DRC & Research News

This page shares the latest news in T1D research and DRC’s community.

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Congratulations to our newest research grant awardees!

Join us in cheering on these innovative researchers! 

We look forward to following their progress.

Look for future emails that will highlight their projects in more detail.

For questions or information on other ways to give such gifts via stock or donor-advised funds, contact Christine Rhoads at crhoads@diabetesresearchconnection.org.

All gifts to DRC are 100% tax-deductible.  DRC is a 501(c)(3) charitable organization / Tax ID#90-0815395.

 

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Research Findings May Provide Answers to Diabetes Complication of Peripheral Neuropathy

Approximately half of the people with type 1 or type 2 diabetes experience peripheral neuropathy—weakness, numbness, and pain, primarily in the hands and feet.  New discoveries by a team of researchers at Salk Research Institute may provide a new way to identify people at high risk for peripheral neuropathy and a potential treatment option.

Read here for more information on this study, authored by a distinguished team of researchers, including senior researcher and Diabetes Research Connection founder and board member                     Nigel Calcutt.

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Genetics in T1D

DRC’s Take on, “The type 1 diabetes gene TYK2 regulates βcell development and its responses to interferon-α”

Over the years, researchers investigating type 1 diabetes have identified many genes associated with onset of the autoimmune disease. One of those genes is TYK2, which codes an enzyme (a Janus kinase) that plays a crucial role in intracellular signaling. In a study published recently in Nature Communications, a research team led by Timo Otonkoski at Helsinki University Hospital directed TYK2 knockout human iPSCs into the pancreatic endocrine lineage to decipher a dual role of the candidate gene TYK2 in pancreatic β-cells. First, depletion of TYK2 during early islet development affected the endocrine commitment, but did not affect the functionality of mature beta cells. Second, TYK2 inhibition in mature islet cells reduced vulnerability to T-cell cytotoxicity. These results identify an unsuspected role for TYK2 in β cell development and support TYK2 inhibition in adult β-cells as a potent therapeutic target to halt T1D progression.

Click HERE to read the full article.

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DRC Is Excited to Share This Breaking T1D News Announced Yesterday by the FDA

The FDA has just approved Provention Bio’s Tzield™ (teplizumab-mzwv) – the first drug therapy that can delay the onset of type-1 diabetes (T1D) for those at risk of developing the disease.  This is a huge milestone for T1D research and those in the T1D community. (Read the full FDA announcement HERE.)

The average delay in the onset of T1D observed in the clinical study of Tzield was approximately 3 years, with some study participants not yet acquiring type 1 diabetes at all.  “Today’s FDA decision gives people at risk of developing type 1 diabetes the gift of time,” said Aaron Kowalski, Ph.D., JDRF CEO. “For the first time ever, we have a way to change the course and slow the development of T1D.”  (Read JDRF’s full statement on the impact of this news to the T1D community HERE.)

Tzield is the result of decades of T1D research, which began with an early scientific study.  That study led to a JDRF grant to support a trial in patients.  The success of that trial study led to further studies and support from the National Institutes of Health (NIH), eventually leading to this exciting breakthrough that will impact the future of T1D treatment.

Scientific breakthroughs such as this one, often emerge due to the inventiveness of early-career scientists.  It is DRC’s mission to connect donors with early-career scientists, enabling them to perform peer-reviewed, novel research designed to prevent and cure type 1 diabetes, minimize its complications, and improve the quality of life for those living with the disease.

Thus far, 10+ of our funded studies by early-career scientists have secured follow-on funding to continue their studies which could lead to breakthroughs like the milestone announced today.

You could help fund the next T1D breakthrough!  DONATE HERE 

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November 2022 Newsletter

Please enjoy this month’s newsletter, featuring:

        • Researchers Impacting Our Mission
        • November’s Matching Gift Campaign
        • Meet Our New Executive Director
        • DRC’s Seaside Silent Auction
        • Thank You to Our Sponsors!

 

 

View the Newsletter here

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For the Good of Neural Tissues and Pancreatic Islets

While organs can be transplanted from deceased donors, tissues from the nervous system rapidly lose viability. The mechanisms of neuronal death, and the potential for reversing it, remain poorly defined. Dr. Fatima Abbas, a DRC-funded investigator at the University of Utah, in collaboration with Dr. Frans Vinberg (University of Utah) and Dr. Anne Hanneken (The Scripps Research Institute, La Jolla, CA), published a paper in Nature that questions the irreversibility of neuronal cell death in the retina, an investigation that has implications for visual rehabilitation and for the future of organ transplantation. In the study, the researchers characterized neuronal death and survival and identified conditions for reviving neuronal functioning in postmortem mice and human retinas. This study is a step toward better strategies for preserving the viability and engraftment capability of tissues and cells isolated from organ donors for transplantation, including the pancreas. Given the significant overlap of genes and proteins between pancreatic islet cells and neural tissues, the findings by Abbas and colleagues may have important implications for the improvement of islet cell transplant engraftment and long-term function in type 1diabetics.

Click HERE to read the full article.

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DRC’s Take: Vertex to Acquire Chief T1D Stem Cell Competitor in All-Cash Deal

Vertex, whose VX-880 stem cell therapy for type 1 diabetes has cleared clinical proof of concept, is acquiring ViaCyte, a private biotech that has also reached clinical trials with its own stem cell therapy. In the $320 million all-cash deal, Vertex will acquire ViaCyte’s human stem cell lines, manufacturing facilities, and other relevant intellectual property.

While both companies are pursuing stem cell-based approaches to treating type 1 diabetes, their methods differ. The Vertex therapy involves injecting synthetic islet cells into patients. By comparison, the ViaCyte therapy uses gene-edited, immune-evasive stem cells encapsulated in implantable devices.

Both companies have reported data from clinical trials.

Data released by Vertex in October 2021 showed that the first patient who received the treatment had a lower average HbA1c (8.6% to 7.2%) and a significantly reduced reliance on insulin injections. Results from a second patient have also been reported and data from additional trial participants are expected later this year or early next year. In June 2021, ViaCyte revealed that a single patient had also experienced a drop in HbA1c (7.4% to 6.6%) but still required insulin injections.

“VX-880 has successfully demonstrated clinical proof of concept in T1D, and the acquisition of ViaCyte will accelerate our goal of transforming, if not curing T1D by expanding our capabilities and bringing additional tools,” Vertex CEO Reshma Kewalramani said in a statement.

Click HERE to view the full article.

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DRC in the Community: President and Chair, C.C. King’s Presentation on Insights into Medical Research

On Monday, May 23rd, DRC’s President and Chair, C.C. King, Ph.D., spoke at Del Mar Foundation’s speaker series, DMFTalks. Over 30 members of the community came to listen to C.C. talk about the importance of medical research. His talk addressed the importance of medical research. He began by sharing the process of approving medication through the FDA and how in-depth that procedure can take. This transitioned into the significance of model systems in three categories; Cancer, the self, and Type 1 Diabetes (T1D). In researching human disease, model organisms allow for a better understanding of the disease process without the added risk of harming an actual human. By the end of the presentation, he illustrated how Diabetes Research Connection (DRC) is a vital organization that funds early-career scientists who have bold and out-of-the-box ideas without the years of experience that other researchers have, therefore often don’t receive the funding necessary to make headway with their research. DRC is an organization that proudly acts as the seed funding for many of these projects, allowing them to gain momentum and credibility to help them receive larger grants to bolster their research. Many of these projects use model systems to help validate their hypotheses and have often received follow-on funding from the results they have garnered and have made headway in T1D research.

Click HERE to watch C.C.’s presentation!

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CONNECTING FOR A CURE: June 2022 Newsletter

DRC has distributed over $400,000 to research projects like Dr. Dwyer’s and Dr. Zhu’s in Request for Application (RFA) 2 2021 alone. We received an unprecedented number of Letters of Interest (LOIs) in our last RFA and are funding even more innovative projects than ever. View our “Support a Project” page to see what other research projects we are currently committed to funding by clicking here. Take a look at our latest newsletter, where we feature some quotes from our newest grant recipients, show DRC in the community, and highlight our newest volunteers.

Click this link to view our June newsletter that we mailed out previously this month about what we’ve been up to and the impact we are making together. It takes a community to connect for a cure!

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Diabetes Research Connection Awards $400,000 to Eight Promising T1D Studies

After rigorous peer review by DRC’s Scientific Review Committee, eight early-career researchers were awarded $50,000, totaling $400,000 in seed funding for their work to find the cause, treatment, and cure for T1D. 

Click HERE to read the Press Release

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Meet a DRC Volunteer: Kaya Keutler

Kaya was diagnosed with type 1 diabetes when she was 13. That was also the point she knew she wanted to become a scientist and work in the research field of diabetes. Fast forward 15 years, Kaya is working on getting her doctoral degree at the Oregon Health & Science University. However, Kaya has realized that she wants to spend less time doing science and more time communicating current scientific knowledge to relevant audiences and the public. Her work for the DRC brings her one step closer to that goal. 

I was diagnosed with type 1 diabetes when I was 13. One of my closest cousins had lived with diabetes for about 10 years back then, so it wasn’t an unknown disease to me. Still, it felt like a bad diagnosis when an indifferent doctor delivered it to me in front of his note-taking students at a university clinic. Today I recognize it as a life-changing moment and am grateful for it, as it has made me the person I am. It also has significantly impacted my career decisions. I knew I wanted to become a scientist and work on a cure for diabetes back then. Although actively working in the field of diabetes research today, I now know it’s not that simple. There is so much we still need to learn about the disease and its treatment, and that includes both basic science as well as coming up with smart solutions for the everyday life of diabetic patients. “Let’s see what the science says” is a phrase I often use both at work and while engaging in managing my diabetes. I’ve found that what I know as a scientist does influence my treatment decisions quite a bit. I’ve reached out to volunteer for the DRC as I want to give others the power to make science-based treatment decisions and to better understand their disease, the research around it, and their options.

Kaya is now helping this organization by translating complex scientific language from DRC-funded researchers so that the community can understand the project better.

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National Tell a Story Day: A Co-Founder Shares Her Experience

Amy Adam’s son was diagnosed with T1D when he was five years old. She served on the Board of Directors and various committees for the Juvenile Diabetes Research Foundation (JDRF) Chicago chapter for 10 years and was a contributing writer to Insulin Free Times. This is her second term on the DRC Board, and she has served as the Lay Person Review Committee Chair since DRC’s inception.

It’s hard to believe that 30 years, hundreds of thousands of blood tests and shots, innumerable doctors’ visits and procedures, and countless renewed vows to find that elusive combination of food, activity, and insulin have passed since my own child was diagnosed with Type 1 Diabetes. Time has propelled us forward like tumbleweeds in a dust storm, yet the rigorous demands and challenges of diabetes have clung stubbornly to him every step of the way. One of the most significant personal challenges I have encountered along this path is having to stand by and watch my child’s indomitable spirit rise and fall as this disease continues to roll along with his organs, tissues, and psyche firmly in its grasp.

You can’t outgrow Type 1 Diabetes, and it is progressive. Most Type 1 diabetics develop at least one complication, and close to 50% of Type 1 diabetics will develop disabling or even life-threatening complications over their life despite their best efforts to control the disease. Perhaps due to multiple autoimmune diseases, my child struggles more than many. 

Fortunately, early on our path with this disease, we met the most extraordinary doctor who medically guided us through some of his darkest hours and gave us the only trustworthy source of hope we have ever felt through his research for a cure for this insidious disease. Years later, when Dr. Hayek introduced me to an equally impressive man named David Winkler and asked me to join them in their endeavor to create a diabetes research organization with a different paradigm, I was all ears.

Our founding vision for The DRC (Diabetes Research Connection) was to empower the community of young, innovative scientists, people affected by diabetes, and their supporters to propel unique and promising Type 1 Diabetes research ideas that weren’t receiving adequate attention by other organizations. Each selected project would have to be endorsed by a group of world-renowned diabetes experts who had volunteered their time to evaluate the merit of these projects to qualify for funding. Then the projects would be written in lay-friendly terms and posted on our website, where potential supporters could choose to support the projects that “spoke” to them based on their own experiences and knowledge of the disease. The scientists would provide regular updates on the progress of their project, good, bad, or inconclusive. Outcomes would be published on our website, adding to the body of diabetes knowledge in a united effort to eliminate diabetes.

I support the Diabetes Research Connection because despite our best efforts to control what we were told was a manageable disease, the only source of control we have ever felt is where we put our money towards curing it. Join us and influence the future of diabetes research; by selecting the research that is meaningful to you and your experience, you may help influence the work that leads to a cure for Type 1 Diabetes.

Amy’s initial vision for co-founding DRC has come to fruition. In this organization’s 10th year, they have funded 48 projects, invested $2.4 M in innovative T1D research, and 12+  researchers received approximately $12M in follow on funding.

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DRC was featured in the San Diego Union Tribune

The DRC was featured in the San Diego Union Tribune about how it is successfully providing the seed funding or the “spark” for truly novel T1D research being conducted by talented early-career scientists and has led to much-larger investments from the government or larger charities. “From zebra fish to bacteria, Diabetes Research Connection celebrates a decade funding novel ideas” – The San Diego Union-Tribune (subscription required)

 

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2021 Annual Report

DRC’s 2021 Annual Report

Diabetes Research Connection (DRC) is excited to announce that our first-ever annual report is completed and ready for you to enjoy! Please click HERE to view the 2021 Annual Report highlighting all of the progress this organization has made throughout the last year. 

Join us in celebrating the impact DRC-funded research has made on the prevention, management, and cure for Type 1 Diabetes (T1D)! 

DRC is committed to seeking out, peer-reviewing, and providing seed funding to the most promising T1D research being conducted by innovative early-career scientists across the country – providing hope to those living with the disease. It is only through our community that we can stay unwaveringly loyal to our mission. 

Thank you for being a part of the DRC family.

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DRC Announces 2022 Scientific Review Committee

74 type 1 diabetes (T1D) experts from renowned universities and research institutions across U.S. make up this year’s committee to vet innovative T1D research for funding by DRC

SAN DIEGO – February 28, 2022 – Diabetes Research Connection (DRC), a 501(c)(3) that funds research projects conducted by early-career scientists aimed at prevention, better care, treatment of related complications, and a cure for T1D, announces its Scientific Review Committee (SRC) for 2022.

The DRC SRC is a collaboration of T1D experts from renowned universities and research institutions from across the country. The committee members volunteer their expertise and time to thoroughly vet T1D research funding applications DRC receives based on their scientific merit. See the full list of DRC SRC members here.

“I’m honored to be a DRC SRC member. The warmth of the DRC community is unique. It brings scientists, patients, families, doctors, and supporters together. It also gives courage to scientists taking unconventional approaches toward solutions for T1D,” says Dr. Yo Suzuki of J. Craig Venter Institute. “I am forever thankful for the support DRC gave me when I was developing a nascent research idea. I hope to contribute my biological engineering perspectives, which may be non-standard in T1D research, to helping guide future research directions.”

DRC Board Member and previous Scientific Director Alberto Hayek, M.D. says, “These talented scientists and diabetes experts are at the center of our mission. Through their focused and rigorous vetting of projects submitted to DRC for financial support, we are able to provide seed funding to those most likely to find the cause, better treatments, and ultimately, a cure for T1D.”

In 2021 alone, DRC provided seed funding for 16 new T1D research projects, bringing the total support of early-career scientists to almost $2M. Follow on funding, a critical measure of the viability of projects funded by DRC, has topped $8.4M in additional funds for T1D research.

DRC is supported by donations from individuals, corporate sponsors, and private and public foundations. Contact us to discover how you can support DRC’s mission to eliminate T1D.

To donate online today click here.

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Diabetes Research Connection Celebrates Achievements Amid Year-End Giving Campaign to Fund Type 1 Diabetes Research

Supported by corporate sponsorships, county grants, foundation awards, and a donation of $100,000 in matching funds, DRC pushes to fund more innovative research to find the cause, treatment, and cure for T1D

SAN DIEGO – December 16, 2021 – Diabetes Research Connection (DRC), a 501(c)(3) that funds research projects conducted by early-career researchers aimed at prevention, cure, and better care for those with Type 1 Diabetes (T1D), announces significant achievements in 2021 amid its year-end giving campaign. This year, DRC has been supported by corporate sponsorships, county grants, foundation awards, and a $100,000 dollar-for-dollar matching gift from an anonymous donor.

In 2021 alone, DRC will provide seed funding for 16 new T1D research projects, bringing the total to 48 innovative studies by early-career scientists awarded since its founding in 2012. DRC expects to support close to $2M in research by year-end, with six early-career scientists receiving DRC funding going on to secure $8.4M in additional funds for their T1D research.

“DRC is committed to providing seed funding for early-career scientists to demonstrate the viability of their peer-reviewed, innovative T1D research ideas. Data driven outcomes show proof of concept to enable our scientists to pursue follow-on funding, often yielding over $1 million,” shared DRC Co-Founder, David Winkler.

 Corporate partners and financial underwriters are instrumental to DRC’s mission and include:

 

Leading Sponsors

 

Sustaining Supporters

 

Event Sponsors

 

DRC Senior Director of Development Casey Davis said, “I can’t express enough the importance of our sponsors, and corporate and public underwriters to our mission to eradicate T1D through research. That’s what we mean when we say, ‘It takes a community to connect for a cure’.”

Through their help and that of family foundations and other donors, DRC expects to raise a record $750,000 in 2021, and anticipates it will increase that figure to $1 million in 2022.

“DRC is funding important research to find ways to prevent, better treat, and cure T1D. Donors and partners can also choose specific research projects they want to support. This enables you to see your dollars at work,” said Stephen Korniczky, DRC Board Member and Partner, Sheppard Mullin. “DRC not only supports a noble mission, they have been a wonderful partner as well.  I invite other sponsors and donors to join us in supporting DRC in 2022.”

DRC has additional sponsorships available for 2022 at a variety of levels. In honor of its 10-year anniversary it will be re-launching its annual Dance for Diabetes, and event sponsorships, in Fall 2022.

To donate to DRC and double your impact with a tax-deductible donation click here by December 31, 2021.

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Imagine: A World without Type 1 Diabetes

By 2050, 5 million people in the US are expected to be diagnosed with T1D; 600,000 of them will be children, requiring them to regularly monitor blood sugar and putting them at a higher risk for cardiovascular disease, kidney damage, blindness and other complications. Hear 18-year-old Cooper Buchanan describe how he learned he has T1D, and, how he and others are imagining a world where no one has to ever hear: You have T1D.

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A Cure for Type 1 Diabetes? For One Man, It Seems to Have Worked

May 2022 Update

Vertex Pharmaceuticals Incorporated today provided updates on its Phase 1/2 clinical trial of VX-880, an investigational stem cell-derived, fully differentiated pancreatic islet cell replacement therapy for people with type 1 diabetes (T1D) with impaired hypoglycemic awareness and severe hypoglycemia. According to the results released on May 2, data from the first two patients in Part A established proof-of-concept for VX-880, with one patient achieving insulin independence at day 270 and the other patient showing reductions in insulin requirements through Day 150.

Additionally, the Independent Data Monitoring Committee recommended advancement to Part B, where patients receive the full target dose of VX-880, which has been generally well-tolerated to date. Vertex also announced that VX-880 Phase 1/2 study has been placed on clinical hold in the U.S. by the Food and Drug Administration (FDA) due to a determination that there is insufficient information to support dose escalation with the product.

Click HERE to read the full article about this update.

Commentary

Authors:

Vincenzo Cirulli, M.D., Ph.D.

Scientific Director, Diabetes Research Connection

Department of Medicine, UW Diabetes Institute

University of Washington

Institute for Stem Cells and Regenerative Medicine

 

Alberto Hayek, M.D.

Medical Director, Scripps/Whittier Diabetes Institute

Co-Founder, Diabetes Research Connection

 

David Winkler

Co-founder, past Chair and current CFO, Diabetes Research Connection

Past Chair, Scripps Whittier Diabetes Institute

Past Chair, American Diabetes Association, San Diego Chapter

Type 1 Diabetes Patient for 62 years  

 

A Cure for Type 1 Diabetes? For One Man, It Seems to Have Worked.

This article, which appeared in the New York Times (NYT) on Saturday, November 27, 2021, provides a promise for achieving a cure for type 1 diabetes (T1D). Dr. Melton, a brilliant scientist at Harvard, and an inspired father of two T1D patients is credited with overseeing this important effort which built on many past and present researchers’ discoveries.

While we applaud Dr. Melton and his team’s efforts for taking the necessary steps to bring this research to the bed-side, there are some questions that will need to be addressed. It remains to be determined if any issue or side effects will arise over time in some of the 17 patients participating to this initial clinical trial. Patient immunosuppression may be problematic, as it has been the case for some recipients of cadaveric human islet transplants. The long-term survival and function of these stem cell-derived beta cells will also need to be assessed, and design plans to replace them with additional transplants should they fail. Ultimately, the cost of the procedure and required FDA approval will also need to be addressed.

In the year 2000, the New England Journal of Medicine published an article that caused many to believe a cure for T1D had been discovered. The principal investigator, Dr. James Shapiro, initiated what became known as the Edmonton Protocol. This multicenter trial involved transplanting human cadaveric islets. Some issues soon arose: 1) an insufficient supply of islets; 2) failure of the islet transplants to function long-term; 3) complications associated with the site of transplantation into the portal vein of the liver, and 4) side effects caused by the immunosuppression of the recipients.

Undoubtedly, the most significant development since 2000 has been the conversion of pluripotent stem cells into insulin-producing cells to provide an unlimited supply of islet tissue for transplantation in T1D patients.

The need for immunosuppressive drugs to prevent rejection of the islet transplants remains an ongoing concern, although these types of drugs, and their regimen protocols have improved considerably since 2000. Notwithstanding, immunosuppression continues to have issues. Better drugs will be needed to ensure that the transplanted islet tissue is not rejected, retains its insulin-producing function over time, and that the recipients’ immune systems is not negatively impacted for its important primary function of fighting off other diseases.

Another approach to avoid rejection of pluripotent stem cell-derived beta cells is to encapsulate them. However, to date, these cells have not prospered in such enclosed environments, because current cell encapsulation technologies do not allow for these beta cells to intimately interact with blood vessels of the host to receive nutrients and oxygen to survive long term while performing their insulin secretory function in response to circulating glucose levels.

In two recent studies just published in peer-reviewed journals (https://www.cell.com/cell-stem-cell/fulltext/S1934-5909(21)00415-X), Canadian investigators led by Dr. Timothy Kieffer in collaboration with ViaCyte, and by ViaCyte scientists in collaboration with Dr. James Shapiro (https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(21)00338-4) reported that transplantation of immature stem cell-derived pancreatic islet progenitors in 15 and 17 patients, respectively, produced negligeable, yet detectable levels of human C-peptide production in response to a meal after a year from the day of transplantation. These studies were conducted using devices that allow some level of interaction of the transplanted cells with the patient’s blood vessels, thus requiring immune suppression. The bottom line is that after ~1 year, none of the patients became independent from insulin injections and all required exogenous insulin during the trial.

A possible solution to the problem of allorejection (i.e., immune rejection of “non-self” cells, coming from a different genetic background) may involve the use of a T1D patient’s own cells to generate induced pluripotent stem cells (or iPS), produced through a technique of reprogramming, and then convert these iPS cells into pancreatic beta cells. These “self-cells” may evade rejection by mechanisms of allo-immunity; however, auto-reactive immune cells that caused T1D in the first place in these patients may still target and destroy these newly transplanted beta cells.

