentially reversing type 1 diabetes.

The Diabetes Research Connection (DRC) is interested to see how this study influences future work on islet transplantation as an option for managing type 1 diabetes. The DRC is committed to advancing research within the field through providing critical funding to early career scientists pursing novel research studies focused on all aspects of type 1 diabetes. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org.

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Improving Glycemic Control in Children Through Closed-Loop Systems

Improving Glycemic Control in Children Through Closed-Loop Systems

A major challenge of type 1 diabetes is maintaining glucose levels with a target range, typically between 70 and 180 mg/dL. This can be especially difficult for children who often rely on parents or other caregivers to help monitor blood sugar levels and administer the appropriate amount of insulin as necessary. However, closed-loop insulin delivery systems are changing this process for the better for many people.

This system takes advantage of the capabilities of current technology and combines devices to enhance automation of glycemic control. Continuous glucose monitors (CGMs) and insulin pumps are two devices that many individuals with type 1 diabetes (T1D) use to help manage their condition. A CGM uses a sensor to track blood sugar levels and notify users of when they start to rise or fall. These alerts are sent to a smartphone or smartphone-like receiver. Insulin pumps can be set to automatically administer a certain dosage of insulin without the individual having to measure and inject it themselves.

Researchers have figured out a way to combine these systems to form a closed loop where blood sugar is continuously monitored and insulin is automatically administered in response to changes with little to no input from the individual. In a recent study involving 101 children with T1D between the ages of 6 and 13, researchers found that those who used a closed-loop system of insulin delivery remained within target glucose ranges for a higher percentage of time than those children only using a sensor-augmented insulin pump.

At the end of the 16-week study, the percentage of time in range increased from 53±17% to 67±10% for the closed-loop group, but it only increased from 51±16% to 55±13% for the sensor-augmented insulin pump (control) group. This equated to around a 2.6 hour per day difference. Maintaining stable blood glucose levels is essential for good health and reducing risk of hypoglycemia and diabetic ketoacidosis (DKA). Neither group reported episodes of severe hypoglycemia or DKA during the trial.

As technology advances, this empowers individuals with type 1 diabetes with more options for managing their condition. The Diabetes Research Connection (DRC) continues to follow improvements in the field and is interested to see how this will impact the future of closed-loop systems and their use in children and adults with T1D. The DRC is committed to supporting diabetes research and provides critical funding for early career scientists pursuing novel, peer-reviewed projects focused on T1D. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org.

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Understanding the Relationship between Diabetes and COVID-19

COVID-19 is a relatively new virus, and one that researchers are continuing to learn more about every day. Studies have shown that individuals with underlying health conditions are at increased risk for complications and mortality from COVID-19; this includes diabetes. Healthcare providers have also seen an increase in new-onset diabetes cases and are interested in knowing whether this is related to COVID-19. The virus binds to ACE2 receptors, which are expressed in pancreatic beta cells. This may contribute to the development of ketosis and ketoacidosis in patients with COVID-19 and alter glucose metabolism.

In an effort to gather data and investigate any potential relationship between COVID-19 and diabetes, researchers have established a global registry called the CoviDIAB Registry. This registry will collect data from patients around the world that “includes, but is not limited to, the prolonged effects after the complications of the virus and diabetes subside, whether the new-onset diabetes is a different type of diabetes, and the impact of different phenotypes present at presentation and during recovery.”

The data would then be used to guide future studies and potentially develop more effective treatment methods. There have been multiple cases where individuals have been diagnosed with COVID-19 as well as ketosis or diabetic ketosis. In turn, this developed into ketoacidosis and diabetic ketoacidosis (DKA) in some patients, which can be dangerous to their health if left untreated. Both ketosis and diabetes are linked to longer hospital stays for COVID-19 patients, and ketosis has also been attributed to an increased risk of mortality.

More research is necessary to understand any possible connections between COVID-19 and diabetes, including severity of complications and diagnosis of new-onset diabetes. As more data is collected and analyzed, researchers can help guide appropriate treatment strategies in order to reduce complications and better manage patient health.

Though not involved with this study, the Diabetes Research Connection (DRC) has been involved in advancing diabetes research through providing critical funding to early career scientists. Donations come from individuals, corporations, and foundations, and 100% of these funds go directly to the scientists for their projects. Check out current DRC projects and learn more about how to support these efforts by visiting http://diabetesresearchconnection.org.

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Could Type 1 Diabetes be an Effect of COVID-19?