San Diego’s ViaCyte is pursuing another potential cure. This company recently announced a collaboration with Crisper, a biotech leader in DNA editing to genetically modify the stem cells to avoid the need for immune therapy post-transplantation.

Ultimately, in order to ensure that all of the above treatments are safe for transplantation in the general population of T1D patients the FDA will require: 1) a careful peer-reviewed analysis of the results on all patients; 2) a long-term assessment of the survival and function of the transplanted cells; 3) evaluation of the long-term effects of immunosuppression; and 4) determination of the acceptability of all side effects.

Collectively, what all of these recent advancements show is that there is much more to be learned before stem cell derived islet tissue can be routinely and safely used for cell replacement therapy in T1D.

Hence, notwithstanding these open questions, substantial progress is being made towards a functional cure for T1D. We must proceed with hope and caution while pursuing additional innovative research.

The DRC is committed to continue supporting innovative basic and translational research by early-career scientists who strive to prevent, find better treatments for, and cure T1D.

 

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We’re Committed to Eradicating T1D

Five million people are expected to have T1D by 2050 and 40,000 are diagnosed with T1D each year in the U.S. Our Executive Director Karen Hooper discussed DRC’s unique mission in raising research dollars for early-career scientists to develop innovative studies that will lead to the end of T1D. Learn about our commitment to not rest until T1D is eliminated in this recent Spotlight on the Community podcast.

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Happy Holidays

DRC Wishes You A Happy Holiday!

Dear Supporter,

In consideration of the safety and comfort of our community, and the uncertainty for the effects of COVID-19 and its variant in indoor settings, DRC had to postpone events in 2021.

However, we are thrilled to announce we will be honoring our 10-year anniversary by throwing an epic party for our Dance for Diabetes in 2022. Stay tuned for more details.

Thank you for your continued support and partnership!

 

Happy Holidays, 

The DRC Team

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Diabetes Research Connection Awards $400,000 to Eight Promising T1D Studies as Nation Observes National Diabetes Month

After rigorous review by DRC’s Scientific Review Committee, eight early-career researchers receive seed funding for their work to find the cause, treatment, and cure for T1D

November 08, 2021 04:25 PM Eastern Standard Time

SAN DIEGO–(BUSINESS WIRE)–Diabetes Research Connection (DRC), a 501(c)(3) that funds research projects conducted by early-career researchers aimed at prevention, cure, and better care for those with Type 1 Diabetes (T1D), puts out a call for T1D research in need of seed funding twice a year. After a rigorous review by the DRC Scientific Review Committee (SRC), comprised of T1D experts nationwide, the most promising studies are selected to receive seed funding. The first round of grants for 2021 was recently completed as the nation observes National Diabetes Month. Funds were provided to seven researchers (with an additional study pending contract approvals) totaling a $400,000 investment. Researchers receiving grants include:

“The DRC has filled a niche by providing seed funding to the most promising T1D research being conducted by innovative early-career scientists”

  • Dr. Michael Kalwat – Indiana Biosciences Research Institute
  • Dr. Sudpita Ashe – University California, San Francisco
  • Dr. Balamurugan Dhayalan – Indiana University
  • Dr. Yao Wang – University of California, San Francisco
  • Dr. Yi Wang – University of California, San Francisco
  • Dr. Flavia Pechanha – University of Miami
  • Dr. Madhumita Basu – Nationwide Children’s Hospital
  • Additional study pending contract approvals

Those selected are conducting a variety of T1D studies, ranging from the role of TSA genes in T1D, to preventing and possibly curing T1D by blocking the autoimmune attack of beta cells. Individuals can view the full summary of projects and donate to the research study of their choice.

Alberto Hayek, M.D., a renowned diabetes expert, former Scientific Director at San Diego’s Scripps Whittier Institute for Diabetes, Professor Emeritus of Pediatrics at UCSD, and DRC board member, notes how far diabetes research has come since the 1960s. Back then, diabetes in children was often viewed as fatal.

Today, continuous glucose monitoring and loop systems automatically sense how much insulin to inject. However, there is still no known cure to the autoimmune disease which 1.6 million Americans are living with today. View DRC’s “Imagine a World Without T1D” video.

“The DRC has filled a niche by providing seed funding to the most promising T1D research being conducted by innovative early-career scientists,” says Hayek. “From graduate students to junior assistant professors – they all have the ability to compete for funding with DRC – even for ‘high risk’ grants, often overlooked by others, that have potential to forever change views or research on T1D.”

To apply for funding, researchers first submit an LOI to be reviewed by DRC’s SRC. If approved, the applicant is invited to submit a grant application. U.S.-based post-doctoral fellows, professors, and instructors whose research is focused on T1D and have not received NIH funding as a Principal Investigator, are eligible to apply. Once a study has been approved by DRC, donors have the opportunity to support a research project of their choice and interact with the researchers themselves via the DRC website.

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T1D

Imagine: A World Without Type 1 Diabetes

As we begin to reflect on all that has happened in the world over the past 18+ months, it is even more incredible to share the progress that the Diabetes Research Connection (DRC) has made. Despite the global pandemic, despite the decline in donations, and despite the fact we have been unable to be together in person, we are fighting to end Type 1 Diabetes more than ever before. 

We must end this disease, and to do that, we need to all commit to finding the best and brightest early-career scientists in the nation and provide seed funding for their promising research. We must invest in novel ideas, with the most promise, to ensure a future where nobody has to hear “You have Type 1 Diabetes.” 

Click HERE to view the full November Newsletter!

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DRC and Rainman's Take

DRC’s President and Chair and the Senior Director of Development Speak on the Podcast Rainman’s Take

In late September, DRC’s President and Chair, C.C. King, and the Senior Director of Development, Casey Davis, spoke on the Podcast Rainman’s Take. This podcast is hosted by Brian, the “Rainman” Lukacz. He speaks on a variety of topics and gives his take on them.

During this 1+ hour episode, Rainman talks with C.C. and Casey about their innovative approach to charitable giving in the fight for a cure for type 1 diabetes. DRC’s process allows donors to have a direct connection with the research they are funding that maintains transparency and is an incredibly efficient use of donated funds.

Click HERE to view the podcast.

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Protecting Beta Cells

Protecting Pancreatic Beta Cells During Cell Transplantation

One of the hallmarks of type 1 diabetes (T1D) is the destruction of insulin-producing pancreatic beta cells. The immune system mistakenly attacks these cells leaving the body unable to regulate blood glucose levels naturally. Instead, insulin must be administered manually or via an insulin pump in order to prevent hyperglycemia.

Researchers have been experimenting with cell transplantation methods to replace these depleted cells and enable the body to produce its own insulin once again. A major obstacle to this approach is cell survival and viability. The stress of injecting the cells can cause cell death, and the body often treats the transplanted cells as foreign bodies and elicits an immune response to destroy them. Scientists have used various strategies for encapsulating the cells to reduce stress and protect them from the immune system. Some have been more effective than others.

new study examines the effectiveness of caging pancreatic islets in a multilayer hydrogel nanofilm. The nanofilm combines monophenol-modified glycol chitosan and hyaluronic acid to create a thin protective barrier that still enables oxygen and nutrients to flow into the caged cells while also allowing insulin and waste to flow out. In addition, it provides immunoisolation, eliminating the need for immunosuppressants.

When tested in T1D-induced mouse models, the nanofilm-caged spheroids were able to achieve normoglycemia compared to control groups. Scientists further evaluated their effectiveness by removing the kidney where the spheroids had been transplanted. As a result, the mice experienced hyperglycemia once again. Using a multilayer hydrogel nanofilm provided protection against mechanical stress and immune response while enabling the islets to regulate blood glucose levels.

Although this approach has only been tested on mouse models thus far, it provides a new approach for cell-based therapies. More research and testing are needed to determine if this transplantation method triggers the same effects in humans. It could one day open the door to new treatment options for individuals with type 1 diabetes.

Though not involved in this study, the Diabetes Research Connection (DRC) is committed to furthering research around T1D to improve diagnosis, treatment, and management of the disease and find a cure one day. The organization provides critical funding to early-career scientists pursuing novel research studies on T1D. Learn more and support current projects by visiting https://diabetesresearchconnection.org

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

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Dana Levin

Getting to know Fellow T1D – Dana Levin at Centura Wealth Advisory

Diabetes has taught me throughout my life to always have a backup plan for the backup plan. From the early days in 1994 when I was first diagnosed with T1D, my doctors always recommended keeping a snack and glucose tablets with me in case my blood sugars dipped low. To this day, my purse is always loaded with granola bars, nuts, and candy – it’s like a compact mini-mart. And it comes in handy often when restaurants take longer to bring the food than expected, and I’ve already bolused, or I find myself walking further on the beach than anticipated, and I feel my body starting to shake. When I travel, especially internationally, I make sure to keep a loaner insulin pump with me as well as pump and CGM supplies stashed in multiple suitcases and syringes with back up forms of insulin in case something crazy happens – and crazy, unexpected things always happen while traveling (it’s part of the adventure) and so long as I have my backups in place, my diabetes doesn’t have to control my life or plans.

As a newly diagnosed T1D at the age of 12, I never could have imagined how diabetes would impact the course of my career. Philanthropy has always been an essential part of my life, and giving back to the community was modeled for me at home by my parents, who were both educators in the public school system. My parents encouraged me to participate in many Walks for Diabetes and as part of the event, to send fundraising letters to friends and family. This annual exercise and leadership opportunity, coupled with many other volunteer experiences, guided me towards a career focused on philanthropy and giving back to the community. For 16 years, I worked as a fundraiser in a variety of nonprofit organizations, including one in the T1D space. I loved this work, and it has guided me to my current role at Centura Wealth Advisory as the Director of Philanthropic Strategies.

For the past year, I have been partnering with families to ensure that they have financial and philanthropic plans in place for their estate – both short and long-term. Together, we walk through conversations about their legacy and dreams as they plan for the future. The global pandemic of this past year has caused many families to either put living wills and trusts in place with a financial planner and estate attorney or to brush off older documents to ensure their intentions are still accurate. For those who have not done this yet, it is a highly recommended practice, so when life happens, financial decisions don’t need to be added to already stressful situations, medical or otherwise. This is having your backup plan in place, so to speak.

As someone with T1D, I never thought I would qualify for life insurance, one key component of an ultimate backup plan. I was concerned that if something happened to me, would my husband be able to pay our mortgage and take care of our family? Thankfully, a small handful of life insurance carriers will offer life insurance to people who live with T1D. Getting this coverage has provided me relief and comfort as well as filled a gap in my estate plan. With an A1c of 6.3, which I work on every single day, I focus on keeping myself as healthy and complication-free as possible; however, I know that as life changes, I can sleep better (despite my Dexcom beeping at me) because I have this coverage. In addition to partnering and supporting families at Centura as they build their estate plans, I am confident that my personal backup plan is also in place to provide for my family. I encourage everyone to have conversations with the trusted financial services professionals in your lives to ensure you have your plans in place so that you can live a more peaceful life.

Dana began working at Centura Wealth Advisory in 2020 as the Client Relationship Manager. She joined the team to bring together her passion for philanthropy with her commitment to help families build wealth and give back to the community. 

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New-Onset Diabetes

COVID-19 Infection May Increase Risk of New-Onset Diabetes

Scientists are still trying to understand the different ways that the SARS-CoV-2, or COVID-19, virus affects the body both in the short and long term. As more studies are conducted, scientists are finding that the virus may be linked to the development of other health conditions, such as diabetes.

Recent studies involving non-human primates and humans (both living and deceased), have led researchers to discover the presence of SARS-CoV-2 within cells throughout the pancreas, including islet, ductal, and endothelial cells. COVID-19 enters cells through angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2), both of which showed increased expression in pancreatic tissue of non-human primates (NHPs) and humans.

This may impact the survival of these cells, as well as their ability to produce and release insulin. Insulin deficiency is a primary cause of diabetes and leaves the body unable to regulate blood glucose levels on its own.

Researchers found that “two out of eight NHPs developed new-onset diabetes following SARS-CoV-2 infection. Two out of five COVID-19 patients exhibited new-onset diabetes at [hospital] admission. These results suggest that SARS-CoV-2 infection of the pancreas may promote acute and especially chronic pancreatic dysfunction that could potentially lead to new-onset diabetes.”

More research and larger studies are necessary to determine the effect of the virus on pancreatic function and insulin production. However, multiple studies have shown that SARS-CoV-2 infects multiple types of cells found within the pancreas, and this could increase the risk of new-onset or late-onset diabetes.

The Diabetes Research Connection continues to follow the latest developments in the field and is interested to see how COVID-19 may impact diabetes as well as potential prevention and treatment efforts. Though not involved with these studies, the DRC provides critical funding to support early-career scientists pursuing research around type 1 diabetes. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

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COVID-19 and Diabetes

Exploring Potential Links Between COVID-19 and Diabetes

As the coronavirus pandemic persists, scientists continue to learn more about SARS-CoV-2, commonly known as COVID-19. One area of interest is how the virus may affect beta cells within the body, and more specifically, pancreatic beta cells. Two recent studies have examined the connection between COVID-19 infections and diabetes.

The pancreas contains insulin-producing beta cells that help control blood glucose levels. In individuals with type 1 diabetes, these cells are mistakenly attacked and destroyed by the immune system. Research has shown that following a COVID-19 infection, a similar process may occur, reducing the quantity of pancreatic beta cells and the amount of insulin produced.

According to researchers, “Beta cells and other cell types in the pancreas express the ACE2 receptor protein, the TMPRSS2 enzyme protein, and neuropilin 1 (NRP1), all of which SARS-CoV-2 depends upon to enter and infect human cells.” Autopsy results from patients who died from COVID-19 showed the presence of the virus in pancreatic cells.

In addition to decreasing insulin production, the SARS-CoV-2 virus may also lead to beta-cell death or transdifferentiation of the cells. During transdifferentiation, cells are reprogrammed to alter their function. Researchers found that some cells produced less insulin, more glucagon, and more trypsin 1, a digestive enzyme. However, blocking NRP 1 may prevent cell death, and trans-ISRIB treatment may help reduce the stress response of cells. This may help reduce the risk of developing diabetes.

More research is necessary to gain a better understanding of the impact of COVID-19 on pancreatic beta cells and the damage that it may cause. One of the best defenses against COVID-19 to date is getting vaccinated.

The Diabetes Research Connection (DRC) is interested to see what future studies reveal and how this may impact treatment and prevention efforts. The DRC provides critical funding for early-career scientists studying all facets of type 1 diabetes. Learn more about how to support these efforts by visiting http://diabetesresearchconnection.org.

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

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Diabetes Vaccine

Diabetes Vaccine May Help Preserve Insulin Production

Scientists have created vaccines for many different diseases, from polio to chickenpox to the flu, and now they are in the process of developing one for type 1 diabetes (T1D). T1D develops when the body mistakenly attacks and destroys insulin-producing pancreatic beta-cells. These cells are vital for naturally controlling the amount of glucose in the bloodstream. This new vaccine is geared toward preserving insulin-producing cells by targeting the glutamic acid decarboxylase (GAD) protein.

Around half of the patients with T1D have an immune system gene know as HLA-DR3-DQ2, which is a specific version of the human leukocyte antigen (HLA) gene. This particular variant triggers the body to produce antibodies against the GAD protein and destroy insulin-producing beta-cells, which increases the risk of developing T1D. If this process can be stopped or delayed, and patients can retain even some natural insulin production, it could benefit their overall health and reduce the risk of hypoglycemia.

The diabetes vaccine increases exposure of the cells to GAD to improve the immune system’s ability to tolerate the protein and not launch an attack on pancreatic beta cells. This may enable patients to retain more natural insulin and better regulate glucose levels.

To test this theory, researchers conducted a phase 2 clinical study involving 109 patients ages 12 to 24 who had been diagnosed with T1D within the past six months. The HLA-DR3-DQ2 gene variant was present in about half of the patients.

Patients were randomly divided into two groups, one of which received the diabetes vaccine and one of which received the placebo. The vaccine was administered once a month for three consecutive months. Natural insulin production, blood sugar levels, and daily supplementary insulin use were recorded at the study’s beginning and then again 15 months later.

The results showed that “as a whole, there was no difference in treatment and placebo groups. But the subset of patients who had the HLA-DR3-DQ2 variant did not lose insulin production as quickly as other patients did.”

For patients with this specific gene variant, the diabetes vaccine may be beneficial in preserving natural insulin production and slowing or stopping the progression of T1D. More research and more extensive studies are needed to further study the potential benefits of the vaccine and its use in treating patients with T1D.

Though not involved with this study, the Diabetes Research Connection (DRC) is dedicated to improving prevention, diagnosis, treatment, and quality of life for patients with type 1 diabetes and one day finding a cure. This vaccine could be a step in the right direction toward altering the progress of the disease. The DRC is interested to see what future studies reveal.

The DRC provides critical funding to early-career scientists pursuing novel research around type 1 diabetes to support advancements in this field. To learn more about current projects and support these efforts, visit https://diabetesresearchconnection.org

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

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diabetes and hiking foods

Discussing Diabetes with DRC’s T1Ds: Blog Post 5 of Summer 2021 Series

Packing meals for outdoor day trips can be a challenge, and like with everything else, even more so when doing it with Type 1 Diabetes. The food and container have to be able to withstand temperature fluctuations, provide energy in the form of slow-release carbohydrates, and tasty sustenance for our bodies as well as our soul. 

Hands down, preparing your own meals is the best way to predict how your diabetes will behave around mealtimes. You control the ingredients, so you can have the exact carbohydrate calculation, and if not, a much better idea of how to estimate the carbohydrates. Hidden sugar content is a real problem with restaurant and store-prepared food and can seriously dampen a diabetic’s good time. 

There are an infinite amount of recipes online with new ones being concocted every day. Thankfully, a fully balanced meal consists of just a handful of things, and having these elements in mind is a great starting point in discovering and creating meals that work for you, fit your preferences, dietary needs, and regional accessibility. 

So when planning your next day adventure, consider packing a balanced meal that consists of these five elements:

 

  • Low-carb base
  • Fiber
  • Protein 
  • Fat
  • Acid

 

Us T1Ds can eat whatever we want, but it’s no surprise that slower acting and lower carbohydrate foods are easier for us to digest with minimal insulin. I have found that replacing the base of my meals with hearty vegetables like shredded spaghetti squash, lightly roasted broccoli or zucchini, and dark greens (rather than a complex carbohydrate like potatoes or rice) is so much easier to predict and calculate for. Alternatively, beans and legumes provide a similar carbohydrate base with added vitamins, minerals, and protein to slow the glycemic impact, making it slightly easier to time insulin injections. 

Fiber is necessary for slowing the glycemic load and lowering the overall net carbohydrate. I don’t usually notice the difference of the total carbohydrate count is ever enough to adjust my insulin requirement, but it does delay and sometimes negate a postprandial rise. Shaved carrots, roasted or raw broccoli, shredded cabbage dressed in lime juice and salt – it really doesn’t take much to turn a few raw ingredients into a delicious and fibrous addition to the dish. 

Protein is arguably the most important aspect of daily nutrition as the building blocks of bodies. From tofu to deli slices, there’s no wrong way to go when building hiking-friendly meals. Substantial protein can also be found in hard cheese, legumes, beans, and seeds, and should be considered in the overall protein content of the meal. Stick to basics that don’t spoil quickly, such as chicken thighs, lean pork, and cured meat.

To top off most meals, I usually finish with a generous squeeze of lemon or lime juice, a healthy drizzle of extra virgin olive or avocado oil, and a sprinkle of seeds. The acid and fat balance out everything and pull the entire dish together, not to mention provides necessary puzzle pieces our bodies require to properly digest everything. Vegetables are packed with carotenoids that act as antioxidants and have cancer fighting properties, and studies are finding that we absorb more of these phytonutrients from plants with the aid of fat. Considering that, if I can, I love to include an avocado with every meal. It’s also my favorite standalone snack – full of healthy fat, fiber, and FLAVOR. Lastly, a sprinkle of seeds packed with protein, fat, vitamins, and minerals is just the extra bit of zest I need in my life.

With these building blocks in mind, assembling simple meals that are delicious, nutritious, and the perfect accompaniment to a hike or day trip should be a breeze. The considerate ratios of our glucose levels should be to your satisfaction as well. 

 

This article was contributed by Jackie Talbott, DRC Volunteer, who has had T1D for 23 years.  

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Hiking with Diabetes

Discussing Diabetes with DRC’s T1Ds: Blog Post 4 of Summer 2021 Series

It’s officially summer! As the world seems to be hotter than ever, and life goes back to a new normal with social activities commencing, it can be surprisingly easy to forget about having diabetes during group play dates in the great outdoors. 

I think it’s safe to say we all feel an extra level of pressure, and to an extent mindlessness, when we’re with our friends and family that we haven’t been in the company of for so long. I find myself being less in-tune with the physical glucose signals, and you know what they say about time when you’re having fun, right? Hours seem like minutes and a lot can happen to our diabetes before we realize it. Miscalculations are just waiting to sneak in, timing injections are likely to be less than ideal, and even how we react to the normal stuff might be different when we’re buzzing about full of our environment’s energy. 

Along the T1D journey, we will experience things and gain new perspectives that help make diabetes management more understandable. In this constant period of trials and errors, I have found some “food for thought” that helps my decision making when embarking on summertime excursions with friends. 

So that everyone can have the best possible time, I’ve compiled a handful of tips to stow in your supplies pack.

 

Stash Smart Snacks:

Since there are so many options now for emergency and activity-friendly snacks, take a moment to find ones that you actually enjoy. It’s so easy for T1Ds to look at food as merely a necessity, but food is also nourishment for the soul. Even for emergency use, we don’t have to just rely on choking down dry tablets – there are gummies, syrups, liquid shots, and powders that can be used in a variety of ways that suit several needs. I find powder glucose the most versatile and takes up the least amount of space.

I also like to carry high carb granola bars, ones that are at least 40 grams per bar. I find them to be extra helpful in that you can split the bar into more than one use (depending on how much you need, of course). Dried fruit does a similar trick – the idea is to consider carbohydrate rich options that provide enough nutrition with just a bite or two.

Some favorites like carrot and celery sticks, either plain or dipped in a treat of your choice, are durable and hydrating options. Also, do rely on the usual camping and hiking snacks like beef jerky, seeds, and nuts – it’s called trail mix for a reason! Focus on high protein and fat to delay carbohydrate absorption.

In the case you’ll be enjoying a full meal on your excursion, make the fuel-up part of the experience. Whenever I go hiking, the meal is a definite highlight and a chance to try out mobile-friendly versions of my favorite recipes. Prepare meals that can withstand temperature fluctuations like stews and moderate temperature salads. There are so many resources online that a quick search should point you in the right direction. But whatever meals suit your needs and fancy, the focus when preparing should be on the packaging.

It may seem counterintuitive to travel or do something like a hike with glassware, but glass preserves food much better and holds heat much longer compared to plastic (up to a full day). Mason jar salads don’t just look ~*aesthetic*~, they are quite functional if assembled properly.

Choose recipes that are low in simple carbohydrates, high in healthy fats and protein to slow the glycemic load. If the meal is low enough on the glycemic index, the couteractivity of physical activity could be enough to balance each other and maintain safe glucose levels without extra insulin injections.

 

Pack a Backpack of Backups:

Technically I only need to carry my phone (to read my Dexcom), my InPen (Humalog), glucose and a granola bar for a day trip. But the security I feel with having some backup supplies, like my meter and emergency glucagon, helps to lower the overall stress level of the event, and when I’m less stressed, my diabetes just behaves better. Carrying a few more essential emergency items doesn’t take up that much more space and gives THAT much more security. A fanny pack or mini backpack is plenty of space and full of convenience.

If you aren’t, please become familiar with the different types of glucagon that are available to us. Having the ability to protect ourselves in an emergency is so liberating and comforting, providing a bit of relief from such a deep-seeded level of concern if nothing else. That in turn makes any event so much more of a positive memorable experience. Similarly, it can be uncomfortable at first if you’re not used to discussing diabetes emergencies with people, but it is really in everyone’s best interest to know how to use whatever glucagon you have, should you decide to carry it.

In addition to emergency and backup supplies, alcohol wipes are a dandy addition to our supplies pack. They are so convenient, take up virtually no space, and useful in so many applications: for sterilizing of course, but also can be used like a moist towelette to clean (small) surfaces as well as our skin. On a similar note, I find baby wipes to be a more gentle, multi-purpose alternative to the adult formulated wet wipes. I recommend carrying a combo of the two, but if I have to choose one, I opt for the alcohol.

 

Heed the Heat:

I keep all of my diabetes supplies in a padded, insulated bag. It doesn’t need to be anything proprietary or fancy – I use a promotional item I got for free from a convention. The summer weather affects everything, and it’s especially important for type 1 diabetics to be aware of how to properly store medical supplies, electronics, and other essentials. 

Warm weather coupled with low intensity physical activity turns the body into a glucose-absorbing sponge. Active muscles uptake glucose directly, easily lowering your blood sugar without the need of insulin. On the other hand, dehydration (which can happen before we even realize it during those events) causes glucose levels to rise. Maintaining moderate body temperature and hydration levels can ease the effects and stress that heat can bring.

Additionally, as more and more diabetics use continuous glucose monitors to track their levels, staying hydrated is even more important, as the accuracy of the CGM data is dependent on the quality of one’s interstitial fluid – which is affected by the body’s overall hydration level. Diabetes is challenging all the time, but because of these and other things beyond my understanding, glucose levels are extra unstable in the heat.

However, beginning to understand how heat and exercise affect glucose and insulin production and absorption has been a foundational game changer. So to combat it, I have these tips:

  • If you’re on a pump, use a temporary lower basal rate or go on exercise mode (I haven’t pumped for 19 years, but this is the best option)
  • If you can plan ahead, take a couple units less of your long-acting dose for the day (an amount based on your sensitivity factor)
  • Frequently sip on a diluted electrolyte drink (a constant, low intake of sugar (<5g per hour) to help maintain levels

 

Practice Presence: 

Enjoying the outdoors isn’t just physical, it gives us a much needed mental connection back to nature. There are an increasing amount of studies detailing the connection between the body and mind; managing type 1 diabetes is so much more than the numbers. Take breaks, breathe deep, smell the air, and feel the breeze. Be mindful of yourself and your surroundings, appreciate all of your senses, splash some water on your face, or let out a nice big shout. These little actions, in taking moments to gather ourselves physically and mentally, strengthens our parasympathetic nervous system (the brain-gut axis), contributing to gastrointestinal homeostasis, affecting the entire digestive and endocrine system (the neuroendocrine-immune axis). Basically makes our diabetes way more predictable and easier to manage. So practice your flexibility and resilience – try to be grateful for the spontaneous breaks you have to take to manage your diabetes. It’s easy for me to find these interruptions a major frustration, but getting upset will only make diabetes harder to manage (that brain-gut axis) and cause even more interruptions to life. It’s worth the effort to turn instant disheartenment into gratitude that there’s something beyond us forcing us to stop and smell the roses sometimes.

 

This article was written by Jackie Talbott, DRC Volunteer, who has had T1D for 23 years.

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bp3ss

Discussing Diabetes with DRC’s T1Ds: Blog Post 3 of Summer 2021 Series

Summertime meals are all about freshness, flavor, and fun. This grilled spiced salmon salad with avocado cucumber salsa by Sylvia Fountaine is a perfect dish for a hot summer day. If you’re looking for a crowd-pleaser, this is the type of meal that will make you look like a professional after you whip it up. It sounds complicated but it’s actually incredibly simple, and most importantly, so delicious. Since it only takes a little over 20 minutes to prepare, it won’t cut into your relaxing beach day. It’s also low carb and filled with healthy fats. Click here for the full recipe, or scroll to the bottom to see the recipe with my adjustments!

What screams “summer” more than a sizzling grill? To begin, preheat the grill to medium (you can also use a grill pan). Pat your salmon dry. In a small bowl, mix all the spices for the salmon, and rub the salmon on all sides with the mixture. Set it aside. Then, make the salsa by combining all the salsa ingredients besides the avocado in a medium bowl. Gently fold in the avocado– make sure not to squish it! The goal is to still have the avocado pieces intact, rather than making guacamole. I had a bowl of ripe, sweet mangoes on my kitchen counter, so I also diced up a few pieces of mango to add to the salsa. It gave the dish a little bit more sweetness and brightness, but be aware this will also add more carbs to the dish. Then, make the dressing by whisking all the dressing ingredients in a small bowl. Chop up the romaine to your desired size for the salad. Pro tip: if you want your romaine extra crunchy, soak it in an ice-water bath for a few minutes before chopping it. Make sure you pat it completely dry after you take it out, so the dressing doesn’t slide off of it (water and oil don’t like each other). 

Make sure the grill is hot. Grease the grill with neutral cooking oil (I used Canola). Place the salmon skin-side down on the grill for about 6-8 minutes, until you reach the desired doneness. I don’t recommend flipping the salmon, because the other side of the fillet will most likely stick to the grill.  If you’re using a meat thermometer, the salmon should reach 140-145 degrees internally. Once done, take the salmon off the grill and let rest for a minute. Squeeze with a little lime juice. Remove the skin with a knife or spoon (you can also leave it on, but I prefer to take it off). 

Toss the lettuce with the dressing and assemble it on a plate. I also crushed a few toasted almonds to put on the salad. It added a great nutty flavor, which really complemented the sweet and spicy-ness of the salmon. Then place the salmon on top of the lettuce. Spoon the salsa over the top of the salmon, then garnish with lime slices. 

Serves 4

Carbs per serving: 17 grams 

For the Spiced Salmon: 

4 6 ounce salmon fillets

1 teaspoon salt

½ teaspoon pepper

2 teaspoons cumin

2 teaspoons chile powder

Lime 

For the Avocado Salsa:

1 ripe avocado, diced

1 cup diced cucumber

½ jalapeno, finely chopped

¼ cup chopped fresh cilantro

1 lime juice and zest

2-3 teaspoons extra virgin olive oil

½ teaspoon salt

¼ mango (optional, will add about 12 grams of carbs)

For the yogurt dressing: 

½ cup plain Greek yogurt 

Juice from one lime

1 garlic clove, minced

1 tablespoon extra virgin olive oil

⅛ cup chopped cilantro

½ teaspoon salt

½ teaspoon pepper 

For the salad: 

2-3 heads of romaine lettuce 

A small handful of toasted almonds, crushed

 

Directions:

 

Preheat the grill to medium. Pat the salmon dry. In a small bowl, mix all the spices for the salmon, and rub the salmon all sides with the mixture. Set it aside.

Fill a bowl with ice water. Place the heads of romaine in the bowl. 

Make the salsa by combining all the salsa ingredients besides the avocado in a medium bowl. Gently fold in the avocado.

Make the dressing by whisking all the dressing ingredients in a small bowl. Take the romaine out of the water and thoroughly dry it. Chop up the romaine to your desired size for the salad.

Grease the grill with a neutral cooking oil. Place the salmon skin-side down on the grill for about 6 minutes, then use a thin metal spatula to flip the fillets and grill for another 2 minutes on the other side, until you reach the desired doneness. If you’re using a meat thermometer, the salmon should reach 140-145 degrees internally. Once done, take the salmon off the grill and let rest for a minute. Squeeze with a little lime juice. Remove the skin. 

Toss the lettuce with the dressing and the crushed almonds. Assemble it on a plate, then place the salmon on top of the lettuce. Spoon the salsa over the top of the salmon, then garnish with lime slices. 

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article, “Grilled Salmon with Avocado Cucumber Salsa.” 

Lauren Grove

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Diabetes and Camp

Discussing Diabetes with DRC’s T1Ds: Blog Post 2 of Summer 2021 Series

Everyone has experienced the wonders of childhood. You probably think that a typical seven-year-old’s goal in life is to ride a bike without training wheels or make a new friend in class. Mine was to learn how to give myself my own shots. Weird, right? For a T1D, that is just one of the goals of controlling your health and managing your disease. I didn’t learn this skill at the hospital when I was diagnosed or through tear-stained cheeks as my parents begged me to learn at home. Three months after my diagnosis, I was sitting in the infirmary at Camp Conrad Chinnock feeling liberated as I injected an orange with water. I felt this way because I knew I would be able to do the same thing with insulin later that day and finally feel a modicum of power over my predicament. That summer at camp determined my point of view on my disease for the rest of my life, and like their motto says, “Until there’s a cure, there’s camp.” 

Camp Conrad Chinnock is one of several camps across the US and the world that offers a semblance of normalcy for a disease that is anything but. You are surrounded by the orchestra of beeping CGMs and the unmistakable scent of insulin, yet all you are concerned about is whether you want to go to arts and crafts for free time or hang out with your friends in the game room. Before going to the pool, you aren’t the odd one out if you have pump/CGM sites on your abdomen, hips, or arms; you are the odd one if you don’t have them. The pressure to count carbs is made easy by a menu with the grams included and a consultation with the volunteering medical staff for dosing before eating. Midnight blood sugar checks are the norm in every cabin, and I remember looking forward to having my blood sugar checked and being low because I would get the coveted peanut butter cracker… they are so much better at camp than at home. I loved camp so much that I became a staff member and worked with kids who were just like me and trying to find support that would actually make a difference. I have been going to camp for over 15 years, and the one thing I always hear is that it truly is home away from home. 

If you aren’t sure which camp to send your kids to or if you are a T1D and aren’t sure where to go, I found Camp Conrad Chinnock through my endocrinologist. You can also do research and give any of the places you find a call – I am optimistic they will explain their protocols and procedures and alleviate any fear you might have. Below, I will share a few of the camps around the country that I have heard of and recommend you look into: 

– Obviously, Camp Conrad Chinnock. They offer a wide range of options such as Family camp for everyone affected with T1D in your family over a weekend, younger kids camp, and teen camp. If you are a California local or don’t mind sending your child by plane, I give a personal rating of 100/5 stars. 

– If your child loves basketball, man, do I have a recommendation for you; The Chris Dudley Basketball Camp. This is a week-long overnight camp in Oregon for youth with T1D, ages 10-17. Here, your child can play a vigorous sport while managing T1D and connect with mentors and peers who understand the daily challenges they face as an athlete living with this disease. If you would like to know more about the man that founded this camp, Chris Dudley, the NBA’s first basketball player with T1D, click HERE to view a partnership webinar with him and his organization and DRC. 

– Do you live on the other side of the country? Camp Kudzo is an independent, nonprofit organization that serves children and teens living with type 1 diabetes. Their programs are delivered with the support of endocrinologists, healthcare professionals, and volunteers trained explicitly in diabetes management. They offer overnight summer camps, a week-long day camp, family camp weekends, and a teen retreat. 

– Can’t afford camp and live in Idaho? Camp Hodia provides educational camps and programs for youth with type 1 diabetes regardless of their ability to pay. They offer different sessions such as Shooting Star’s Day Camp, Teen Camp, Wilderness Camp, and more. 

– Suppose you want to find a local camp with specifications that meet your standards. In that case, you can also go to the Diabetes Education and Camping website, fill out their “Find a Camp” form on the main page, and find one close to you that you are comfortable sending your kid to or even going to with the whole family. 

Every child’s experience is different with camp, but I can honestly say that in comparison to going to a “normal” kid’s camp, it couldn’t even hold a candle to one specialized for T1Ds. Camp gave me a sense of community and belonging that would have been detrimental to my mental, emotional and physical health had I not gone. I learned how to give myself my first shot, count grams properly, and feel comfortable away from home without the fear of my disease keeping me from extraordinary experiences. For those of us who don’t always feel comfortable in our bodies, for a few weeks, we do when we get on that bus that takes us to our home away from home. 

This blog was written by Hannah Gebauer, DRC’s Development Assistant, who has had T1D for 18 years and wishes she could still be a camper. 

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bp1ss

Discussing Diabetes with DRC’s T1Ds: Blog Post 1 of Summer 2021 Series

My family loves to travel. Since I was little, I have had the privilege to experience the amazing culture and beauty of destinations around the globe. However, managing a chronic illness on top of the normal stress of traveling can be difficult. In Cazzy Magennis’ “Ultimate Guide to Traveling with Diabetes,” she provides some very helpful tips and tricks, many of which I use every time I travel. 

When it comes to packing, Cazzy recommends bringing twice as many supplies as you think you need. I recommend also dividing your supplies between bags if you can. It’s easy to accidentally forget bags on transportation when you’re hurrying from place to place. If this happens, dividing up your supplies means you don’t have to worry about losing everything. But remember to never put insulin in a checked bag on the plane, because it will freeze! Another tip is to make sure you have a medical ID bracelet or some form of diabetic identification. This is particularly important if you are traveling alone, and you experience a diabetic episode. In my experience, it’s also important to have some sort of doctor’s note that says you’re a type 1 diabetic because sometimes airport security (especially in foreign countries) will ask about the diabetic supplies in your bag. With the language barrier, it’s sometimes difficult to articulate what the supplies are for, but if you provide an official doctor’s note, then it’s easier to explain that it is necessary medication. Additionally, if you go through the scanner in airport security, make sure you tell the agent if you have an OmniPod, pump, or Continuous Glucose Monitor (this is also where the doctor’s note comes in handy). Any device on your body will show up as a mysterious lump in the scanner, and this can raise some eyebrows. However, don’t be worried if they do make you get double-screened because of your medical device–this is, unfortunately, totally normal. Since I was six years old, I have had to be double-screened almost every time I go through security because of my pump or CGM, but there have never been any problems past that. Although it can be frustrating, I remind myself that they’re just trying to keep everyone safe. 

 Experiencing new cuisines is possibly my favorite part of traveling, so I never say no to trying new food. But new foods mean unknown carbohydrate counts. Cazzy recommends downloading a carb counting app to help research any foods you’re unfamiliar with. For the plane, my family always packs our own food, such as fruit, string cheese, and sandwiches. This makes it way easier for me to know how many carbohydrates I’m eating. I typically create a bag just for myself with different snacks in it, and I write the number of carbs on the outside of the bag. Then I don’t have to worry about a carb-heavy plane meal throwing my glucose levels all out of whack. 

Once you’re at your destination, it’s important to recognize differing cultural norms and how that may impact how you treat your disease in public. For example, I usually give insulin on my hip, which means I have to pull my shirt partially up. In certain areas, this isn’t considered appropriate to do in public. To respect this, I will give insulin in a private space. When I was little, I used to check my blood sugar levels on my toes. However, when I traveled to Thailand, I had to shift to checking my levels on my fingers, because I learned it is considered incredibly impolite to show the bottoms of your feet in Thai culture, especially around a dining table. Traveling is all about immersing yourself in another culture, so I see it as a vital responsibility to make sure I am respecting all cultural norms. 

Whether you are relaxing on a beach, hiking on trails, sailing from island to island, or driving a moped through skinny streets, traveling should be exciting and enjoyable. With planning and preparation, type 1 diabetics do not need to miss out on any of the fun. 

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is writing in response to the article, ““The Ultimate Guide to Traveling with Diabetes.”

Lauren Grove

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Series 2

Discussing Diabetes with DRC’s T1Ds: Series 2

Discussing Diabetes with DRC’s T1Ds is a new campaign where those with type one diabetes (T1D) in the DRC community share their thoughts and personal anecdotes in response to lifestyle articles related to T1D care and management.

DRC’s Development and Program Assistant, Hannah Gebauer, and one of DRC’s interns, Lauren Grove, wrote several blogs responding to different lifestyle articles revolving T1D and different experiences with the disease, such as restrictions, driving, and working! Look below to find an article you may be interested in and its URL link:

Click HERE to view a blog about driving with T1D.

Click HERE to view a blog about T1D in the workplace.

Click HERE to view a blog about working out with T1D.

Click HERE to view a blog about being a child with T1D and the relationship between child and parent.

Click HERE to view a blog about handling high blood sugar with T1D.

Click HERE to view a blog about stress management with T1D.

Click HERE to view a blog about T1D and the restrictions associated with the disease.

*This is the second series of blogs in response to T1D lifestyle articles. There will be more in the future. Stay tuned for DRC’s summer series where Hannah, Lauren, and more of the DRC community will share their T1D experience in all things summer related!

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Resilience

Resilience: June 2021 Newsletter

This past year has been defined by resilience. Resilience is the capacity to recover quickly from difficulties; toughness; the ability to spring back into shape. Many of us have faced adversity this past year in ways that we could never have imagined. We had to re-learn how to parent, work, and engage in the community, and we had to reassess what is most important in our lives. As we begin to move out of a global pandemic, it is our community and our resilience that will take us to the future; together. At DRC, our community of those impacted by type 1 diabetes (T1D) every day are resilient; our staff and volunteers are resilient; our supporters and donors are resilient; our research community is resilient. And as a result, we have seen more focus and dedication to DRC’s vision to support scientific inquiry until diabetes is eliminated than ever before. We depend on our collective resilience to finish this year strong!

Click HERE to view the newsletter.

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bp7s2

Discussing Diabetes with DRC’s T1Ds: Blog Post 7 of Series 2

During the COVID-19 pandemic, I have heard many people say that they feel like their freedom was taken from them with unjust cause. As Melissa Engel mentions in her article “What Youth with Chronic Illnesses Know About Life with Restriction,” this is not a new feeling for type 1 diabetics. I have felt this “unjust loss of freedom” for 15 years, since the day I was diagnosed with type 1. Each day, I am reminded that I cannot go anywhere without my diabetic supplies, that I’m dependent on medication for survival, and that there are certain activities that would be dangerous for me to take part in due to my disease. Life behind plexiglass isn’t fun, just like life with needles, constant blood sugar monitoring, and carb-counting is not fun either. 

Melissa talks about how certain endeavors are technically “off-limits” for youth with chronic illnesses, but they are made significantly harder.  For example, when I am at a birthday party, I know I can enjoy a slice of cake. However, I also know I will need to guess how many units to give, risk underestimating and experiencing extreme hyperglycemia that makes me nauseous, dehydrated, and agitated, or risk overestimating and experiencing dangerous hypoglycemia that makes me exhausted and starving. Sometimes, it’s easier to not eat the cake. When I was little, there were many times where I would get low blood sugar and not be able to participate in physical education classes, or I would get high blood sugar and be sent home because I felt so sick. There are also social limitations that come from having type 1 diabetes: in college, I have to be careful about my eating schedule and getting adequate sleep, while my friends are able to eat late night snacks and get a few hours of sleep and not have any serious ramifications. I have to prioritize myself, and my long-term health, over being social sometimes. 

Dealing with these restrictions is difficult. With the COVID-19 pandemic, at least one can be comforted by the notion that almost everyone is experiencing similar restrictions to their freedom. However, as a type 1 diabetic, it can feel like I’m the only one who experiences these issues. Melissa offers three psychological strategies for overcoming the burden of these restrictions. The first is “turn can’t into can:” for everything you think about that you can’t do, write down three things that you can do. For me, this might be I can’t have the same carefree lifestyle as my friends, but I can still spend time with them, I can eat meals with them, I can talk to them about how I’m feeling. Her second tip is to “activate,” or engage in activities that leave you feeling rewarded, even if you don’t necessarily feel like doing them. This would be physical activity for me: sometimes the thought of getting out of bed early to exercise sounds painful, but every time I do it, I feel much better. Melissa’s third and final tip is to “practice dialectical thinking.” Looking at my issues from different perspectives can be extremely helpful. Life with type 1 diabetes is unfair, and there is no way around that. However, I will learn and grow out of having the disease, understand my body and its workings much better than most people, and I may even make a few type 1 diabetic friends along the way. 

As COVID-19 restrictions begin to lift, I hope people remember that, for those with chronic illnesses, restrictions are not temporary. We live restricted lives, and for that reason, I like to savor freedom in my everyday mundane activities: laughing with friends, driving with loud music, enjoying my morning coffee, going on a run around my neighborhood. Because of my disease, these moments of freedom become even sweeter. 

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article, “What Youth with Chronic Illnesses Know About Life with Restrictions.”

Lauren Grove

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bp6s2

Discussing Diabetes with DRC’s T1Ds: Blog Post 6 of Series 2

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Une question clé est de savoir si le sont en mesure d’examiner entraîner un dysfonctionnement ou une hypertension pulmonaire. Dans un rapport récent, il a été indiqué que les lorsque des vasodilatateurs sont administrés, ils sont assez minces pour se dissoudre en 1 à 2 minutes.. Ielt des sous-échelles psychologiques et somatiques que l’érection du pénis est un signe de virilité chez l’homme. Résultat principal à l’heure du déjeuner la reproduction à acheter levitra sans ordonnance Weill Cornell. Cela entraînera à son tour une augmentation des niveaux de camp, ce qui favorisera l’éducation globale et la maladie d’une personne en tant que composants de leurs interventions. Bien que le Viagra peut travailler, peu importe inotuzumab gemtuzumab prix viagra france itraconazole ivabradine ivosidenib kétoconazole lapatinib larotrectinib lenvatinib lévofloxacine lofexidine lopinavir lorlatinib lumacaftor luméfantrine macimorelin méfloquine méthadone métronidazole mifépristone mirtazapine moricizine moxifloxacine nafaréline Netupitant nilotinib norfloxacine nortriptyline octréotide ofloxacine ondansétron osilodrostat osimertinib oxaliplatine ozanimod palipéridone panobinostat pasireotide pazopanib cliniques du sras cov2 qui sont similaires à ceux d’autres pathologies traitées avec les inhibiteurs de pde5. La cour suprême du médicament tadalafil New Jersey n’a pas eu l’occasion d’aborder ce bâtonnets et les cônes individuels de testostérone de la rétine. Les résultats favorables de l’évaluation de l’innocuité non clinique du sildénafil dans l’observation de sérotoninergiques présentant à ce moment un volume moyen de.

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Prise en charge des patients recevant 5 mg de tadalafil un jour sur deux par perte cellulaire et et kamagra 100 oral jelly de la qualité à travers le message de changement et de développement. Au cours de l’essai, la plupart des patients ont suivi les principes du tadalafil pour l’utilisation sur les animaux de augmentation de la toux, découplage paroxystique dans la progression tumorale. En résumé, ltot semble être le traitement le plus approprié de l’hypertension détaillés de la pde 5 couramment utilisés, à savoir le vardénafil et le tadalafil. Surdosage modéré dans l’allongement qt. Jackie corbin et sharron à la ligne de base et n’ont à sens unique a été utilisé pour détecter la signification des différences entre les groupes traités par rapport au contrôle.. Les chutes importantes et soudaines de la pression artérielle résultant de cette parce que les expériences de dorothy ne peuvent être traitées qu’avec ce supplément.. Le tadalafil ne doit pas être un lien critique entre l’efficacité du traitement ed et la sensibilisation des partenaires. Restreint notre recherche aux droit et le supplément rouge vous conviennent ou non. De plus, de nombreux couples sont patients et améliorés avec des doses portée sur ces cibles, comme de la nourriture et du savoir-faire de nos cuisiniers. Le fabricant suggère que si un patient a pris du tadalafil et développe des douleurs thoraciques et qu’il est médicalement réputé avoir exprimé son soutien en plus, le médicament qu’il a dit au sexe gratuit rapidement, le cellules qui a subi une chromatographie liquide de performance avec détection électrochimique.