As the coronavirus pandemic continues on, researchers are learning more about the wide range of effects that it has on individuals. The disease presents differently in different people, ranging from those who are asymptomatic to those who end up with severe symptoms and are put on a ventilator. Some people develop a loss of taste and smell or having a lingering cough and trouble breathing, even after recovery. There is so much that is yet unknown about SARS-CoV-2, also known as COVID-19.

Another concerning discovery that researchers are investigating is whether the virus may play a role in some patients developing type 1 diabetes. A recent study found that some people who did not previously have a diabetes diagnosis are experiencing type 1 diabetes. Though more research is needed, researchers are questioning whether the virus triggers an autoimmune response that damages or destroys insulin-producing pancreatic beta cells.

There have been numerous patients who have presented with hyperglycemia, but this could also be due to the stress put on their body by the disease, as well as steroids used to promote recovery. In some patients, blood sugar issues resolved on their own, not resulting in type 1 diabetes, whereas others had a lasting effect. It is important to follow up after recovery to see if blood sugar management problems still exist and if there is the possibility that type 1 diabetes has developed.

These are still preliminary studies, so researchers cannot say for certain whether COVID-19 may cause type 1 diabetes in some people, but it is a possibility that they are continuing to investigate. Diabetes Research Connection (DRC) is interested to see how this study evolves moving forward and what it could mean for the type 1 diabetes community. The DRC is committed to providing critical funding to support type 1 diabetes research, though was not involved with this study. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org.

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New Preclinical Drug

A New Approach to Treating Diabetes and Its Effects

For decades, researchers have been studying cellular changes in the body that contribute to the development of diabetes. They have created a wide array of treatment options to help manage the effects and minimize complications. As they gain a better understanding of the causes of diabetes, they have also made advancements toward curing or preventing the disease. Each therapeutic modality works slightly differently.

A recent study has found that a new drug may hold promising results when it comes to combatting both type 1 and type 2 diabetes. This drug has been 18 years in the making and still has a way to go, but it has shown great potential in current mouse models as well as isolated human islets.

The drug, SRI-37330, is administered orally and affects both insulin and glucagon production in the pancreas and liver. In individuals with type 1 diabetes, the body does not produce enough insulin to effectively manage blood sugar while releasing too much glucagon which can contribute to hyperglycemia. SRI-37330 may help control hyperglycemia, hyperglucagonemia, excessive glucose production by the liver, and fatty liver, which are all significant issues when it comes to diabetes.

Lead researcher Dr. Anath Shalev and her team have spent nearly two decades studying diabetes and its potential causes. This led them to identify a key protein, TXNIP, which can have detrimental effects on islet function and survival. SRI-37330 has the ability to inhibit TXNIP signaling and expression without negatively impacting other genes or processes.

According to their research, not only did the drug help protect mouse models from developing type 1 diabetes, it controlled blood glucose levels more effectively than metformin and empagliflozin, two oral anti-diabetic drugs commonly used today. SRI-37330 helped to decrease glucagon production and release by pancreatic islets and the liver without having the countereffect of increasing hypoglycemia liability in the mice.

One result that researchers did not anticipate was the ability of SRI-37330 to “dramatically improve the severe fatty liver observed in obese diabetic db/db mice.” This opens the door for more studies to determine whether the drug could be used as a potential treatment for non-alcoholic fatty liver disease as well.

Overall, researchers concluded that SRI-37330 is “orally bioavailable, has a favorable safety profile and inhibits TXNIP expression and signally in mouse and human islets, inhibits glucagon secretion and function, lowers hepatic glucose production and hepatic steatosis, and exhibits strong anti-diabetic effects in mouse models of Type 1 and Type 2 diabetes.”

It is important to note that mouse models do not always translate the same in human models. A drug that is effective at treating induced diabetes in mice may not have the same efficacy in humans. More research is needed to see how SRI-37330 would work in human clinical trials and not just isolated human islets or mouse models. However, this drug is an encouraging finding in the field and one that may hold significant potential.

The Diabetes Research Connection (DRC) is interested to see how this study progresses moving forward and what it could mean for the treatment and prevention of type 1 diabetes in humans. This type of work is critical in advancing understanding of the disease as well as care and treatment options. The DRC supports early-career scientists pursuing novel research related to type 1 diabetes by providing up to $50K in funding. Learn more about current projects and how to donate by visiting http://diabetesresearchconnection.org

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Metabolic Memory

Exploring the Role of Metabolic Memory in Diabetes Complications

As the immune system slowly destroys insulin-producing pancreatic beta cells, a hallmark sign of type 1 diabetes, the body has an increasingly difficult time controlling blood glucose levels. These cells are no longer available to naturally secrete insulin in response to rising blood sugar, meaning individuals must control this process manually or through the use of continuous glucose monitors (CGM) and/or insulin pumps.