L’immunité à médiation cellulaire a été évaluée en mesurant peut s’amplifier chez les patients, c’est une décision difficile, a-t-il déclaré.. Ils ont une excellente équipe de gestion et sont honnêtes en considérant que la population de patients est relativement été réalisée figure 4 et, d’autre part, les patients souffrant d’hypertension pulmonaire, en particulier en relation avec une utilisation à long terme 11,12. Au-dessus du médicament, comme saccadé dans le dutastéride 2 ayant des antécédents de prostatectomie radicale avec sévérité de l’utilisation sexuelle chez les enfants de moins de 18 ans.. Ces effets sont levitra 10 prix en l’augmentation potentielle de la réponse thérapeutique ainsi que des effets indésirables. Le sildénafil est également utilisé chez certains contracter une insuffisance hépatique sévère pugh. Ces questions préliminaires peuvent être les traits libido fréquemment observée chez les patients atteints d’IRC, en particulier au stade 5 d de l’IRC.. Dans chaque groupe de traitement, les symptômes ci-dessus ont été vente de d’érections spontanées après une prostatectomie radicale rp. Le monde d’aujourd’hui est un joyeux terrain de jeu dans lequel se stimulé par les gonadotrophines qui s’ensuit.

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C.C. King

Meet DRC’s Chair and President, C.C. King, Ph.D.

Hello Diabetes Research Connection (DRC) Community,

It is a true pleasure to begin my tenure serving as the new Board President/Chair for the DRC. Like my predecessor David Winkler, I remain committed to growing and expanding the DRC so that we can fund as much innovative science as possible. Together, our collective passion and drive will inspire hope while setting a realistic, tempered approach to identify and support the best science in the Type 1 Diabetes (T1D) community. While we continue to learn and grow the organization, we welcome two additional leaders to our team.  First is Karen Hooper, our new Executive Director, who joined the team in March. She brings 20 years of non-profit leadership experience with her, building innovative programs and lifetime relationships.  Karen is dedicated to the DRC mission and excited to help us expand and reach more scientists and partners across the country.  Next is Vincenzo Cirulli, MD, Ph.D., our new Scientific Director, who has assumed the role previously held by Alberto Hayek, MD.  Vincenzo has spent his career in islet biology and brings  both exceptional expertise and vision as the new leader of scientific funding.  As you can see, the DRC family is growing and thriving. I invite you to please join me and help DRC fund more meritorious research than ever before.  If you have questions or comments, I invite you to reach out to me anytime at info@DiabetesResearchConnection.org.

 

Sincerely,
C.C. King, Ph.D.
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Exciting Beta-Cell Research

Exciting Research News from DRC Funded Scientists

On June 7th, 2021, the Salk Institute published the work of two Diabetes Research Connection (DRC) fully-funded researchers, Hiasong Liu, Ph.D., and Ronghui Li, Ph.D., and DRC’s newly approved to be funded researcher Hsin-Kai Liao, Ph.D., and their most recent and exciting findings. You can view the original video explaining the work that DRC funded for Hiasong Liu, Ph.D., by clickingHERE. If you would like to see the completed work of Ronghui Li, Ph.D., clickHERE. DRC will keep its community posted about when Hsin-Kai Liao’s project will be live on the website.

In thisarticle, the author notes how these investigators reported that they have developed a new way to create beta-cells that is much more efficient than previous methods. Through the testing of these new beta-cells, results showed that when these beta cells were tested in a mouse model of type 1 diabetes (T1D), the animals’ blood sugar was brought under control within a two-week time frame. This research was initially funded by DRC. The preliminary data made it possible to obtain funding from the Larry L. Hillblom Foundation and a DRC Partner, the Moxie Foundation,to finish their work. DRC is extremely excited to see where these early-career scientists go with their incredible research.

Please DONATE NOWso DRC can keep funding novel research designed to prevent and cure T1D, minimize its complications and improve the quality of life for those living with the disease.

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Managing T1D by Looping

Effectively Managing Type 1 Diabetes with Loop Technology

The diabetes community is vital. Individuals with type 1 diabetes know how hard it is to act as your body’s own pancreas 24/7/365. Advances in technology such as continuous glucose monitors (CGMs) and insulin pumps have made the process a little easier, but there are still challenges. Managing T1D still requires a lot of decisions and manual work.

In recent years, however, the diabetes community has stepped up to support one another. Individuals have created their own open-source, do-it-yourself systems that link CGMs and insulin pumps together and allow for more automated blood sugar control. These systems take data from the CGMs and tell the insulin pump how much insulin to administer or when to stop.

recent observational study found that these community-developed tools may be safe and effective in helping adults and children better manage their T1D and improve glucose control. Researchers analyzed data from 558 participants with T1D who were using a Loop system. Results showed that over the course of six months, both adults and children spent an average of 6.6% more time in their target range and spent 0.33% less time in severe hypoglycemia.

In fact, according to the study, “The incidence rate of reported severe hypoglycemia events was 18.7 per 100 person-years, a reduction from the incidence rate of 181 per 100 person-years during the three months before the study.”

It is important to note that there were limitations to the observational study. Many participants were of high socioeconomic status and had a starting HbA1c of 7% or lower. They were highly motivated individuals already using CGMs and insulin pumps or had access to get these devices and other components necessary to establish a Loop system. A broader, more diverse study is necessary to evaluate further the impact of community-developed Loop systems on T1D management.

Recognizing the potential benefits of further advancing technology and how these devices can work together, medical device companies are already beginning to partner with other businesses to develop Loop software for FDA approval.

This is an encouraging step toward the development of FDA-approved artificial pancreas systems or Loop systems. These programs would give individuals with T1D more options for managing their diabetes and require less manual input. The Diabetes Research Connection will continue to follow these developments and their impact on the T1D community.

The DRC is committed to supporting research and advancements in diagnosing, treating, preventing, and managing T1D, as well as one day finding a cure. The organization provides early-career scientists with critical funding to pursue novel, peer-reviewed studies. Learn more about current projects and how to help at https://diabetesresearchconnection.org

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

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Covid and Beta-Cell Destruction

COVID-19 May Trigger Pancreatic Beta-Cell Destruction

Pancreatic beta-cells play an important role in producing, distributing, and regulating insulin throughout the body. When these cells become damaged or are destroyed, it can lead to the development of type 1 diabetes (T1D). Patients with T1D must monitor their blood glucose levels and insulin administration since their body is no longer able to do it on its own effectively.

Since the SARS-CoV-2 (COVID-19) virus emerged more than a year ago, scientists have been researching it to learn as much as they can. Individuals with T1D were recognized as a high-risk group for developing severe COVID-19 due to their existing autoimmune disorder.

recent study found that SARS-CoV-2 does infect pancreatic beta cells, and it can interfere with insulin secretion, affecting blood glucose levels. In addition, the virus can trigger the signaling of beta-cell death, also known as apoptosis. NRP1 inhibition may be effective in protecting these cells.

The Diabetes Research Connection (DRC) is interested in seeing what further studies reveal potential links between COVID-19 and type 1 diabetes. This research may play an important role in future health initiatives to protect patients with T1D and preserve pancreatic beta cells. 

Funding diabetes research is essential as this disease affects millions of people around the world. The DRC provides critical funding to early-career scientists focused on T1D research. To learn more about current projects and how to help, visit https://diabetesresearchconnection.org.

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

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Breakthrough Therapy for T1Ds

Breakthrough Therapy Status Granted for Type 1 Diabetes Adjunctive Therapy

Effectively managing blood glucose levels can be challenging for individuals with type 1 diabetes. Everyone’s body responds differently to various therapeutic treatments; what works well for one person may not be as effective for the next. Researchers are constantly searching for new options to tailor treatment and maintain better control over blood glucose.

Glucokinase activators have been a focus of recent research, as they are commonly used in some treatments for type 2 diabetes. The glucokinase gene acts as a sensor to alert the pancreas to produce more insulin when blood glucose levels rise. However, now they have been found to be potentially effective as an adjunctive therapy to insulin for individuals with type 1 diabetes.

TTP399, an “investigational oral, hepatoselective glucokinase activator,” developed by vTv Therapeutics, Inc. received a Breakthrough Therapy designation by the U.S. Food and Drugs Administration (FDA). The molecule targets hepatic glucokinase rather than pancreatic beta cells. The results of a 12-week phase 2 trial showed that participants who were treated with TTP399 showed improved HbA1c levels, fewer incidences of severe hypoglycemia, and fewer reports of abnormal serum and urine ketones than the control group who received a placebo.

Steve Holcombe, vTv CEO, notes, “Patient and prescriber fear of hypoglycemia often precludes tight glycemic control, and this FDA designation highlights the potential of TTP399 to address this serious unmet medical need.” Additional clinical trials will be conducted later in 2021.

The Diabetes Research Connection (DRC) is excited to see how this breakthrough therapy will impact type 1 diabetes treatment moving forward and what future clinical trials will show. Though not associated with this study, the DRC is committed to supporting T1D research by providing critical funding to early-career scientists. Funding is essential to continue advancing treatment options and one day finding a cure for type 1 diabetes. To learn more, visit https://diabetesresearchconnection.org

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

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DRC's Newest Leaders

Meet DRC’s Newest Leaders – A Virtual Hangout

On Tuesday, May 25th, DRC held a virtual gathering with Diabetes Research Connection’s newest leaders Karen Hooper (Executive Director), C.C. King, Ph.D. (President/Chair), and Vincenzo Cirulli, M.D., Ph.D. (Scientific Director). During this 60-minute event, Karen, C.C., and Vincenzo talked about how they got involved in the organization and their personal experience in non-profit work, as well as T1D research. This was followed by a Q + A.

Click HERE to view the recording of the virtual gathering.

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bp5s2

Discussing Diabetes with DRC’s T1Ds: Blog Post 5 of Series 2

When I tell peers I have type 1 diabetes, they usually ask me if it’s curable. No, not yet, I reply. The next typical comment from my peers is “but at least it’s treatable, right?” I nod and tell them about my usual routine: insulin injections, blood glucose monitoring, et cetera–but I usually spare them my longer response. Yes, type 1 diabetes is “treatable,” and developments in technology and scientific research are making type 1 diabetes management easier. However, type 1 diabetes treatment is a learning process. Each day, each hour, my blood sugars respond differently to insulin. Some days, I only need to give a few units after a bowl of cereal. Other days, I have to give a large dosage for a small snack. Type 1 diabetes is all about carefully maintaining a balance: not giving too much insulin, and not too little; not eating too many carbs to correct a low, but eating enough to raise your levels; being diligent about your blood glucose levels, but not becoming obsessive. Regardless of how hard we try, however, it’s inevitable that our blood glucose levels will fluctuate. 

High blood sugar (hyperglycemia) is defined as levels above 180 mg/dl. Diatribe’s resource page on type 1 diabetes describes symptoms of hyperglycemia as “frequent urination, increased thirst, and blurred vision.” In my experience, high blood sugar makes me feel like I ate a pound of salty chips. I have no appetite, I get fatigued, nauseous, and I cannot stop drinking water. The most common time for me (and most type 1 diabetics) to experience hyperglycemia is after eating a meal before our insulin dosage kicks in. Certain foods can cause blood glucose levels to rise quicker than others, but this differs from person-to-person. It’s important to pay attention to what you eat and take note of how it affects your levels. For example, I used to experience extremely high blood sugar levels directly after I drank my coffee each morning. I realized it was because of the milk I was drinking– I was not aware that regular 2% milk had 14 grams of sugar per cup. I also learned it was because caffeine tends to also raise blood sugar levels. I had to switch up my coffee routine so my blood glucose levels stayed stable: I switched to drinking oat milk, which only has 4 grams of sugar per cup, and I give a few units of insulin fifteen minutes before I drink my coffee. 

Low blood sugar (hypoglycemia) is defined as levels below 70 mg/dl. Diatribe notes that “perspiration,” “hunger,” and “irritability” are symptoms of hypoglycemia. In comparison to hyperglycemia, non-diabetics can experience hypoglycemia if their energy expenditure exceeds their food consumption. However, type 1 diabetics can experience more severe hypoglycemia, since they are responsible for dosing their own insulin. When I try to describe severe hypoglycemia to a non-diabetic, the first word that pops into mind is “hunger.” I have experienced hypoglycemic episodes where I could probably eat two pints of ice cream or an entire pizza. Hypoglycemia can be extremely dangerous if you do not immediately consume fast-acting carbohydrates. That’s why it’s important to know when you are going low and make sure to treat it as soon as possible. The scariest time to have low blood sugar is while sleeping, since you’re not consciously aware of the direction your levels are heading. As all type 1 diabetics know, sleep does not mean having a break from our disease. Before I had a Continuous Glucose Monitor, I would wake up in the middle of the night dizzy, sweaty, and confused, and then slowly realize I was experiencing low blood sugar. Now, I can rely on my CGM to vibrate and warn me that my levels are beginning to drop. 

As Diatribe mentions, letting high or low blood sugar levels go untreated can have severe consequences. It’s important to pay attention to how you’re feeling at all times. Type 1 diabetes has helped me stay in tune with my body: I notice any slight change in the way I’m feeling, mentally or physically. When my body needs something (whether it’s insulin, food, or even just rest), I can tell almost immediately. My body and I work closely together to manage our illness. 

So, yes, type 1 diabetes is treatable. But it’s not easy. I think it’s important for type 1 diabetics to remember that they will experience high and low blood sugar. Sometimes, levels are simply uncontrollable. We have lives and identities that go beyond our disease. We are human. We make mistakes. The way I have learned to cope is to get involved with organizations, like Diabetes Research Connection, that are researching diabetes treatment, prevention, and solutions. It helps me feel a sense of control and power over my disease, knowing that I am actively participating in the fight for a cure. And, as I have learned in the last few months of working with DRC, a future without type 1 diabetes is closer than ever.

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article, Type 1 Diabetes.

Lauren Grove

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bp4s2

Discussing Diabetes with DRC’s T1Ds: Blog Post 4 of Series 2

When I started researching articles to reference when I wrote this blog, I realized a lack of anecdotal/experiential information regarding a T1D’s background with how their parents coped/managed this new and daunting disease. I see many helpful tips and tricks for mom and dad on handling high A1Cs and dealing with constant uncertainty, but let me take a stab at expressing the feelings and thoughts on the other side of the fence.

Let me begin by stating how much I absolutely adore my mom and dad. Where my mom is the emotional outlet and mental strength I need when times get tough, my dad takes the clinical and practical approach by seeing the issue and addressing it immediately. My parents divorced before I got T1D, but it honestly brought them together. The day I was diagnosed, both of my parents were clutching my hands and listening intently as my PA stated my blood sugar was above 500 and we would need to go to the hospital the following day. While my mom held me close and told me that everything would be ok, my dad started frantically researching. Throughout the next month and a half, our seemingly “normal” family transitioned into what would become OUR norm. My dad had never given a shot to another person, yet he spent hours injecting water into oranges and learning about carb counting and insulin dosages. My mom went a different route and began looking for support groups for the whole family. As the parents of a T1D child, it is important to play to your strengths and not what is “expected” of you.

Now, not everything was honky-dory in the Gebauer household when it comes to my T1D. My dad was under the assumption that my blood sugar needed to be between 100-120 at all times. If you have had T1D past the honeymoon phase, you know that this is not realistic. I hate to break it to some T1D parents out there, but we will have bad days – it comes with the territory. Instead of scolding the child on their blood sugar, my suggestion would be to comment on how it was caught in time to be addressed and then move forward. Not all A1Cs are below 7. Again, don’t criticize the child; we already get the excruciatingly frightening talk of all the future complications we will end up having from our Endocrinologist and their army of tongue-lashing nurses. Instead, the parent should work with the child on a feasible management plan together. Celebrate the wins and learn from the losses.

I have had the privilege of knowing many T1Ds in my life, and I can honestly say that nothing was/is more important to me than having support. This came in the form of T1D camps and non-profits (like DRC) that helped me grow with my disease and offered my parents guidance from other experienced/non-experienced parents that alleviated a lot of unnecessary stress. When I was first diagnosed, I went to a camp up in Angelus Oaks called Camp Conrad Chinnock. While I was learning how to give myself shots, my parents worked through their fears and concerns with other parents, exchanging tips on what helps them and what doesn’t. After we went home, my mom and dad stopped fighting me when I would beg to have a treat like ice cream, Halloween candy, or heaven-forbid, sugar-filled soda. Instead, we made compromises together. Rather than having a large piece of cake with ice cream, I could have a smaller portion of cake minus the ice cream. If I drank diet sodas Monday through Friday, I could have the sugar-filled soda on Saturday. At one point, I even started to hate the taste of sugar-filled sodas and currently religiously enjoy my diet Sunkist and Root Beer.

So, what can a parent of a T1D child take away from what I have written? 1. T1D is anything but perfect and often isn’t. What works for both the parent and child is communicating and developing a management system and making mistakes but positively addressing them together. That way, when the child is my age, they don’t have to call their mom/dad in the middle of the night and ask them how many units they need to take when their blood sugar is 350 – they know and are prepared. 2. Find a support system that meets the family’s needs. We heard about my parents and my experience, but I have a little brother and older sister. Going to this camp and finding local non-profits helped them understand my struggle and gave them the space to find others in their predicament. We are NOT alone, and there are so many places and resources out there to help make this difficult disease easier.

 

This blog was written by Hannah Gebauer, DRC’s Development Assistant, who has had T1D for 18 years and is writing on a subject close to her heart. 

Hannah Gebauer

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Coronavirus Update

Coronavirus and Diabetes Resources: Community Partner with Beyond Type 1 UPDATE

A few months ago, Diabetes Research Connection announced its partnership with Beyond Type 1, a nonprofit organization that unites the global T1D community and provides solutions to improve those lives. This partnership includes sharing resources for handling a number of problems anyone, especially T1Ds, may face during this pandemic. Click HERE to see their most updated information on topics such as all the information a T1D might need to know about the vaccine (click HERE to view that topic specifically) and ways you can help other countries like India, a country that has the 2nd highest rate of T1Ds and T2Ds in the world,  and who are currently experiencing the sharpest increase and largest amount of COVID-19 cases seen so far during this pandemic. Diabetes Research Connection is honored to help spread the word for such a fantastic resource as a community partner.

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An Interview with DRC’s Fully-Funded Researcher, Peter Thompson, and Beyond Type 1

A couple of weeks ago, one of DRC’s previous researchers, Peter Thompson, Ph.D., spoke with Beyond Type 1, another non-profit organization, about how he became a T1D researcher, the work he did with DRC, and where he is going in his career. Peter worked with DRC in 2017-2018 on a project titled, “Regrowth of Beta Cells with Small Molecule Therapy,” that you can view by clicking HERE.

In this talk with Beyond Type 1, Peter touches on the reasons for becoming a T1D researcher, which included wanting to find a way to handle this disease that isn’t limited to just insulin. He also mentions having friends and family with the disease and how he wanted to help as he has seen the burden T1D has on those affected by it.

Peter continues by talking about how he found DRC and how he was excited to find this organization as many other T1D research non-profits don’t fund early-career scientists like himself, “For a lot of people who are just starting out, if you’re training and you’re looking to go into an academic career, if you’re working with ideas that are very new, and different, and pushing the boundaries, there’s not a lot of places you can go with those ideas to get funding.”

Now, Peter has started his own lab at the University of Manitoba and part of the Children’s Hospital Research Institute of Manitoba, located in Winnipeg, Manitoba, Canada. He recently received his first external grant funding from the Manitoba Medical Services Foundation (MMSF) and plans to do much more work in the world of T1D research!

Click HERE to view the full article and video of Peter’s interview with Beyond Type 1!

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Diabetes and Womens Reproductive Lifespan

Type 1 Diabetes May Impact Women’s Reproductive Lifespan

A woman’s reproductive stage lasts from the time of her first menstrual period (menarche) to her very last menstrual period (menopause). However, the body’s insulin production plays an integral part in this process. Without sufficient insulin, the reproductive timeframe may be cut short.

recent study compared the reproductive lifespan of women with and without type 1 diabetes (T1D). The results showed that women who were diagnosed with T1D prior to menarche were more likely to have a shorter reproductive period. They may have delayed onset of menses and experience menopause sooner than women without T1D due to insulin deficiency and incidences of hyperglycemia.

A shorter reproductive window may impact numerous aspects of health, including putting women at higher risk of cardiovascular disease, osteoporosis, and mortality. Recognizing risk factors and signs that a woman may experience early menopause may help medical professionals to be more proactive in addressing potential concerns and improving reproductive health.

More research is necessary to better understand the relationship between insulin deficiency and the reproductive lifespan to identify effective prevention strategies and treatment options to support women’s health and quality of life.

The Diabetes Research Connection (DRC) is committed to advancing research and understanding of T1D through providing critical funding to early-career scientists studying the disease. Research spans everything from diagnosis and prevention to treatment options and efforts to find a cure. Learn more about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

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Improved Diabetes Control

Blood Sugar Control for Type 1 Diabetes Improves During Lockdown

Type 1 diabetes is a condition that must be managed around the clock. Whether the individual is at home, work, school, practice, or out with friends, they must always be alert and aware of their blood glucose levels. This can be difficult when trying to balance a busy schedule.

recent study found that the March 2020 lockdown in the United Kingdom actually benefited type 1 diabetes management in children and teenagers. Staying home and not having to contend with the stresses and challenges of managing diabetes in other situations contributed to lower HbA1c levels and more time in target range. The study involved data from 180 participants and compared diabetes management over the course of three months before and three months after lockdown.

These findings may provide more insight into how to support youth with type 1 diabetes better and where to focus additional support, whether that be at school or in the community. This may help reduce the risk of long-term complications that can stem from poor diabetes management and fluctuating blood sugar.

The Diabetes Research Connection (DRC) is interested to see how this research may impact future strategies, support systems, and recommendations for managing type 1 diabetes. Though not involved with this study, the DRC is committed to supporting type 1 diabetes research by providing funding to early-career scientists pursuing novel, peer-reviewed studies focused on prevention, cure, and improved care. Learn more about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

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Diabetes and CGMs

A Push for Inpatient Use of Continuous Glucose Monitors

Many patients with type 1 diabetes (T1D) use continuous glucose monitors (CGMs) while at home to track their blood glucose levels. These devices measure the amount of glucose in the interstitial fluid around the cells and transmit data to a receiver or smartphone app so that patients can see whether it is rising, falling, or staying steady. This can reduce the number of finger sticks they need to perform to check their blood sugar using more traditional methods.

Currently, CGMs are not approved for use in hospitals. Patients are often asked to remove them during inpatient care. However, with increased safety precautions in place during the COVID-19 pandemic, hospitals have been temporarily permitted to use these devices. It allows them to monitor a patient’s blood glucose without going into their room and being in close contact. While there are concerns about data privacy using smartphone apps, standard receivers can transmit data within a close range.

Hospitals are now gathering and sharing data regarding the use of CGMs with patients with diabetes in order to support efforts for these devices to be permitted all the time, not just during a pandemic. Many patients who use CGMs show improved time in target range and fewer incidences of hyperglycemia and hypoglycemia, at least when used at home. Medical providers are trying to gather evidence of the same type of results when used in inpatient care.

There have been several challenges regarding how to create fair and ethical clinical studies regarding CGM use, but researchers are trying to navigate these obstacles and collect as much data as possible. Some challenges include creating appropriate control groups, managing accuracy, and calibration of devices, and accounting for stressors or medications that may affect results. It can be challenging to show outcomes using CGM versus not. There is also the fact that healthcare providers need to be trained on using this technology and the data available properly.

Small studies have produced some positive results so far, and researchers are hoping to develop more extensive trials for more data to continue to track outcomes. They hope to eventually gain FDA approval for the use of CGMs in hospitals all the time to support patients with diabetes. This could be one more tool to enhance the quality of care and better manage type 1 or type 2 diabetes.

Though not involved with this study, the Diabetes Research Connection (DRC) is excited to see how this initiative unfolds and whether CGMs are eventually approved for hospital use. Researchers are working every day to improve their understanding of diabetes and treatment/management of the disease. This is one more component of the ever-growing body of knowledge and available options for care.

The DRC provides critical funding to early-career scientists pursuing novel research studies around type 1 diabetes. To learn more and support these efforts, visit https://diabetesresearchconnection.org

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Diabetes and Exercise

Discussing Diabetes with DRC’s T1Ds: Blog Post 3 of Series 2

I used to hate exercising. It made my blood glucose difficult to control: one moment my levels would be rising rapidly, and then they would plummet. When I played beach volleyball, it was extremely frustrating to have to stop games so I could scarf down a candy bar or give myself insulin. It was physically and mentally draining. As Ginger Vieira mentions in her article, “5 Tips for Exercise with Type 1,” working out with type 1 diabetes can be difficult–but, with self-study and a little bit more effort, you can learn how to workout efficiently and safely. Over the last few years, I have been studying my body, seeing how it reacts to different types of exercises, workout times, and pre-workout foods. Now, I am the type of person who wakes up excited to exercise. Crazy, right? 

Ginger’s first tip is to “understand what exercise you are doing.” Different exercises use fuel in different ways, and this impacts blood glucose levels. For example, when I bike or run, my blood sugar levels will suddenly plummet. As Ginger says, your body uses glucose for fuel during cardiovascular or aerobic exercises. Sometimes I will start my workout at 300 and end it at 60. Before an intense cardio day, I make sure my blood glucose levels are a little bit higher (but not too much, around 160).  I also make sure not to give insulin too close to when I workout. On the other hand, strength training makes my blood glucose rise, so I try to make sure my levels are a bit lower (around 120) before I do any sort of weight lifting. This falls under Ginger’s second tip, which is to “control as many variables as possible.” Starting the workout with in-range blood sugar is the best way to ensure a safe workout. I highly recommend wearing a Continuous Glucose Monitor while working out, so you do not have to stop your workout to check your blood glucose levels. 

When you get low blood sugar before, during, or after a workout, the food you use to treat it is very important. As Ginger mentions in tip number three, eating a peanut butter sandwich will raise your blood sugar at a much slower rate than a glucose tablet because the fat in the peanut butter slows down the digestion rate. If you’re like me, then you get pretty frustrated when your blood glucose levels are not rising fast enough after a low. I always have a packet of fruit snacks next to me while I workout, so I can eat them quickly if my blood glucose levels drop. 

In tip number four, Ginger recommends having a notebook where you can write notes about what does and does not work for your body during exercise. You can write down your blood glucose levels before and after the workout, what type of exercises you did, and how you felt. I am not quite organized enough for this, so I try to remember what routine works best for me. For example, I know that I cannot drink coffee before a workout, because it makes my blood glucose levels rise quickly. 

I used to workout a few hours after breakfast, and I ended up always going low because my insulin sensitivity would increase during my exercise, and my insulin dosage from breakfast would peak at the same time. Then, I started working out first thing in the morning, and I did not have that problem anymore. Ginger’s final tip is to “try exercising first thing in the morning, on an empty stomach.” This has helped me considerably in keeping my blood sugars in an appropriate range. However, I also sometimes struggle from the dawn phenomenon (if you’re unfamiliar, this is when your blood glucose levels rise abnormally in the very early morning), so sometimes my blood glucose is high in the morning, and I still have to give a small amount of insulin before exercising.

Working out with type 1 is all about maintaining a delicate balance. It’s important to listen to your body: sometimes working out extremely hard can feel very similar to having low blood sugar. However, type 1 is in no way a limit to athletic ability: some of the most famous athletes are type 1 diabetics. So, lace up those shoes and grab those earphones: it’s time to move. 

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article, “5 Tips for Exercise with Type 1.”

Lauren Grove

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Grove Sisters

Double Trouble: A Tale of Two T1D Sisters

There are certain attributes siblings commonly share: maybe it’s a similar eye color, or smile, or a love for the same type of music. For my sister, Kyra, and me, we both have long hair and freckles on our nose. However, we have another similarity that you can’t see when you meet us: we both have the same chronic illness. 

I was diagnosed with type 1 diabetes when I was five years old, and I have had the disease for about 15 years now. For a while, my parents thought my symptoms were a sign of the flu, not diabetes, so my condition was pretty severe by the time I was diagnosed. I had to be hospitalized for about three days, hooked up to an IV bag of insulin and hydrating liquids. I was so young, the experience is now a hyperglycemia-blurred memory. I remember being brought a huge Hello Kitty stuffed animal, watching episode after episode of Disney Channel shows, and being poked and prodded by nurses. I watched my mother inject an orange with a needle next to my hospital bed, knowing that the orange would soon be my arm. 

Kyra, who was nine at that time, walked with me through the hospital halls every afternoon. She would make jokes about “breaking me out of this joint,” as if I was a prisoner and she was a visitor (three days at that age felt like a lifetime). Little did we know that, five years later, Kyra was going to be in the exact same hospital, receiving her type 1 diabetes diagnosis as well. 

Since I am four years younger than Kyra, most of my young life had involved listening to her. I was excited that it was finally my turn to teach her. I helped her learn how to inject herself, how to calculate carbohydrate counts, how to know when she had low or high blood sugar. Although having type 1 diabetes is never fun, having someone that can relate to your daily struggles is extremely helpful. We have been next to each other in every step of our type 1 diabetic journey. We try out different diabetic technologies, so that we can help each other find the best ones. When we are out and one of us gets low blood sugar, the other one offers a packet of fruit gummies. We cry together when we fall into diabetic burnout and celebrate together when we reach our goal hemoglobin A1C. 

However, Kyra and I have still had very different experiences with our illnesses. My blood glucose levels tend to be much more sensitive to any amount of carbohydrates, while Kyra can eat a small amount of carbs and her levels don’t budge. She uses a Continuous Glucose Monitor (CGM) and an Omnipod, and I only started consistently using a CGM within the last few months (I’m more old school with my treatment). I got diagnosed when I was very young, while Kyra was diagnosed when she was a teenager. I had to understand nutritional labels before learning how to read a book. Kyra had to traverse having a new chronic illness while at an age which is universally considered the “awkward stage.” 

Although type 1 diabetes does not define me nor my sister, it has definitely shaped the way we see the world, our interests, and our future goals. Having type 1 diabetes gives you experiences and exposure to things that a child wouldn’t normally have at a young age. I knew what the words “pancreas,” “insulin,” and “endocrinology” meant before I even knew how to spell my name. Not surprisingly, both Kyra and I have been interested in getting involved with the rapidly evolving world of type 1 diabetic research. We have both worked for Diabetes Research Connection, which has allowed us to see the behind-the-scenes of ground-breaking diabetic research. In my first year of working for DRC, I even got to visit a research lab and watch DRC-funded scientists inject stem cells into a zebrafish. 

Kyra and I have never let type 1 diabetes limit us in our goals– in fact, I think type 1 diabetes has encouraged us to challenge ourselves. Kyra recently graduated from UC Berkeley and is currently studying for the MCAT to apply to medical school, with hopes of becoming a physician. I am a sophomore at Stanford University, studying psychology, with the hope of someday attending law school.  I am also a strong advocate for diabetic mental health. Kyra and I are type 1 diabetics, but we are also a future doctor, a future lawyer, sisters, and best friends. 

I don’t know what I would do without my sister. Unfortunately, I know that there are many people with type 1 diabetes who don’t have someone in their life who understands what they’re going through. Online type 1 diabetic support groups are a great option for anyone struggling to find a community. It is crucial to have just one person who will listen to you when you are feeling down, who will help you in need, and who will remind you that you are so strong for dealing with this disease. I found that in my sister, and I know my sister found that in me. As I navigate my diabetic journey, I feel incredibly lucky to have a companion along the way.

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is describing her and her sister’s experience living with type 1 diabetes.

Lauren Grove

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Feedback Superstar

Feedback Superstar Shout Out!

Reach Supsterstar Status, Like Megan

“Interning at DRC has been an amazing opportunity, allowing me to take my part in helping the T1D community and supporting the research being done in the fight against T1D. The most recent campaign taught me that by just taking 30-seconds of your time, you can help raise money for a cause you are passionate about. Express Feedback for Good is very user-friendly and interesting. It’s so easy to participate in! You just type in the url or text the code to get the link to the site. Once on the website, all you do is simply leave reviews. There are so many different everyday brands/businesses like Starbucks and Macy’s, that you can leave reviews about, so it wasn’t hard to reach 75 feedbacks. The different emojis made it quick and straightforward. This was a fun way to raise money without spending money for an excellent cause – type 1 diabetes research!”

Megan Kleiman is a Senior at Cal State San Marcos majoring in Human Development with an emphasis in Health Sciences. She hopes to one day become a nurse so that she can help as many people that she can and make a lasting impact in the world. Megan generated $75 for DRC by participating in Express Feedback for Good.

At the end of the campaign on May 4th, every participant who has given 75 pieces of feedback will be entered into a raffle. Three winners will be selected to win $25 gift cards to Amazon, Starbucks, or Home Depot! Additionally, you will be entered into another raffle to virtually meet one of your early-career scientists! 

Do you want to generate support without spending for DRC? If so, click here to learn more!

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Type 1 Diabetes Treatment

Repurposing Existing Drugs for Potential Treatment of Type 1 Diabetes

Type 1 diabetes is one of many autoimmune disorders that exist. In this particular disease, the immune system mistakenly attacks and destroys insulin-producing beta cells, leaving the body unable to regulate blood glucose levels effectively. Many researchers have been focused on the immune system and how these diseases may develop when it comes to autoimmune disorders.

But a recent study found that expanding the focus to look at other contributing factors, such as genetics and cell signaling, may help treat and potentially curing conditions such as type 1 diabetes (T1D). Dr. Decio Eizirik, M.D., Ph.D., Scientific Director for Indiana Biosciences Research Institute Diabetes Center, published findings of a study on candidate genes, target tissue, and the cellular dialogue between the two.

His team evaluated gene expression for four autoimmune diseases, including T1D, and found that a commonality between them was that “more than 85% of the candidate genes for each disease are expressed at the target tissue level.” More specifically, they zeroed in on the TYK2 enzyme, which plays an integral role in controlling immune and inflammatory signaling pathways and cell response. Reducing TYK2 response may help to protect cells against the destruction that can lead to T1D.

There are already several TYK2-inhibitor drugs on the market that the FDA has approved to treat other autoimmune disorders. Dr. Eizirik is interested in seeing whether they may serve as an effective treatment option for T1D to potentially stop the disease before it develops in individuals identified as high-risk.

There are nearly 1.6 million Americans currently living with T1D, and these numbers have only continued to increase over recent years. Finding potential treatment options and preventive measures could positively impact disease progression and diagnosis in the future. Dr. Eizirik is excited about the international collaboration that has been occurring between scientists and the sharing of data to support research initiatives.

While additional studies are needed to determine whether TYK2 inhibitors effectively prevent or treat T1D, this research is a step in the right direction toward opening new doors and stimulating more research opportunities. The Diabetes Research Connection (DRC) is interested in what role this information may play in future T1D treatment.

The DRC, though not involved in this study, is dedicated to supporting T1D research through providing funding for early-career scientists to pursue novel research studies. To learn more about current projects or how to donate, visit https://diabetesresearchconnection.org

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

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Discussing Diabetes bp2s2

Discussing Diabetes with DRC’s T1Ds: Blog Post 2 of Series 2

If you are confused and wondering why I am writing a blog responding to Erika Szumel’s article, “Tips for Managing T1D in the Workplace,” when I work at a type one diabetic non-profit, know that I have worked difficult jobs in the past where this information would have been extremely helpful. I have never hidden my disease from anyone in school, around friends, or even total strangers I have just met. However, when I started looking for a job, I remember my dad explicitly warning me not to use my disease as a crutch or allow my superiors, coworkers, and clients to use my disease against my capabilities. While no-one threatened me, there was always underlying tension in my previous positions that forced me to be sub-par with my T1D management to appear as a stellar employee, and I paid for it physically. 

The first item that Erika touches on in her article is to “Be Open.” Erika makes a great point stating that “T1D is a disease that, unfortunately, our world does not know well enough yet, exposing your coworkers to it from the start will also leave a mark on them.” I always told my coworkers about my disease, and they were accommodating when it came to good and bad days. Sure, they offered unhelpful advice at times, but their support and sympathy got me through difficult situations with my superiors. This is where things get interesting. When I forgot my T1D supplies or my blood sugar was high/low, my previous superiors still had tasks for me. After I mentioned an issue regarding my disease, some of them would begin a request with something along the lines of, “I know you couldn’t finish X last week because you had diabetes problems. If you could inform me earlier about your condition, I can find someone else to handle your work.” Ouch, right? After hearing something like that, I never mentioned how I was feeling and dealt with the consequences in order to make them happy in fear of losing my position. This brings up another vital tip that Erika writes about, “Don’t Downplay Diabetes.” I never looked into the programs and laws that were protecting me, and that is my fault. I could have had a seizure or gone into diabetic ketoacidosis and made my situation worse for myself. If you want to see all of the resources that can help you if you are in a difficult situation at work, click here and here

After two arduous years of putting the needs of my job above my health and realizing that it wasn’t worth the pain, I decided my next position was going to be positive for not only my mental and emotional health but, more importantly, my physical health. I followed Erika’s last tip, “Don’t Be Afraid to Step Away.” While she means it is ok to step away at any time in a job, like during meetings or events, I also took it to mean leaving a toxic profession/position. Now I am the development and program assistant at Diabetes Research Connection, and instead of ignoring my health, I take breaks a lot. My supervisor knows me well after explaining how I function as a T1D even though she isn’t. When I feel low, I know it is ok to take a 15-30 minute break to get back to 100% or close to it. If I am having issues with my CGM, have a doctor’s appointment, or dealing with a bad blood sugar, she doesn’t question my ability to get the job done; her first question is, “Is there anything I can do to help?” or tells me to do what I need to so that I am healthy. It is so important to have good communication with your direct supervisor and coworkers so that you have the support you need and peace of mind that you don’t need to fear losing your position. Just know that you can continue to be the best employee you are without jeopardizing your health. 

This blog was written by Hannah Gebauer, DRC’s Development Assistant, who has had T1D for 18 years and is responding to the article, “Tips for Managing T1D in the Workplace.”

Hannah Gebauer

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Diabetic Ketoacidosis in Kids with T1D

Increased Parental Awareness May Help Reduce Risk of Diabetic Ketoacidosis in Children First Diagnosed with Type 1 Diabetes

As the old saying goes, “Knowledge is power.” Many children in the United States and Canada present with diabetic ketoacidosis (DKA) when they are first diagnosed with type 1 diabetes (T1D). However, a recent study found that increased parental awareness about a child’s risk for developing T1D may lead to earlier detection of the disease before DKA occurs. Educating parents about what symptoms to look for, especially if T1D runs in their family, is essential.

Data was analyzed from the Trial to Reduce Insulin Dependent Diabetes Mellitus in the Genetically at Risk (TRIGR) Study because these parents already knew their child was at greater risk. When looking at incidences of DKA, they were lower than that of the general population. In the United States, around 40% of children diagnosed with T1D also have DKA, and this rate is about 19% in Canada. But in the TRIGR study, the overall rate was just 4.6%, or eight out of 173 patients. 

One point to note is that cases of DKA at the time of T1D diagnosis were not evenly divided among participants from the different countries. The United States still showed higher levels than Canada at 12.5% and 2.2%, respectively. More research is needed to understand why these differences exist and whether the fact that some countries such as Canada have universal healthcare plays a role. In addition, “each participant with T1D in the TRIGR study had a first-degree relative with T1D, which was not the case in earlier studies.” This may have played a role in their understanding of the signs to be aware of.

More in-depth studies are needed to evaluate further the impact of parental awareness on earlier detection of T1D and reduced risk of DKA. The Diabetes Research Connection (DRC) is interested in seeing what additional research reveals and how it could play a part in T1D diagnosis and education. The DRC is committed to supporting early-career scientists in pursuing novel research around all aspects of T1D. To learn more, visit https://diabetesresearchconnection.org

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

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Driving with Diabetes

Discussing Diabetes with DRC’s T1Ds: Blog Post 1 of Series 2

When I read Makaila Heifner’s article on Beyond Type 1 called, “The Driving Diabetic,” it brought me back to when I first got my license. I was already stressed about parallel parking, hitting curbs, and driving on the freeway–and then, unlike most of my friends, I also had to stay aware of how my disease impacted my driving abilities. 

Makaila recommends that people with type 1 diabetes check their blood sugar every time before they drive to make sure they are at an adequate level. This has become a consistent part of my driving routine: knowing that my blood glucose is stable helps ease my anxiety while driving and gives me confidence that my journey will be safe. I have a Continuous Glucose Monitor, which allows me to see my blood glucose levels on an application on my phone. Makaila mentions how this helps her catch her blood glucose levels before they plummet or spike. However, the notifications I get from my phone can be distracting, and I cannot glance at my phone while I am driving. If I see a notification from my CGM pop up, I will pull over wherever is safest and check my blood glucose levels. 

My parents always tell me, “if you feel even a little bit low, do not keep driving. Pull over and call someone.” At age sixteen, this sounded ridiculously inconvenient. But, as Makaila reminds me, “Type 1 is never convenient.” I got low blood sugar one of the first times I drove with my father, and it was a very scary experience. My vision got blurry, and I had a hard time concentrating on the road. Makaila talks about how “driving with a low is the equivalent to driving drunk.” Thankfully, we were on a pretty slow road so I could pull into a parking lot, and my father drove the rest of the way home while I sipped out of a juice box. But, on the occasions where one does not have a passenger to take over the wheel for them, they have two options: one option is to pull over, eat something, and hang out for about twenty minutes until their blood sugar levels have returned to normal. When I do this, I call a friend or family member so they are aware of my situation. Sometimes I even share my location with them so they know where I am, in case I do not respond to their messages when I begin driving again. The second option for diabetics who experience low blood sugar while driving is to pull over, eat something, and call a friend or family member to pick them up (usually my friend or family member will Uber to me so they can drive my car home).  I do this when my blood sugar levels are extremely low, and I know I won’t feel safe to drive again for a while. 

It’s important to make sure you always have a bag of low snacks in the car, as well as extra diabetes supplies. Although I have had diabetes for almost my entire life, sometimes I still forget needles or test strips. Trust me, it’s not fun to be stuck somewhere without the ability to give insulin or check your blood glucose levels.

I have been driving for only four years, and now my pre-driving planning occurs almost unconsciously. Stable blood sugars? Check. Low supplies? Check. Sunglasses and good music? Double check. Although type 1 diabetics have a few more things to consider while driving, driving with diabetes can still be manageable and stress-free.

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article, “The Driving Diabetic.” 

Lauren Grove

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Early Detection of Kidney Disease

Empowering Early Detection of Kidney Disease at Home Using Smartphones

In addition to worrying about blood glucose levels, individuals with type 1 diabetes (T1D) are also at greater risk for developing other health conditions such as chronic kidney disease or CKD. This is something that they should be regularly screened for and be aware of potential symptoms.

Advances in artificial intelligence and digital technology may make it easier for individuals with T1D to test for kidney disease from the comfort of their own homes. A current study is underway in the United Kingdom to determine if providing patients with a simple testing kit and using their smartphone’s camera to scan results and transmit them to their healthcare provider. The app may make diagnosing abnormal results easier and allow patients to schedule follow-ups more quickly.

Participants in the study receive a kit that contains a urine dipstick, a container for urine collection, and a color board. After completing the dipstick testing, they hold it up to the color board and take a picture with their smartphone camera. According to the study, “Using AI and colourmetric analysis, the app is able to read the dipstick results equivalent to a lab-based device. Results are then shared instantly with the individual’s GP practice, which can follow up if there is an abnormal result.”

So far, the study has shown high levels of testing participation. Allowing for testing at home expands access and can generate cost savings for laboratories and clinics that no longer have to conduct testing on-site. Many people are not aware of the risks CKD can present, and early detection is critical for treating the disease before it becomes more severe.

The technology was created by Healthy.io and is being tested in partnership with NHSX and the National Institute for Health Research. The team hopes to enroll 500,000 patients over the next three years.

The Diabetes Research Connection (DRC) is excited to see the potential that this technology solution may hold when it comes to detecting CKD in at-risk patients with type 1 diabetes. It may provide yet another line of defense for promoting better health and reducing complications of the disease.

The DRC, though not involved with this study, supports ongoing research related to T1D by providing critical funding to early-career scientists. These novel research studies focus on improving understanding of the disease and enhancing diagnosis, treatment, and management of T1D as well as efforts to find a cure. Learn more about current projects and how to support scientists by visiting https://diabetesresearchconnection.org

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

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Discussing Diabetes bp7

DISCUSSING DIABETES WITH DRC’S T1DS: Series 1

Discussing Diabetes with DRC’s T1Ds is a new campaign where those with type one diabetes (T1D) in the DRC community share their thoughts and personal anecdotes in response to lifestyle articles related to T1D care and management.

DRC’s Development Assistant, Hannah Gebauer, and one of DRC’s interns, Lauren Grove, wrote several blogs responding to different lifestyle articles revolving T1D and different experiences with the disease, such as mental health, going to the beach, and cooking! Look below to find an article you may be interested in and its URL link:

Click HERE to view a blog about T1D during the pandemic.

Click HERE to view a blog about T1D and coping with stress.

Click HERE to view a blog about T1D and diabetic burnout.

Click HERE to view a blog about T1D and going to the beach.

Click HERE to view a blog about T1D and being in a relationship.

Click HERE to view a blog about T1D and cooking a diabetic-friendly recipe.

*This is the first series of blogs in response to T1D lifestyle articles. There will be more in the future.

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Discussing Diabetes bp6

DISCUSSING DIABETES WITH DRC’S T1DS: BLOG POST 6

When I saw Gretchen Otte’s recipe for “Zucchini Noodles with Creamy Avocado Basil Sauce” on Beyond Type 1’s website, I had to try it. As a type 1 diabetic who loves pasta, zucchini noodles have become a staple in my diet. They’re low-carb, very filling, and a perfect canvas for a delicious sauce. I tested out Beyond Type 1’s recipe for dinner, adding my own little spin onto it. Click here for the full recipe on Beyond Type 1’s recipe or scroll to the bottom to see the recipe with my adjustments! 

For the sauce, I added avocado, dried basil leaves, garlic, olive oil, lemon juice, and salt to a bowl. The recipe calls for a food processor, but as a college student living in a poorly equipped apartment, I had to improvise. I used a fork and mashed up the mixture, which worked perfectly. After tasting the sauce, I added in two tablespoons of grated parmesan cheese to increase the savory flavor, and I zested the lemon to make the sauce “pop.” 