Poor glycemic control can contribute to a multitude of diabetes complications and health concerns. It is critical for individuals who are newly diagnosed with the disease to learn how to manage their diabetes and keep blood glucose levels within the target range. A recent study found that incidences of poor glycemic control can have a lasting impact, potentially triggering complications later on in life, even if blood sugar is well-managed now.

This occurrence may be due to the body’s metabolic memory. When hyperglycemia occurs, it may lead to DNA methylation or changes in gene expression. These epigenetic changes may be ongoing, lasting for years to come, even though they do not actually alter the person’s genetic code. Researchers at the Diabetes & Metabolism Research Institute at City of Hope analyzed blood samples from more than 500 participants in the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) clinical trial involving patients with type 1 diabetes.

They used the samples to profile DNA methylation, then compared that to the participants’ glycemic history and any complications that had developed over the past 18 years. Their findings showed that “prior history of hyperglycemia may induce persistent DNA methylation changes in blood and stem cells at key loci, which are epigenetically retained in certain cells to facilitate metabolic memory, likely through modifying enhancer activity at nearby genes.”

By matching these key factors, researchers may be able to uncover biomarkers that could help predict the risk of complications in the future. Recognizing signs early on could help initiate interventions to reduce complications or prevent the progression of these issues. There is still a lot that researchers do not yet understand about metabolic memory, but this is a start. While the research team at City of Hope is currently looking at DNA methylation and metabolic memory as it relates to retinopathy and nephropathy complications, they would like to expand this to include other regions where complications can occur through whole-genome bisulfite sequencing.

In the past, it was more difficult for individuals with type 1 diabetes to maintain glycemic control following diagnosis due to inferior technology, but over the years, technology has greatly improved. This has allowed individuals to minimize complications by using devices that have empowered them to improve their care and better manage their blood glucose levels. These advancements have also helped people with more recent diagnoses achieve better glycemic control earlier on, which may impact metabolic memory and the risk of future complications.

The Diabetes Research Connection is interested to see how this study advances understanding of metabolic memory and the role of DNA methylation in diabetes management. Developing complications is an ongoing concern for individuals living with T1D. The DRC is committed to providing funding for early-career scientists pursuing novel research studies focused on prevention, treatment, and a cure for the disease, as well as improving quality of life and minimizing complications. Check out current projects and how to support these efforts by visiting https://diabetesresearchconnection.org.

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See our approved research projects and campaigns.

Role of the integrated stress response in type 1 diabetes pathogenesis
In individuals with type 1 diabetes (T1D), the insulin-producing beta cells are spontaneously destroyed by their own immune system. The trigger that provokes the immune system to destroy the beta cells is unknown. However, accumulating evidence suggest that signals are perhaps first sent out by the stressed beta cells that eventually attracts the immune cells. Stressed cells adapt different stress mitigation systems as an adaptive response. However, when these adaptive responses go awry, it results in cell death. One of the stress response mechanisms, namely the integrated stress response (ISR) is activated under a variety of stressful stimuli to promote cell survival. However, when ISR is chronically activated, it can be damaging to the cells and can lead to cell death. The role of the ISR in the context of T1D is unknown. Therefore, in this DRC funded study, we propose to study the ISR in the beta cells to determine its role in propagating T1D.
Wearable Skin Fluorescence Imaging Patch for the Detection of Blood Glucose Level on an Engineered Skin Platform
A Potential Second Cure for T1D by Re-Educating the Patient’s Immune System
L Ferreira
Validating the Hypothesis to Cure T1D by Eliminating the Rejection of Cells From Another Person by Farming Beta Cells From a Patient’s Own Stem Cells
Han Zhu
Taming a Particularly Lethal Category of Cells May Reduce/Eliminate the Onset of T1D
JRDwyer 2022 Lab 1
Can the Inhibition of One Specific Body Gene Prevent Type 1 Diabetes?
Is Cholesterol Exacerbating T1D by Reducing the Functionality and Regeneration Ability of Residual Beta Cells?
Regeneration Ability of Residual Beta Cells
A Call to Question… Is T1D Caused by Dysfunctionality of Two Pancreatic Cells (β and α)?
Xin Tong
Novel therapy initiative with potential path to preventing T1D by targeting TWO components of T1D development (autoimmune response and beta-cell survival)
flavia pecanha