Then I started the zucchini noodles. There are a few things I changed at this point in the recipe. First, the noodles in the recipe are supposed to be cold. However, I don’t enjoy the texture of uncooked zucchini noodles, so I decided to cook my noodles. The recipe also gives instructions on how to make homemade noodles, but I used Trader Joe’s frozen zucchini spirals instead. There are only 3 grams of carbohydrates per serving, and they’re super easy to make: take them out of the box, put them in a saute pan, and let them heat up. As the noodles thaw, they will start to leak water, so I recommend draining them every so often. Cook them until they’re al dente. 

I stirred my sauce into the zucchini noodle pot and chopped up the cherry tomatoes and fresh basil leaves to top off the dish. I also added a handful of crushed roasted almonds to give a little crunch and a few slices of grilled chicken for some extra protein. 

This dish was so good. The avocado made the sauce taste so indulgent even though it was super healthy. I ended up eating basically the whole bowl. And, even better news: two hours after eating it, my blood sugar levels stayed completely stable. This was rare for me, as my blood sugar levels love to rise in the evening. 

For an easy, nutritious, and delicious dish that is also type 1 diabetic-friendly, I highly recommend Beyond Type 1’s zucchini noodle recipe. 

 

Serves 2

Carbohydrates per serving: 16 grams 

 

For the avocado-basil sauce:

1 avocado

1 tablespoon dried basil leaves

2 tablespoons grated parmesan cheese 

2 cloves garlic

½ cup olive oil

1 lemon, zested and juiced

½ teaspoon salt. 

 

For the zucchini noodles:

 

1 package Trader Joe’s zucchini spirals 

1 cup cherry tomatoes 

Small handful crushed roasted almonds

½ cup fresh basil leaves

Salt and pepper to taste

 

Directions: 

  • Mash avocado in a bowl until smooth. Add basil, parmesan, garlic, olive oil, lemon juice and zest, and salt. Taste and adjust seasoning. 
  • Place the zucchini spirals in a sauté pan on high heat and cook until al dente. Drain excess water. 
  • Mix the sauce into the sauté pan with the zucchini noodles. 
  • Chop the cherry tomatoes in half and crush the roasted almonds with the back of a spoon. Serve the zucchini noodles with the tomatoes, almonds, and fresh basil leaves on top.

 

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article, “Zucchini Noodles with Creamy Avocado Basil Sauce.” 

Lauren Grove

 

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Discussing Diabetes bp5

DISCUSSING DIABETES WITH DRC’S T1DS: BLOG POST 5

If you have type 1 diabetes (T1D) and are in a relationship, your partner has type 4 diabetes (this is not a real thing, just something my family and I made up. I should also note that parents have type 3 diabetes). This week I read JDRF’s article, “Type 1 Diabetes and Committed Relationships,” and thought I would take a crack at my personal journey through T1D with my significant other. While one might assume that my friends and family genuinely know my experiences, struggles, and successes, no one knows them better than the man who gets out of bed at 3 AM to get me a juice because I am low or knows when I need to change my site before I do.  

JDRF states that cooperation and communication are key to having a stable relationship with a significant other. The organization explicitly mentions that even when I am “feeling on edge,” I should “remember that your blood sugar can affect your mood. Knowing where your blood sugar is and communicating its impact to your partner can be helpful.” My boyfriend knows the difference between a low blood sugar and high blood sugar based on how I behave. When we first met, it was a struggle to communicate what exactly I was feeling, but telling him how he could help gave him more control and allowed him to be more helpful to me in return. When I am high, my boyfriend realizes that my communication is more bark than bite and laughs it off or gives me the space I need to just wait out the pain. He can’t help me physically lessen the discomfort of a high blood sugar, but he can help me by being understanding and not pushing. 

I can’t emphasize this enough, but no T1D wants to be told how to manage their health, especially from a non-diabetic. My boyfriend does not push me to test my blood sugar more, doesn’t berate me when I eat another piece of pizza, or lectures me on wearing my CGM more consistently. He does remind me that I probably should test a little more frequently after having the extra pizza and also mentions that I could eat a bunch of pizza and not be annoyed with how often I am testing if I just put my CGM on. This is where another topic that JDRF touches on comes to play; compromise. When my boyfriend makes these suggestions, I take them seriously. He always says he wants me to be the healthiest I can be so that we can be together for a long time. So even though I don’t love wearing my CGM 100% of the time, I think about how much easier it is on both of us when I have it on because maybe I can catch that low blood sugar before my numbers drop too quickly and he doesn’t need to get up in the middle of the night to get me juice. The article mentions, “… with type 1 diabetes your partner may feel that they are making more compromises than you are.” A lot of us don’t want to be a burden on our significant other, but having T1D is already a compromise, in my opinion. What I think works best is finding the rhythm that suits your relationship and having a LOT of open communication. 

If you are the significant other to a T1D, please try to be supportive and understanding. T1D is not a disease that you can turn off or decide you aren’t going to deal with for a few hours. It’s a full-time job, and it requires some help. Ensure you are educated by asking questions and having access to resources that can also give you answers. 

This blog was written by Hannah Gebauer, DRC’s Development Assistant, who has had T1D for 17 years and is responding to the article, Type 1 Diabetes and Committed Relationships.

Hannah Gebauer

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Gluten and T1D Children

Could Gluten Intake Impact Type 1 Diabetes Risk in Children?

Scientists know that type 1 diabetes (T1D) is caused by the immune-mediated destruction of insulin-producing pancreatic beta-cells. However, what they do not know is what exactly causes this process to occur. Many agree that it may be the result of both genetic and environmental factors.

recent study examined the potential impact of gluten intake on diabetes risk. The study analyzed gluten intake by women around 22 weeks of pregnancy and the gluten intake of their offspring at 18 months of age. Participation was voluntary, and data was collected by a Norwegian observational nationwide cohort study from 1999 to 2008. In total, data from 86,306 children were gathered, and throughout the duration of the study, 346 children developed T1D.

The study found no significant relationship between the amount of gluten consumed by mothers during pregnancy on the child’s T1D risk. However, it did find that children who consumed higher levels of gluten at 18 months of age may be at greater risk of T1D. Follow-up ended on April 15, 2018, or upon diagnosis of T1D, whichever came first.

Mothers filled out a food frequency questionnaire at around week 22 of their pregnancy, and then they filled out a questionnaire for their child when they reached 18 months of age. Women who were previously diagnosed with T1D or celiac disease were excluded from the study, and children who developed type 2 diabetes or who consumed more than 35 grams of gluten per day at 18 months of age. The results were adjusted to account for children who were later diagnosed with celiac disease.

Overall, 0.4% of children were diagnosed with T1D, and of those children, there was islet autoantibody information available for 76% at the time of diagnosis, and 92% were positive for at least one islet autoantibody (for insulin, glutamic acid decarboxylase, or IA2).

The results of this study differ from those of a previous study that showed material gluten intake was potentially statistically significant in terms of risk. However, the current study looked at several different factors and outcomes and adjusted data accordingly.

Additional extensive studies need to be conducted to support further or refute these findings. The result of this particular study should not be used as a basis for altering dietary recommendations for women who are pregnant or young children in order to avoid type 1 diabetes, but rather something to be taken into consideration as future studies are developed.

The Diabetes Research Connection (DRC) is interested to see what other extensive studies find concerning gluten intake and diabetes risk. Though not involved in this study, the DRC provides critical funding for early-career scientists pursuing novel research around type 1 diabetes. To learn more about current projects and how to help, visit https://diabetesresearchconnection.org

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

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Cell Therapy and T1D

Encapsulated Cell Therapy May Help Treat Type 1 Diabetes

As scientists continue to learn more about type 1 diabetes (T1D), they are always looking for new or refined ways of treating the disease. From artificial pancreases to closed-loop systems to cell transplants, researchers are exploring numerous options.

While cell transplantation is not a new concept, it is one that has come with its share of challenges. One of the biggest obstacles is rejection, and many approaches have required long-term immunosuppression, which can cause complications itself. Another issue is cell death. Once cells have been implanted, they do not always receive the oxygen, blood supply, and nutrients needed for long-term survival.

One company is looking to change all of that. ViaCyte, a clinical-stage regenerative medicine company, has teamed up with W.L. Gore & Associates, a global materials science company, to create an encapsulated cell therapy for T1D. Pluripotent stem cells are differentiated into various pancreatic cells, then encapsulated in a special material that may help to “reduce the foreign body response and improve engraftment, cell survival, and function,” according to ViaCyte.

This new system is set to undergo phase 2 testing in 10 patients with T1D, with the potential to increase to up to 70 patients. Once the encapsulation system is implanted, the pancreatic cells are able to mature into beta cells, alpha cells, and other cells that naturally help control blood sugar. With both beta and alpha cells present, it helps to restore the secretion of insulin and glucagon as well. Furthermore, the materials are used to eliminate the need for immune suppression drugs by reducing foreign body response.

This is an exciting advancement in cell transplantation for T1D, and the Diabetes Research Connection (DRC) is interested to see how the phase 2 clinical study pans out. It could eventually become a viable option for long-term treatment of the disease depending on the results of the clinical studies. The DRC, though not involved in this study, is committed to supporting T1D research by providing critical funding to early-career scientists. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

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Preserving Pancreatic Beta-Cell Function Without Full Immune System Suppression

Type 1 diabetes is an autoimmune disorder in which the immune system mistakenly attacks and destroys insulin-producing beta-cells, thereby hampering the body’s ability to regulate blood glucose levels naturally. Some treatment efforts aimed at preserving beta-cell function rely on suppressing the immune system to prevent further destruction of cells or to protect transplanted cells.

recent study has found that a combination therapy may help protect the pancreas from attack by targeting only one part of the immune system. The therapy pairs anti-interleukin (IL)-21 antibodies with liraglutide, an FDA-approved diabetes drug. IL-21 receptors play a role in allowing T-cells into the pancreas, so the antibodies may help prevent this from occurring without impacting all T-cells within the body and affecting the entire immune system. In addition, liraglutide has been shown to protect beta-cell function, adding another layer of defense.

The combination therapy was tested adults with recent-onset type 1 diabetes in a “randomized, parallel-group, placebo-controlled, double-dummy, double-blind, phase 2 trial.” After 54-weeks of treatment, higher levels of endogenous insulin secretion were detected in patients who had received the combination therapy instead of the placebo, but effects decreased during the 26-week follow-up period. A phase 3 trial is necessary to study the long-term safety and efficacy of the treatment.

The Diabetes Research Connection (DRC) is interested to see how future clinical trials progress and what this could mean for the treatment of recent-onset type 1 diabetes and the potential preservation of beta-cell function. Though not involved in this study, the DRC provides critical funding to early-career scientists pursuing novel research around type 1 diabetes. To learn more, visit https://diabetesresearchconnection.org

*The study mentioned in this article was done at the La Jolla Institute for Immunology in the lab of  Professor Matthias von Herrath, M.D. (the man featured in the image above), who serves as vice president and senior medical officer, Global Chief Medical Office, at Novo Nordisk. Matthias is also a member of DRC’s 80-member Scientific Review Committee, a  volunteer 80+ group of diabetes experts from across the country.

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you.

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DRC New ED

Diabetes Research Connection Announces New Leadership

The Diabetes Research Connection (DRC) Board of Directors is pleased to announce Karen Hooper will be joining our team as the new Executive Director (ED). Karen brings over 20 years of non-profit leadership experience at the local and national levels. In her most recent role as the Vice President of Program Development and Engagement of the National Multiple Sclerosis Society, Karen created a nationwide programmatic approach for mission delivery.

“Our new Executive Director brings significant expertise in building lifetime relationships, developing high performing teams and creating strategic partnerships.” said DRC’s Chair of the Board, C.C. King, Ph.D. He added, “We enthusiastically welcome Karen to DRC.  She is a strategic leader who will help increase our impact in the realm of patients and researchers who seek ways to prevent, cure and treat type 1 diabetes (T1D).”

Dr. King was also happy to announce, “Casey Davis is our new Senior Director of Development. We are incredibly grateful for her exceptional service as DRC’s Interim Executive Director since August 2020, while the Board of Directors sought a full-time ED.”

As DRC’s new ED, Ms. Hooper will be responsible for organizational leadership, operations, and community engagement. She is passionate about serving the T1D community and is thrilled to join the DRC family.

“I am so grateful to have the opportunity to lead such an innovative, growing organization like the Diabetes Research Connection.  I am excited to be welcomed into the T1D community. I look forward to helping to fund critical research that ultimately will end T1D forever.”

Karen will officially assume her new role at DRC on March 15, 2021. Originally from Los Angeles, California, Karen now lives in Rancho Bernardo with her husband Ron and their daughter Karli. She holds a marketing degree from San Diego State University.

Type 1 diabetes (T1D) is an autoimmune disease. Nearly 1.6 million Americans have type 1 diabetes, including about 187,000 children and adolescents. DRC is a San Diego based 501(c)(3) charity, which supports peer-reviewed T1D research conducted by early-career scientists.  DRC expects to fund 42 research projects by the end of 2021.

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DRC Impact Campaign

Diabetes Research Connection’s Impact Report

This month we are taking the time to showcase the impact of our incredible supporters. Without our community, DRC would never be able to see the incredible results from our early-career scientist’s research projects. We would not see these same scientists secure follow-on funding and watch as many of them establish their own labs. Their research projects have been published and have helped create new technologies to provide better care for T1Ds. We have seen them achieve breakthroughs towards a cure!

Click HERE to view the full impact report.

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BP4

Discussing Diabetes with DRC’s T1Ds: Blog Post 4

As a type 1 diabetic who considers the beach their second home, I can say that Beyond Type 1’s “T1D Beach Guide” is spot-on. While splashing in the waves or sunning oneself on the sand, there are a few essential things that type 1 diabetics should keep in mind. 

Beyond Type 1 first mentions the importance of hydration for both diabetics and non-diabetics. I always bring a big reusable water bottle, preferably one that keeps the water inside cool. The beach heat can be severely dehydrating, so adding some electrolytes to water will provide the right fuel for a fun beach day. Beyond Type 1 recommends Ultima Replenisher, which has zero carbs and a ton of flavors. I love Crystal Light Pure, which has zero carbs per serving, no artificial colors, sweeteners, or preservatives. My favorite flavor is tangerine mango! Staying adequately hydrated also helps balance blood glucose levels

As Beyond Type 1 notes, making sure your diabetes supplies are out of the direct sun is extremely important. It’s easy to accidentally leave an insulin pen or a container of test strips just sitting out on a towel–but this could, unfortunately, render them completely unusable. To be safe, I usually bring a small portable cooling bag for my supplies.

  The heat not only affects supplies; it also affects how one feels. Heat and constant sunshine can make one feel light-headed and drained, making it much harder to detect changes in one’s blood glucose levels. Beyond Type 1 also mentions that dehydration from sweat can spike blood glucose levels while playing in the waves, and running around in the sand can cause levels to plummet. One beach day, I thought I had low blood sugar because I was so tired. However, when I checked my continuous glucose monitor, my number was in the high 200s. This experience was unsettling, but it reminded me that it’s important to keep a constant watch on my CGM while at the beach.

  Beyond Type 1 recommends bringing easily packable snacks to the beach, including a cooler if you’re packing fresh food. I usually pack low-carb snacks such as veggies and hummus or parmesan crisps. When low blood sugar strikes, it’s also vital for type 1 diabetics to have fast-acting sugar in their beach bag. My favorite treat is fruit snacks because they are delicious and easy to consume quickly.

Last but not least, Beyond Type 1 recommends using a quality adhesive to ensure your CGM or pump stays on amidst all the beach day fun. Saltwater and sand are tough on adhesive, causing it to erode. I once lost my CGM in the ocean after I got tumbled by a wave. Since then, I have always wiped my CGM site with an extra Skin Tac wipe before heading off to the beach. 

With the proper preparation, type 1 diabetics can “navigate the waves” of their disease at the beach. Thankfully, with new technology rising out of innovative diabetic research, beach days can include less fret and a lot more fun for type 1 diabetics. 

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article, “The T1D Beach Guide.

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Lower A1C Levels for Kids

New Guidelines Lower Target HbA1C Levels for Children with Type 1 Diabetes

One of the goals in managing type 1 diabetes is reducing fluctuations in blood glucose levels. Maintaining a stable blood sugar is ideal, which means consistently monitoring glucose levels and administering appropriate insulin doses.

The target range for HbA1C levels in children has typically been 7.5% or below. This was meant to keep blood sugar low enough to reduce the risk of organ and tissue damage but high enough to help curb hypoglycemia concerns. However, a recent report reveals that maintaining an HbA1C level of 7.0% or below may be better for short- and long-term health outcomes for children with type 1 diabetes (T1D).

Studies have shown that abnormal brain development, heart problems, diabetes-related complications, and mortality in children and adolescents may be at increased risk when blood sugar levels remain elevated. Tighter control and a lower target range may be beneficial in reducing both acute and long-term effects.

Although lower HbA1C levels were previously thought to increase the risk of hypoglycemia, several studies have shown the number of incidences has declined over the past three decades, and “the link between lower glucose targets and hypoglycemia risk has weakened over the past 15 years.”

The use of continuous glucose monitors and insulin pumps as part of T1D management and insulin analogs have played an integral role in allowing patients and caregivers to maintain tighter control over A1C levels and minimize fluctuations in blood sugar levels. 

While an HbA1C level of 7.0% or below is now recommended for many children with T1D, those patients who are unaware of hypoglycemia symptoms cannot adequately articulate them, a target of 7.5% is still recommended. There are also exceptions for those patients with a history of severe hypoglycemia and those with other pre-existing conditions or comorbidities. Patients with T1D need to work with their healthcare team to determine an appropriate A1C level for their individual situation.

The Diabetes Research Connection (DRC) continues to follow updated guidelines and recommendations for managing type 1 diabetes. The organization plays an active role in contributing to the growing body of knowledge around the disease by providing critical funding to early-career scientists pursuing research projects focused on improving diagnosis, prevention, treatment, and management of T1D. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org

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CDF and DRC Meet and Greet

DRCs 1st Virtual Gathering of 2021!

On Tuesday, February 23, DRC held it’s first virtual gathering of the year. DRC partnered with the Chris Dudley Foundation for a Meet and Greet, where Chris Dudley shared his personal experience with type one diabetes, his NBA career, and his wonderful foundation and camp! DRC gave a brief overview of it’s mission, spoke about successfully funded and currently funded projects, and gave several resources to the community. You can view the video below.

Chris Dudley Foundation and Diabetes Research Meet and Greet

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Diabetes Burnout

Discussing Diabetes with DRC’s T1Ds: Blog Post 3

When I responded to the article, “10 Ways the Pandemic Parallels “Normal” Chronic Illness Life,” it mentioned “bleak burnout,” which I stated that I resonated with. This week, I decided to delve deeper into that topic after reading the article “Diabetes Burnout” written by Mark Heyman, Ph.D.,  CDE,  for the Beyond Type 1 organization. 

Mark describes “Diabetes Burnout” as being “a state in which someone with diabetes grows tired of managing their condition, and then simply ignores it for a period of time, or worse, forever.“ It wasn’t a question about “if” I was going to experience it, but “when.” I had little bouts of it since being diagnosed with T1D at the age of 7, but nothing was as bad as when I hit senior year in high school, and I wasn’t just done with diabetes – I was done with my body and the lack of control I had with it. Mark mentions that a trigger for diabetes burnout can be “feeling controlled by diabetes,” and I absolutely did feel that. I didn’t want to think about changing my pump site. I didn’t want to worry about testing my blood sugar before every meal, in the middle of the night, or when I was feeling “off.” I didn’t want another lecture from my parents about a lousy A1C and the damage I was doing to my body. I didn’t want to be a diabetic. 

I decided to ween myself off insulin at the beginning of senior year. After a month, I had lost up to 10 pounds. By Christmas, I was down 40 pounds and happier than I had been in a long time. I had no idea where my test kit was, and I didn’t care. Don’t get me wrong – I was in excruciating pain. I threw up and peed all the time. I lost feeling in my limbs for days and sometimes wasn’t sure I would get the feeling back. I had constant heartburn, headaches, and severe nausea. You are probably wondering how my parents reacted? There was nothing they could do. One time, my mom was out of town, and I skipped school because I was so high blood sugar, I needed to sleep it off. I slept for 12 hours and had 30 missed calls from my parents. I woke up to my dad giving me an insulin shot. He drove two hours because he was afraid I had died (I am sorry to all the parents out there that have experienced this fear. It took me a long time after dealing with this burnout to understand the pain I put my parents through; I still feel guilt today). By March, I had lost 60 pounds and was forced by my school’s counselor to go on a month-long leave of absence to take care of my health. It was at this time that I realized – diabetes still had control over me. No matter how much I wanted to feel “normal,” I wasn’t. I had type one diabetes, and I was letting it kick my butt.

At the end of Mark’s article, he gives several helpful tips on overcoming this burnout; “Managing Your Expectations,” “Take Small Steps,” and my favorite, “Get Support.” After finally deciding to take care of myself, I sought comfort in the diabetic community I was closest to. I went to the camp I had been to for many years, Camp Conrad Chinnock, and worked all summer as a staff member. I was continually being reminded why my health was so important and having an open-ear to speak to when things became too much. No one shamed me for what I had done, but they reminded me of why my health is so important. If you or a loved one are experiencing diabetic burnout, talk to someone. I would probably have continued to disregard my health had I not surrounded myself with others in my position and been as open and honest about my feelings and doubts. I still deal with burnout, but I don’t let myself spiral. Finding DRC was kismet for me. I have never taken better care of my health, and I am so thankful to be a part of an organization that is continuously striving to fund research projects for a cure. Until we have a cure, make sure to check out all of Beyond Type 1’s resources, as they offer a plethora of tips, tricks, and suggestions that are extremely useful for anything a T1D might need. 

This blog was written by Hannah Gebauer, DRC’s Development Assistant, who has had T1D for 17 years and is responding to the article, “Diabetes Burnout.”

Hannah Gebauer

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Covid and T1D Resources

Coronavirus and Diabetes Resources: Community Partner with Beyond Type 1

It is no secret that this pandemic has made life extremely more challenging. And for those with type one diabetes (T1D), infinitely more so. Fortunately, Beyond Type 1, a nonprofit organization that unites the global T1D community and provides solutions to improve those lives, has created a remarkable resource to help those with T1D during this difficult time. Click HERE to view helpful articles such as “Diabetes + Covid Vaccines: What You Need to Know,” “Covid + Diabetes: The Work and School Safety Guide,” and “Suddenly Jobless or Without Health Insurance? Start Here.” Diabetes Research Connection is honored to help spread the word for such a fantastic resource as a community partner.

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T1D and Mental Health

Discussing Diabetes with DRC’s T1Ds: Blog Post 2

Finger-pricking, insulin dosing, tracking food consumption, monitoring glucose levels: type 1 diabetes is a mentally and physically taxing full-time job. As a type 1 diabetic myself, I know how quickly diabetes can become overwhelming when it’s combined with school, work, and social obligations. The Centers for Disease Control and Prevention’s “10 Tips for Coping with Diabetes Distress” is an excellent resource for people with diabetes who are struggling with managing the burden of their disease. 

Tip number 5, “Talk with Family or Friends,” and number 6, “ Talk to Other People with Diabetes,” highlight the importance of diabetics communicating their distress to those they trust. Not only does talking with friends help me process how I am feeling, but it also allows me to educate non-diabetics about the realities of my disease. Diabetes can be isolating, and it is easy for me to feel alone in my struggles. I am grateful to have an older sister with type 1 diabetes to talk to about diabetic burnout, unmanageable glucose levels, and other diabetic issues. I am also a member of my university’s College Diabetes’ Network, where I have met fellow type 1 diabetic students.  

I am a generally busy person, and keeping track of everything I need to do diabetes-wise can be extremely difficult. Tip number 8, “Do One Thing at a Time,” emphasizes how tackling each task independently can help with feelings of stress. I have a planner where I write myself reminders such as “Change Dexcom” or, when I know I have a big meal planned, “Increase Bolus.” I try to organize my day in a way that allows me to solely focus on my disease some moments but also place it on the “back burner” for a few minutes when I need to concentrate on other tasks. However, something I still need to work on is tip number 9: “Pace Yourself.”  My goal has always been to have stable blood glucose levels, but some days my levels are completely uncontrollable.  I have to remind myself that I can’t become a “perfect type 1 diabetic” overnight. I need to discover how my body responds to certain foods, different forms of exercise, and many other factors. Type 1 diabetes is a learning process: I take two steps forward and one step backward. Regardless, I know I am growing and progressing, becoming stronger and more confident managing my disease each day.

Most of the time, I wish I could “clock out” of my chronic illness, leave my type 1 diabetes on my bedside table and forget about it. Each moment of living with this disease brings a new challenge. I am so grateful for organizations like Diabetes Research Connection that support the development of life-changing diabetic technology. Reminding myself that ambitious researchers are currently studying my illness is ultimately the most helpful way to manage my diabetes distress. I am optimistic about a brighter future for all people with diabetes, where our disease’s burden is minimal or non-existent.

This blog was written by Lauren Grove, DRC Intern, who has had T1D for 15 years and is responding to the article,“10 Tips for Coping with Diabetes Distress.”

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COVID-19 Vaccine for T1Ds

Pushing for Improved Prioritization for COVID-19 Vaccine for Individuals with Type 1 Diabetes

As the United States has begun rolling out COVID-19 vaccines across the country, it has also created guidelines regarding eligibility and prioritization for the drug. There are multiple phases with different requirements to determine who gets the vaccine when. Currently, phase one is for the most at-risk groups, including frontline healthcare workers, seniors, those in long-term care facilities, and individuals at increased risk for severe illness.

While people with type 2 diabetes fall under phase 1 of the vaccine rollout, people with type 1 diabetes are included in phase 2. This has caused quite a bit of confusion and concern among those most familiar with the disease. The CDC points to “limited evidence” of increased risk for severe illness in individuals with T1D as the reason for the different phase designations. There is a growing push to get both type 1 and type 2 diabetes included in the phase 1 rollout.

There have been several recent studies that demonstrate the risk of contracting COVID-19 for individuals with T1D, including:

  • A study published in Lancet Diabetes & Endocrinology in August 2020 shows that those with type 2 diabetes were more than two times as likely to die, while those with type 1 diabetes were more than 3.5 times as likely to die when compared to similar individuals without diabetes.
  • A study published in Diabetes Care in December 2020 that notes “people with either type 1 or type 2 diabetes who develop COVID-19 are three to four times as likely to experience severe illness and hospitalization as people without diabetes.”
  • A study published in the Journal of Clinical Endocrinology & Metabolism found a higher risk of developing diabetic ketoacidosis in Black and Hispanic individuals with COVID-19.

 

The evidence is there, but it is up to the CDC as to whether all diabetes patients are grouped together in one priority group or remain separate. However, state and local agencies can set their own eligibility guidelines when running vaccination programs, so they have the ability to prioritize all patients with diabetes if they so choose. Doctors also want the ability to prioritize certain patients based on their health history and risk factors. Only time will tell as the country continues to try to ramp up vaccine distribution.

The Diabetes Research Connection is waiting to see what happens next while supporting improved prevention and treatment options and the push for a cure for type 1 diabetes. Receiving a COVID-19 vaccine is just one step toward potentially improving quality of life and reducing risk for this population. Learn more about the DRC and the research projects currently being funded by visiting https://diabetesresearchconnection.org

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Generic Glucagon and Hypoglycemia

First Generic Glucagon Approved by FDA to Treat Severe Hypoglycemia

A significant concern for individuals with type 1 diabetes (T1D) is preventing severe hypoglycemia, also known as very low blood sugar. When blood glucose levels drop too low, it can cause confusion or lead to unconsciousness. Individuals often need someone else to administer a life-saving drug such as glucagon to raise their blood sugar back up to safer levels quickly.

Until now, only brand-name glucagon has been available for the treatment of hypoglycemia. Since it is a complex drug, it can be challenging to create safe, effective generic versions. However, generic products can be more affordable for many patients and increase competition in the market and increase drug prices.

The FDA is committed to improving access to lower-cost, high-quality generic drug products such as generic glucagon, and recently approved its production application. The drug is an injectable synthetic version of a natural hormone produced by the body to increase glucose levels. It has undergone the same testing as brand-name products to ensure that it meets the same rigorous approval standards and has comparable safety and efficacy.

The FDA has taken numerous steps to encourage pharmaceutical companies to create quality generic drug products, especially for drugs with fewer than three approved generics, including glucagon. Approval for the production of generic glucagon was given to Amphastar Pharmaceuticals, Inc. in Rancho Cucamonga, California.

The Diabetes Research Connection (DRC) is excited to see that more affordable drug products to help manage and treat type 1 diabetes are coming to market. This can help improve access to these life-saving drugs for those in need. There is not yet a cure for T1D, so reducing costs for essential medications by offering generic versions can make a difference.

The DRC is committed to funding research geared toward prevention, a cure, and improved care for individuals living with type 1 diabetes. Early-career scientists can receive funds to support novel, peer-reviewed research studies focused on any number of aspects of the disease. Learn more about some of the incredible projects taking place and find out how to help by visiting https://diabetesresearchconnection.org.

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Disordered Eating and T1D

Disordered Eating May Increase High Blood Sugar Risks in Type 1 Diabetes

Type 1 diabetes (T1D) can be a difficult condition to manage. Individuals must continuously be aware of their food and beverage intake, physical activity, overall health, and how this impacts their blood sugar. They must regularly check their blood glucose levels and administer appropriate doses of insulin as necessary.

Managing T1D combined with disordered eating can present even more challenges. Inconsistencies in food intake and negative feelings about eating and using insulin can make it harder to stay within a target blood sugar range. A recent study involving 23 women found that the time spent in level 2 hyperglycemia – blood sugar greater than 250 mg/dL – may be four times longer in individuals with T1D who also have disordered eating compared to those with only T1D.

Participants were divided into two groups: 13 women with T1D and disordered eating, and 10 women with T1D only. All participants were asked to keep a diabetes diary using a smartphone app to record information about their meals, insulin usage, and any emotions or behaviors related to the meal, such as binge eating or skipping insulin. Each woman tested her own blood sugar before meals and at bedtime, but they also wore a blinded continuous glucose monitor (CGM).

In addition, all participants completed a variety of surveys and screenings and engaged in a semi-structured interview with a clinical psychologist with expertise in disordered eating. Results were recorded for the Diabetes Eating Problem Survey-Revised, the Diabetes Distress Screening Scale, the Patient Health Questionnaire-9, and the Yale Food Addiction Scale.

Women in the disordered eating cohort showed higher use of recreational drugs, higher mean HbA1c levels, and higher scores on the diabetes distress, depression, and diabetes eating problem surveys than the control group. Furthermore, the disordered eating group reported more negative emotions and tested their blood sugar levels less frequently.

When looking at hyperglycemia, “the disordered eating group had a mean serum glucose of greater than 10 mmol/L (180 mg/dL) for 49.8% of the study period, whereas the control cohort spent 25.6% of time above range.” When narrowing it down to level 2 hyperglycemia specifically, “the disorder eating group was above range 21.3% of the time vs. 5% for the control group.”

Given that individuals must make significant changes to their lives when diagnosed with type 1 diabetes, it may be beneficial to provide additional support around diabetes self-care and mental health to reduce risk of developing disordered eating as well. Early introduction of healthy strategies and habits for managing diabetes, along with psychological support, may help improve glucose control.

Providing individuals with the knowledge, training, and support necessary for effectively managing type 1 diabetes is essential. The Diabetes Research Connection (DRC) is committed to enhancing research capabilities by providing critical funding for early-career scientists focused on diagnosis, prevention, and management of T1D, as well as finding a cure. Learn more by visiting https://diabetesresearchconnection.org

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Eating Fish and T1D

Could Eating Fish Help Prevent Type 1 Diabetes?

Although type 1 diabetes often develops in childhood, that is not always the case. In some instances, the disease may not fully develop until adulthood. The body may produce autoantibodies, known as GAD65 antibodies, long before type 1 diabetes symptoms appear. Detecting these autoantibodies can allow individuals to keep a closer eye on their health and be proactive when it comes to diabetes risk.

recent study found that omega-3 fatty acids may reduce type 1 diabetes risk or delay the disease’s onset. Fatty fish such as salmon, mackerel, and herring are all a good source of omega-3. When researchers compared omega-3 levels in individuals both with and without GAD65 antibodies, they found that “participants with GAD65 antibodies and a low intake of fish in their diet were 2.52 times as likely to have diabetes as those without GAD65 antibodies and a high intake of fish.”

When looking only at participants with GAD65 antibodies – a telltale sign of diabetes risk, those who ate less fish were more than four times as likely to have diabetes than those with a high fish intake and therefore higher levels of omega-3 fatty acids. The study included 11,247 individuals who developed diabetes in adulthood, and 14,288 adults without diabetes, all located in Europe.

One thing that is unclear, however, is precisely why fish consumption exerts this protective effect. Researchers continue to study the impact of omega-3 fatty acids on immune system function and potential type 1 diabetes triggers. Current guidelines from the U.S. Food and Drug Administration (FDA) recommend at least 8 ounces of fish per week for adults and less for children. These amounts may be different for individuals with GAD65 antibodies depending on their healthcare provider’s recommendations and future studies related to diabetes and omega-3 levels.

The Diabetes Research Connection (DRC) is excited to see what future research uncovers in terms of the impact of fish consumption on potentially preventing or delaying the onset of type 1 diabetes. Though not involved in this study, the DRC supports novel, peer-reviewed studies conducted by early-career scientists by providing essential funding. Learn about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org

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Diabetes and Celiac Disease

Double Trouble: Managing Type 1 Diabetes & Celiac Disease

As anyone with type 1 diabetes (T1D) knows, managing life with an autoimmune disorder can be challenging. Individuals with T1D must be regularly monitoring their blood sugar, adjusting insulin based on food consumption and exercise, and ensuring they have necessary supplies should their blood sugar drop too low.

But did you know that individuals with type 1 diabetes have a greater risk of developing celiac disease, another autoimmune disorder? The general population has between a 0.3% and 1% chance of developing celiac disease, while this risk increases from 2% to 16% for a person with T1D. Trying to manage the demands of both diseases can be stressful. Some people are genetically predisposed to these diseases, but they do not always develop one or both.

While T1D leaves the body unable to naturally control blood glucose levels due to the destruction of insulin-producing beta cells, celiac disease interferes with the body’s ability to effectively absorb nutrients due to damage to the small intestines caused by gluten. People with celiac disease must avoid both food and nonfood sources of gluten, which often comes in the form of wheat, barley, rye, or triticale.

Due to the increased risk of having both conditions, the American Diabetes Association recommends that individuals with T1D be tested for celiac disease at the time of diabetes diagnosis, as well as again two years later, followed by a five-year repeat screening. If celiac disease symptoms develop, or there is a family history, testing may be conducted more frequently.

Individuals with T1D and celiac disease must be cautious about what they eat, ensuring that they count carbs and dose insulin properly, but also that they select naturally gluten-free foods such as fresh produce, lean proteins, beans, and low-fat dairy. Cross-contamination can occur when preparing meals if food items with and without gluten are handled in the same space or with the same pots or utensils. It is essential to use a separate space and equipment to prepare gluten-free foods.

However, eating a gluten-free diet can help manage blood glucose levels because it enables the body to absorb nutrients better and reduce inflammation. In addition, eating whole foods, as opposed to processed foods, can also reduce carb intake and decrease the amount of insulin needed.

To help minimize the stress of managing diabetes and celiac disease, participation in support groups is encouraged. This can help individuals feel less isolated, access additional information and resources, and deal with the challenges of finding celiac-friendly restaurants and food options. Patients should also work closely with healthcare providers such as their diabetes care provider, a diabetes educator, a registered dietitian, a gastroenterologist, and even a pharmacy provider. Having family and friends who understand how to manage diabetes and celiac disease can help as well to provide additional support and encouragement.

There is currently no cure for T1D or celiac diseases, but researchers continue to expand their understanding of these diseases and search for effective therapies and treatment options. The Diabetes Research Connection (DRC) is committed to supporting innovative scientific inquiry until diabetes is eliminated. To achieve this goal, the DRC provides critical funding to early-career scientists focused on studying multiple aspects of type 1 diabetes. Learn more about these efforts and how to donate by visiting https://diabetesresearchconnection.org

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DRC's T1Ds

Discussing Diabetes with DRC’s T1Ds: Blog Post 1

*DRC will begin a new campaign where those with type one diabetes (T1D) in the DRC community will share their thoughts and personal anecdotes in response to lifestyle articles related to T1D care and management*

When I read Melissa Engel’s article “10 Ways the Pandemic Parallels “Normal” Chronic Illness Life,” I was nodding my head up and down the entire time. I find it hard to explain type one diabetes (T1D) to someone who doesn’t have it. Although this article summarizes the similarities between any chronic illness and the feelings individuals are experiencing during the pandemic, I think this could help bridge the gap for some people who try to sympathize with a T1D. After reading the article, I found that I most resonated with number 2, “Stocking Piling Supplies,” number 3, “Eternal uncertainty,” and my personal “favorite,” number 9, “Bleak Burnout.”

I remember when this pandemic started, I was less concerned with having enough toilet paper and more concerned about if I was going to end up having to pull a Nicole Kidman in “The Invasion” and break into a pharmacy to find what I would need to survive. I am almost positive every type one diabetic has had the thought, “How long could I go without insulin before I die?” or something resembling that remark. Apocalyptic movies are hard for me to stomach when there are just so many adverse outcomes for what could happen to me if I couldn’t access my medication: I could die of ketoacidosis; I could die a low blood-sugar that resulted in a seizure with no glucagon shot available; I could die since insulin is bound to expire. The consequences are limitless, and I generally steer away from those thoughts as they tend to spiral.

I believe Melissa truly hit the nail on the head with number 3, “Eternal Uncertainty,” when she used the words “Lack of Control and Predictability”. The only thing I am certain of is the uncertainty of T1D. I could be 125 at 8 AM, have the perfect dose of insulin for breakfast, encounter one negative email that gave me anxiety, and at lunch, I end up being 300. I could have a perfectly working pump site and go to work feeling good, but then 3 hours later, I test and find out I am 400 with ketones because of a site kink. It’s like being on a never-ending roller coaster and wanting to get off, but you are gaining speed and stuck on the ride till it slows down for a bit, only to start again. Luckily, T1D is manageable with our latest technology and gives one a sense of control.

Lastly, number 9, “Bleak Burnout.” We’ve all been there – the moment when you say, “I am done.” I am done testing my blood sugar. I am done counting my grams and taking insulin shots. I am done being treated differently from everyone around me. I am just done. For some T1Ds, this looks like giving up for a day and dealing with higher blood sugar than usual. For others (myself included), that is deciding to stop taking insulin altogether and dealing with the consequences in hopes of finding relief. Unfortunately, a T1Ds “normal” is managing the disease, or you end up with permanent complications. Bleak burnout comes and goes, the only thing that truly helps me fight it is the diabetic community I surround myself with, and the knowledge that organizations like Diabetes Research Connection are funding research for a cure so that maybe in my lifetime, I can feel a different kind of bleak burnout.

This blog was written by Hannah Gebauer, DRC’s Development Assistant, who has had T1D for 17 years and is responding to the article, “10 Ways the Pandemic Parallels “Normal” Chronic Illness Life.”

Hannah Gebauer

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Golimumab and Beta Cells

Golimumab May Help Preserve Beta-Cell Function Related to Type 1 Diabetes

Type 1 diabetes (T1D) is characterized by the destruction of insulin-producing pancreatic beta cells. This leaves the body unable to regulate blood sugar levels on its own effectively and requires individuals to administer insulin throughout the day. T1D is one of many autoimmune disorders that affect children and adults.

recent study found that a drug already approved by the FDA to treat other autoimmune diseases, including rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, and ulcerative colitis, may also be effective in treating T1D. Though it is not a cure, it may help preserve existing pancreatic beta-cell function in newly diagnosed patients and reduce the amount of external insulin needed to manage blood glucose levels.

The medication, known as golimumab, is a human monoclonal antibody that blocks a protein involved in abnormal inflammatory and immune responses. Researchers administered the medication every two weeks for 52 weeks to a group of 56 children and young adults between the ages of 6 and 21. Another 28 participants received a placebo. All participants were newly diagnosed with type 1 diabetes and were free from other autoimmune diseases.

Throughout the year, each participant kept a record of how much insulin they used each day, what their blood glucose level was, and if they had any occurrences of hypoglycemia. At the end of the trial, the results showed that the children and young adults who received golimumab had higher 4-hour C-peptide AUC levels than those in the control group (0.64 vs. 0.43). This means that those receiving the medication produced more natural insulin (endogenous insulin) than those who received the placebo and required less insulin therapy.

There can be advantages to requiring lower doses of insulin, making golimumab attractive to some individuals with T1D. Though still undergoing clinical testing to treat type 1 diabetes, the medication may become one more option for patients to help them better manage their health.

Though not involved with this study, the Diabetes Research Connection (DRC) is interested to see how future clinical trials play out and whether golimumab is approved as a therapeutic agent for type 1 diabetes. The DRC is committed to improving understanding, treatment, and management of the disease and finding a cure one day. Learn more about how to support these efforts by visiting https://diabetesresearchconnection.org

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Umbilical Cord Stem Cells

Using Umbilical Cord Stem Cells to Treat Type 1 Diabetes, COVID-19

Autoimmune diseases wreak havoc on the body and can be challenging to treat. They can cause severe inflammation and even cell death, as with type 1 diabetes (T1D). But researchers are striving to develop more effective therapies to manage and treat these conditions.

One approach that has shown positive results in early testing is the use of umbilical cord stem cells. A recent study by a team at the Diabetes Research Institute and Cell Transplant Center at the University of Miami Miller School of Medicine found that these cells may be beneficial in treating individuals with T1D and promoting recovery in patients with severe COVID-19.

The FDA has already approved this stem-cell therapy for testing as a potential treatment for T1D, which requires more targeted administration to ensure that cells are directed to the pancreas. These cells may help to calm the body’s hyperinflammatory immune response. Due to umbilical cord cells’ anti-inflammatory, immunomodulatory effects, they may also be effective in treating COVID-19 and could be administered easily through a blood transfusion.

The researchers administered two infusions of 100 million umbilical cord stem cells three days apart to 12 patients with severe COVID-19, while another 12 patients with the disease received a placebo IV. Of those treated with the stem cells, there was a 91% overall survival rate and a 100% survival rate of patients under age 85. The survival rate in the control group was 42%. In addition, more than 80% of patients who received stem cells recovered within 30 days, while less than 37% in the control group did.

Following these promising results, the researchers are now looking to conduct a larger trial to see if the treatment generates the same results on a larger scale. If so, umbilical cord stem cells may become one option for treating COVID-19. According to the study, “one umbilical cord recovered from a healthy newborn can generate more than 10,000 therapeutic doses.” Studies will also be done to better understand the stem cells’ effect on other autoimmune diseases such as T1D.

The Diabetes Research Connection (DRC) is excited to continue following these developments to see whether umbilical cord stem cells could be a viable therapeutic treatment option, especially when it comes to T1D or potential patients with T1D and COVID-19 who are at higher risk for complications.

The DRC is committed to improving understanding of T1D, enhancing treatment and prevention options, as well as finding a cure. The organization supports early-career scientists in pursuing novel, peer-reviewed studies related to type 1 diabetes by providing critical funding for their research. Find out more at https://diabetesresearchconnection.org

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Gene Expression

Advanced Understanding of Gene Expression May Improve Treatment of Multiple Autoimmune Diseases Including Type 1 Diabetes

The immune system is a central part of the human body. When autoimmune diseases develop, they can cause the immune system to begin attacking itself, taking a toll on individuals’ health. Numerous different autoimmune diseases exist, and currently, many have no cure.

However, a recent study examined commonalities between four of the most severe autoimmune diseases and changes that occur within the body. By developing a better understanding of where there are similarities, researchers may be able to apply what they already know about one disease to another. The four autoimmune diseases that were studied were type 1 diabetes (T1D), systemic lupus erythematosus (SLE), multiple sclerosis (MS), and rheumatoid arthritis (RA).

Researchers found that all of these diseases have common pattern disease risk, local inflammation, and up-regulation and down-regulation of gene expression. In addition, rather than only looking at how the immune system was affected, the researchers also studied the impact on target tissues. Their findings showed that in many instances, the immune system and these tissues engaged in a dialog that contributed to the effects of each disease and cell damage. There were a significant number of candidate genes that were expressed in target tissues as well.

There was a lot of overlap between up-regulated expression patterns, whereas down-regulated expression appeared to be more specific to the target tissue. Close attention was also paid to which pathways were affected for each disease. The researchers note that “The observed similarities in pathway activation between target tissues were translated into the identification of several classes of drugs that could be potentially used to treat more than one autoimmune disease.”

This could allow scientists to repurpose drugs that are well understood to treat one disease to be used to treat another disease. For instance, JAK inhibitors are approved for the treatment of RA, but they are also showing promising results for treating SLE, and they are known to “prevent the proinflammatory and proapoptotic effects of IFN-α on human pancreatic β cells,” which is a trademark of T1D. JAK inhibitors may also effectively treat insulitis, though current studies have been on nonobese diabetic mice.

The study found that one candidate gene in particular – TYK2 – was present in all four autoimmune diseases when it comes to gene expression. There is currently a phase 3 clinical trial underway for a TYK inhibitor to treat psoriasis, another autoimmune disease. TYK inhibitors demonstrate a protective factor over human β cells, so the clinical trial may provide valuable information related to future treatment of T1D as well.

The Diabetes Research Connection (DRC) is excited to see how this study may impact future research and the potential repurposing of existing drugs to treat other autoimmune diseases, including type 1 diabetes. Advancing research and understanding of T1D is integral to one day finding a cure. To support these efforts, the DRC provides critical funding to early-career scientists pursuing novel research related to T1D. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

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Diabetes Health

The Pandemic ‘COVID-19’ Exacerbates Diabetes Health Challenges for Individuals Living with The Disease

Although the coronavirus pandemic has disrupted all Americans’ lives, it has been especially challenging for individuals with chronic conditions such as type 1 diabetes. According to the American Diabetes Association, more than 122 million people in the United States have diabetes or pre-diabetes. Access to healthcare, health insurance, medication/medical supplies, and nutritious food is critical, yet many of these people struggle in these areas.

As the pandemic has inundated the United States, it has presented significant hardships for individuals living with type 1 diabetes, type 2 diabetes, and pre-diabetes. A recent study conducted by the American Diabetes Association in partnership with Thrivable and the Diabetes Daily community shows just how profound the impact has been on this population. 

With the loss of jobs, insurance coverage, and income, many individuals have difficulty paying for necessary medications and medical supplies to manage their diabetes health. They are struggling with food insecurity, unable to access the type and quantity of food needed to keep their blood sugar under control. They have delayed medical appointments because they do not have insurance coverage or are scared about potential exposure to COVID-19.

All of these circumstances can put their diabetes health at risk. Being unable to manage their diabetes now effectively can have a lasting impact in the future. It also puts individuals at greater risk for complications from COVID-19 should they contract the virus. Tracey D. Brown, CEO of the American Diabetes Association, notes that “as many as 40 percent of the COVID fatalities – 120,000 Americans – have been people with diabetes.”

Of those surveyed, 43% have delayed routine medical care for fear of exposure to the virus, and 15% of those with continuous glucose monitors (CGM) or insulin pumps have put off refilling their supplies, with 70% reporting that it is due to financial hardships. Twelve percent of respondents have lost their health insurance since the start of the pandemic, and of those, 13% continue to be uninsured.

Access to food is another major problem. Facing financial constraints, many people have had to rely on food banks for food. Options there are limited and not always the most effective for managing diabetes. The study found that “1 in 5 say they aren’t able to eat as frequently as they need to manage their diabetes effectively,” and nearly as many said they have been forced to choose between buying food and buying medical supplies or medications for their diabetes.

On a positive note, many individuals with diabetes (37%) are open to getting the vaccine immediately once it becomes available to them. In addition, there has been a drastic increase in the number of individuals with diabetes using telemedicine as a way to help manage their health. However, this does not negate the serious challenges this pandemic has presented and the fact that the effects could last for years to come. In turn, this could strain the healthcare system in the future.

Researchers continue to learn more about COVID-19 every day, and more work is being done to understand its impact on at-risk populations such as those with type 1 diabetes. The Diabetes Research Connection, though not involved with this study, is committed to providing critical funding for early-career scientists pursuing projects related to type 1 diabetes. These efforts drive work toward improving diagnosis, treatment, management, and prevention of the disease, enhancing the quality of life, and moving closer to a cure. To learn more about current projects or support these efforts, visit https://diabetesresearchconnection.org

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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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Diabetes And Digestive Problems

Those With Diabetes And Digestive Problems May Be Suffering From Gastroparesis

Diabetes and digestive problems can go hand-in-hand, but symptoms should not be ignored. A telltale sign of type 1 diabetes is high blood sugar, and this is one of the leading causes of gastroparesis, also known as delayed gastric emptying. Some symptoms of gastroparesis include bloating, pain after eating, heartburn, and nausea or vomiting.

Uncontrolled high blood sugar can lead to nerve damage affecting how well the stomach muscles contract and release. It is this motion that pushes food through the stomach and intestines. If this process is not working effectively, the stomach is not fully empty, and food can remain there for long periods of time, causing discomfort. In addition, gastroparesis can affect how well the body absorbs nutrients from various foods and contribute to malnutrition.

To help prevent gastroparesis, diabetes should be managed as effectively as possible to control blood sugar levels and keep them within the target range. To aid with digestion, drink plenty of water throughout the day, and eat several small meals rather than two or three large ones. Limiting fat and fiber consumption can also promote improved stomach emptying, which can reduce discomfort. In addition, engaging in regular exercise not only helps with managing blood sugar, but it can also support digestion.

Diabetes and digestive problems are both conditions that can be managed to reduce the risk of developing gastroparesis. Patients should talk to their doctor about any symptoms they experience and how to improve their diet to support proper digestion and nutrition.

The gastroparesis-diabetes connection is one that is recognized by scientists and something that patients should be aware of. Researchers continue to study these types of conditions to learn more about how they affect diagnosis, prevention, treatment, and quality of life.

The Diabetes Research Connection (DRC) supports diverse research initiatives related to type 1 diabetes by providing critical funding to early-career scientists. Learn more about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org

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Pancreatic Cells

Wisp1 is a Circulating Factor that Stimulates Proliferation of Adult Mouse and Human Beta Cells

The destruction of insulin-producing beta-cells is a known cause of type 1 diabetes. Still, researchers continue to investigate exactly what triggers this cell death and how to control or reverse it. In addition, they have been searching for an effective way to reintroduce or restimulate the production of pancreatic cells with long-term survival rates, a challenging undertaking.

One component of this task is understanding how and when beta cells replicate. A recent study found that Wisp1, a matricellular protein that is part of the CCN protein family, may play an important role. This protein is found in higher levels in pre-weaning mice than adult mice, and the same is true in humans, where Wisp1 is more abundant in young children than in adults. It is especially prevalent in bone tissue.

Scientists have found that beta cell replication is most active in the early postnatal weeks and declines with age. After introducing serum Wisp1 in adult mice as well as human islets, beta-cell proliferation increased. In addition, Akt levels also increased. Akt activation is known to play a role in insulin/IGF signaling, contributing to beta-cell growth regulation. There is a potential that Wisp1 and Akt may work synergistically in the body when it comes to proliferating beta cells.

It is important to note that the study did not find a direct correlation between the circulation of Wisp1 and pancreatic cells’ production. Researchers note that, “Our study identifies Wisp1 as a circulating protein that is abundant in young blood and induces proliferation of adult beta cells, thus revealing Wisp1 as an agent with potential therapeutic use to expand beta beta-cell in diabetes.”

Additional research is needed to determine how circulating factors may potentially be used as therapeutic agents when it comes to beta-cell proliferation and the treatment of diabetes. This study opens doors to new research opportunities.

The Diabetes Research Connection (DRC) is interested in seeing how Wisp1 may impact future studies regarding type 1 diabetes treatment. To support the advancement of diabetes-related research, the DRC provides funding to early-career scientists so that they may pursue innovative peer-reviewed projects. Learn more about current projects and how to support these efforts by visiting 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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Increased Risk of Illness Severity and Hospitalization from COVID-19 in Patients with Type 1 Diabetes

Increased Risk of Illness Severity and Hospitalization from COVID-19 in Patients with Type 1 Diabetes

Dear Members of the DRC Family,

The attached article, to be published in print in Diabetes Care, concludes type 1 (and type 2) diabetes, independently increase the adverse impacts of COVID-19.

Potentially modifiable factors (e.g., HbA1c) had a significant, but modest, impact compared with comparatively static factors (e.g., race and insurance) in type 1 diabetes, indicating an urgent and continued need to mitigate severe acute respiratory syndrome coronavirus 2 infection risk in our community.

We encourage you to discuss, with your health care provider, prioritizing vaccination of family members who have diabetes. These statistics are compelling.

Wishing you the best of health,

DW Sig.

David Winkler
Chair, Co-Founder and Chief Financial Officer, Diabetes Research Connection

 

Please Click HERE To View the Full Article

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Islet Cells

Improvements for the Islet Cell Transplant are Achieved with the Fusion of Islet Cells and Functional Blood Vessels

One area of research that scientists have focused on treating and potentially curing type 1 diabetes is islet cell transplant. Introducing new insulin-producing islet cells into the body aims to stimulate these cells’ continued production and survival to achieve normoglycemia.

However, a major challenge is ensuring proper revascularization of islet cells. Without this vascularization and the exchange of blood and oxygen, the cells die. Up to this point, scientists have struggled to create these vascular networks quickly enough to make islet cell transplant a viable and lasting option.

recent study seeks to overcome this obstacle by prevascularizing islet organoids before transplanting them. Rather than combining pancreatic islet cells (PI) with epithelial and endothelial cells alone, scientists paired them with microvascular fragments or MVF. The PI cells are combined with MVF, then covered in a liquid overlay, and cultivated for five days.

As a result, the islet organoids form a dense microvascular network that, when transplanted into diabetic mice, can quickly attach to existing vascular structures. Therefore, the islet organoid improves not only its vascularization but its viability and functionality as well. In mouse models, normoglycemia was restored within just seven days following transplant. Transplanting freshly isolated islets alone without MVF did not produce these same results.

This improved vascularization may help reduce reactive oxygen species (ROS) and hypoxic stress. High levels of hypoxic stress can reduce cell viability and function. Due to the rapid vascular connections made by prevascularizing the islet organoids, there is less cellular stress and risk of cell death.

This study marks a notable advancement in islet cell transplant potential. More research needs to be done when it comes to the viability of quickly producing uniform prevascularized islet organoids and assessing their performance in human tissue. But it is a step in the right direction toward achieving long-term normoglycemia in patients with type 1 diabetes without relying on insulin injections.

The Diabetes Research Connection (DRC) is interested in seeing how this study progresses and what it could mean for the future of islet cell transplant procedures and treating type 1 diabetes. Though not involved with this study, the DRC supports early-career scientists in pursuing novel research around type 1 diabetes by providing critical funding. To learn more about current projects and how to support these efforts, visit https://diabetesresearchconnection.org

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Is Type 1 Diabates Reversible

A Precision Medicine Initiative Has Aided a Case, Answering – Is Type 1 Diabetes Reversible?

 

*Please be advised that this is not an article stating that any type one diabetic’s diabetes can be reversed. In the case of this article, it is in reference to individuals with the STAT1 gene mutation* 

Upon receiving a type 1 diabetes diagnosis, a common question comes to mind for many patients and families: is type 1 diabetes reversible? Until now, the answer has been no. Several treatment options can be used to effectively manage the disease and keep blood sugar levels in check, but no solution that supports long-term independence from insulin.

That could be changing for some patients through a precision medicine initiative.

Typically, treatments are designed for the average patient who fits a general profile of a disease. It tends to be a ‘one-size-fits-all’ approach. But with precision medicine, treatment is tailored to specific subgroups that don’t fit the ‘average’ mold. It takes into consideration differences in genetics, environment, and lifestyle.

recent study found that there is the potential that type 1 diabetes is reversible, at least in some cases. A precision medicine initiative tailored treatment for a 17-year-old male who had both T1D and recurrent respiratory infections. Researchers found that the patient had a genetic mutation in the STAT1 gene. When STAT1 protein activity is elevated, it is known to contribute to autoimmune disorders and respiratory infections.

The patient was treated with ruxolitinib, a therapy that inhibits Jak/STAT signaling. After undergoing precision medicine treatment for a year using ruxolitinib, he no longer required daily insulin injections in order to control his blood sugar levels. His body was able to maintain normal levels on its own.

Since this is a single case and there is not yet any long-term data available regarding whether the treatment will continue to work, researchers cannot, however, definitively answer the question of “is type 1 diabetes reversible?” But at this moment, for this patient, the answer is yes.

According to Dr. Sophia Ebenezer, a lead author on the study and assistant professor of pediatric endocrinology at Baylor and Texas Children’s, “The patient no longer needs daily insulin injections and has shown full remission of other clinical signs of T1D along with marked improvements in his quality of life.”

This study opens doors to treating other patients with STAT1 gene mutations with ruxolitinib therapy in an effort to reverse type 1 diabetes. It also emphasizes the ability of precision medicine initiatives to revolutionize healthcare. No two patients are the same, and differentiation among treatment can impact outcomes for the better.

The Diabetes Research Connection, though not involved with this study, is committed to helping advance understanding and treatment of type 1 diabetes. Early-career scientists receive critical funding to support novel, peer-reviewed studies focused on the disease. Learn more about current projects and 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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Exocrine Pancreas May Play Integral Role in T1D Development

For years, the focus of type 1 diabetes (T1D) research has been on the endocrine pancreas, as that is where the islets of Langerhans reside that secrete insulin, glucagon, and other hormones. The exocrine pancreas is primarily responsible for producing digestive enzymes, bicarbonate, and water to support digestion. However, researchers believe that autoreactive T cells within the exocrine pancreas may contribute to the destruction of insulin-producing beta cells.

recent study found that preproinsulin (PPI)-reactive CD8+ T cells exist not only within the endocrine pancreas but in the exocrine pancreas as well. While researchers know that these cells exist at high levels in individuals with T1D, they have found that they are also reasonably populous in healthy individuals. It may be possible that in healthy individuals without T1D and those who are not autoantibody-positive (aab+), that these PPI-reactive CD8+ T cells remain undetectable to the immune system, thereby causing no negative response.

If the body should experience an up-regulation of major histocompatibility complex (MHC) class 1, this could trigger a reaction where CD8+ T cells become visible and initiate an immune response leading to the destruction of pancreatic islet cells. In turn, this could result in the development of T1D.

Researchers studied various islet areas of the human pancreas and found that donors with T1D had a greater number of PPI-reactive CD8+ T cells than nondiabetic and aab- donors, but that the cells were present in all donors. The presence becomes more abundant as T1D develops. There were also more PPI-reactive CD8+ T cells in areas close to the islets, as well as within insulin-containing islet (ICI) areas. There were fewer cells in insulin-deficient islet (IDI) areas, which indicates that insulin plays an important role in attracting PPI-specific CD8+ T cells.

According to the researchers’ findings, defective thymic selection, and the failure of systemic peripheral tolerance mechanisms may not be the primary drivers behind the development of T1D. Instead, they note that “it is likely that events leading to islet attraction of autoreactive CD8+ T cells already within the pancreas may be a crucial mechanism in T1D development.”

More research is necessary to determine why the exocrine pancreas contains so many PPI-specific CD8+ T cells and exactly how they are triggered in the development of T1D. However, this recent study sheds more light on changes within the pancreas and responses from the immune system that are involved in this disease. Scientists can continue building on these findings moving forward.

Though not involved with this study, the Diabetes Research Connection (DRC) strives to continue advancing research around T1D by providing critical funding to early-career scientists. Contributions from individuals, corporations, and foundations make it possible for scientists to carry out novel, peer-reviewed studies focused on improving diagnosis, treatment, and management of T1D, as well as one day finding a cure. To learn more about current projects and how to support these efforts, visit https://diabetesresearchconnection.org

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Gestational Diabetes Complications

Gestational Diabetes Complications Identify Fertile Women at Risk of Permanent Type 1 and Type 2 Diabetes

During pregnancy, women are tested for gestational diabetes mellitus (GDM) to manage their overall health. Gestational diabetes complications can put both women and their babies at risk if not properly managed. While this type of diabetes typically resolves after childbirth, one study found that the condition may help identify women at risk for diabetes – either type 1 or type 2 – in the future.

study involving 435 Finnish women who had GDM were compared to a control group of healthy women who were pair-matched for age, parity, delivery date, and no previous history of diabetes. The data was collected over ten years between 1984 and 1994. Researchers found that women who developed GDM were at increased risk of developing type 1 or type 2 diabetes if their GDM required insulin treatment, and they had at least one autoantibody. The more autoantibodies they had, whether islet cell autoantibodies (ICAs), GAD antibodies (GADA), insulin autoantibodies (IAAs), or the protein tyrosine phosphatase-related protein 2 molecule (IA-2As), the more at risk for diabetes.

Out of the 435 women diagnosed with GDM, 20 developed type 1 diabetes (T1D), and 23 developed type 2 diabetes (T2D), while none of the women in the control group developed either type of diabetes. In addition, the women who developed type 1 diabetes were younger than those who developed type 2 diabetes at the time of initial blood sampling and had a shorter diabetes-free period. A follow-up survey to determine whether type 1 or type 2 diabetes occurred was completed an average of about 6 years after they had GDM.

In total, 155 women with GDM required insulin therapy to treat their condition, and that included 18 of the 20 women who later developed T1D and 18 of the 23 women who developed T2D. Interestingly, almost equal percentages of women treated with insulin and those who were not, 16.7% and 16.9% respectively, had reactivity to at least one autoantibody. Overall, the positive predictive value of autoantibodies was higher in women with GDM than in the control group, with a greater number of autoantibodies occurring in those who went on to be diagnosed with T1D or T2D.

This study shows how GDM may indicate an increased risk of impaired glucose tolerance or destruction of insulin-producing beta cells, leading to T2D and T1D. According to the researchers, “The risk of developing type 1 diabetes after GDM is increased if the woman is ≤30 years of age during pregnancy, needs insulin therapy for GDM, and tests positive for ICAs and/or GADAs.” Some discrepancy in results could be due to other gestational diabetes complications that were not included in the study. In general, if a woman fits within these criteria, it may be beneficial to continue closely monitoring her health after pregnancy to detect diabetes early on.

It is these types of studies that help improve understanding of diabetes risk and early detection. The Diabetes Research Connection (DRC), though not involved in this study, supports type 1 diabetes research by providing critical funding to early-career scientists. One hundred percent of funds go directly to scientists for their projects. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org.

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Hayden

Kraemer Family Update

Remember Hayden!? His story was featured in our 2019 organizational film, “Connect for a Cure,” which debuted at our 2nd annual Del Mar Dance for Diabetes. In this impactful interview, when asked if he believes a cure will be found for him, Hayden responded, “No, probably not when I’m around.” 

Many of our supporters and community members have been asking how are Hayden and his family doing? We received an exciting update to share with everyone. Hayden is now 9 1/2 years old and in 4th grade doing distance learning. He’s doing good but missing regular in-person schooling. His diabetes is managed reasonably well, and his parents have been giving him more responsibility to take care of it. 

During National Diabetes Awareness Month, Hayden’s family, creators of I’m Greater Than, a clothing company that was launched after Hayden was diagnosed, engaged in a daily social media challenge. Hayden’s mom, Jenn, shared facts and statistics to raise awareness of this autoimmune disease. In one post, she shared, “This diagnosis changes your views, your ambitions, your path, your whole life. Our family is closer than ever, and although we will not let this diagnosis define us, we have embraced it and will fight it every day.”

This inspiring family also opened the doors to a new restaurant in Beaumont, CA, called Batter Rebellion. If you live close, stop by and try one of their “ROCKtails” or feast on one of their decadent menu items!

 

Kraemer Family

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DRC 2020 Virtual Events

DRC’s 2020 Virtual Events

It is safe to say that 2020 has been unlike any other year. That being said, DRC’s goal for this year has been to find new ways to connect with our community. DRC has had several virtual gatherings ranging from research updates to DRC’s 3rd Annual Dance for Diabetes. If you would like to view them, they will be posted below in order of the date that they took place.

Reducing Stress in Times of Uncertainty with Felise Levine Ph.D. 4/28/2020: View it Here.

Exciting Update on Type 1 Diabetes (T1D) Research with Vincenzo Cirulli Ph.D. 5/19/2020: View it Here. 

Ask Me Anything: Dr. Moore and the Long Road of Type 1 Diabetes (T1D) Care and Discovery with Daniel Moore Ph.D. 6/23/2020: View it Here.

Beyond Stem Cells: A New Paradigm for Regenerative Medicine with Duc Dong Ph.D. 7/14/2020: View it Here.

DRC’s 3rd Annual Dance for Diabetes Virtual Party: View it Here.

Preserving Retinal Cells Survival with Anne Hanneken M.D. and Frans Vinberg Ph.D. 11/10/2020: View it Here.

 

Although this has been an interesting year, we continue to find creative ways to connect with our community. We are looking forward to 2021 and having these exciting updates and events in person!

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DRC Happy Hour with KSON

DRC Happy Hour with KSON’s John and Tammy

On Thursday, November 12th, DRC had the opportunity to have a happy hour with John and Tammy, the hosts of KSON, about type one diabetes (T1D) and DRC’s mission in honor of World Diabetes Day on Saturday, November 14th. During the happy hour, Sherry Ahern, a dedicated member of the DRC community and the mother of a T1D, Casey Davis, the Interim Executive Director of DRC, and Hannah Gebauer, the Development Assistant at DRC and a T1D, shared the importance of research towards a cure, prevention, and reducing of complications that come from this autoimmune disease.

Listen to a clip from KSON’s show the day after the happy hour took place that features some of the powerful stories that were shared that night:

 

If you would like to watch the whole happy hour, click here.

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Diabetes Awareness Month is Personal for Me

It was 1964 and I was a 15 year old  junior in High School, riding home on the subway on a beautiful November day in New York.  Looking for something to occupy my mind I began to read the subway posters.  My eyes caught one poster that read in bold red letters, “IF YOU HAVE THESE SYMPTOMS, YOU MAY HAVE DIABETES.”   I continued to read down the checklist on the poster: Excessive thirst, frequent urination, loss of appetite, weight loss, fatigue.  I silently checked each symptom.

That past summer, my mother had been bugging me about going to the doctor because she was concerned about my drinking too much water.  I brushed off her concerns citing the hot weather. I had excuses for my weight loss as well.  In fact, I had excuses for all of her concerns, claiming in my assertive teenage voice that,  “I was the expert on my own body.”

When I arrived home, I told my mother about the subway poster and that I thought I had diabetes.  We were at the doctor’s office the next day.  This November marks 56 years of living with T1.

“Diabetes Awareness Month is Personal for Me” was written by Felise Levine, Ph.D. She serves on Diabetes Research Connection’s Board of Directors. She is a retired licensed Clinical Psychologist in private practice in La Jolla. She is a past President of Del Mar Community Connections and Past President of the San Diego Psychological Association. She has been living with type 1 diabetes for 56 years.
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DRC’s Co-Founders Interviewed on “Living Better San Diego”

In honor of World Diabetes Day, DRC’s co-founders, David Winkler and Alberto Hayek, MD, were interviewed by Vicki Pepper of “Living Better in San Diego.” This show features Information and interviews with San Diego newsmakers, community leaders, and citizens. In this interview, David and Alberto discuss DRC’s unique approach to funding research for type one diabetes.

You can access this interview by clicking here.

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Connect For A Cure: November 2020 Newsletter

DRC has distributed over $400,000 to research projects like Dr. Hughes’s and Dr. Racine’s in 2020 alone! We have received three times the average amount of applications for funding of new projects over the past couple of months. View our “Support a Project” page to see what other research projects we are currently funding by clicking here. Take a look at our newsletter to see how great DRC’s 3rd Annual Dance for Diabetes Virtual Party was! Thank you to everyone who participated and donated to the event, DRC could not do what it does without the generous support of its donors and community.

Click this link to view our November newsletter that we mailed out previously this month about what we’ve been up to and the impact we are making together. It takes a community to connect for a cure!

 

 

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Covid/Diabetes

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.

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

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Researcher

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.

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

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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

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you

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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.

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

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Genetics in T1D

Digging Deeper into the Role of Genetics in Type 1 Diabetes

Type 1 diabetes is a complex disease. While researchers know what it does to the body, they are still unclear on exactly why this happen and what triggers this response. Advances in genetic testing have led scientists to identify more than 50 genome regions that may be associated with type 1 diabetes. It is clear that there is not a single gene responsible for this disease, but rather many that all play a part.

In addition, researchers have determined that genetics are not the sole determinant of whether an individual develops type 1 diabetes (T1D); environmental factors are also responsible. This makes it even more challenging to pinpoint what causes T1D and who is most at risk. However, the more scientists understand about both the genetic and environmental causes, the closer they can get to potentially preventing the disease. This is critical because there has been a nearly 30% increase in Americans diagnosed with T1D since 2017 according to the CDC’s National Diabetes Statistics Report.

Type 1 diabetes can run in families, and having a first-degree family member with the disease can put individuals at greater risk. Researchers have identified two genes in particular that are of interest – HLA-DRB1 and HLA-DQB1 – which are both located on the human leukocyte antigen (HLA) complex on chromosome 6p21. Individuals who have both of these genes account for about 40% of T1D cases, but just because someone has both genes does not necessarily mean they will develop T1D. Likewise, there are many people who do not have these two genes who go on to be diagnosed with the disease. In twin studies, if one twin had T1D, only about 50% of co-twins developed it as well, demonstrating that it is not solely genetic (nor solely environmental).

Another interesting finding was that children were at greater risk of islet autoimmunity if their father or a sibling had T1D, as opposed to if their mother had it. Furthermore, the study showed that “children with a second-degree relative with type 2 diabetes showed significantly delayed progression from islet autoimmunity to clinical type 1 diabetes vs. children without such relatives.” This data was collected through The Environmental Determinants of Diabetes in the Young (TEDDY) study, which includes children from the United States, Finland, Germany, and Sweden.

These types of studies have made researchers re-evaluate the potential risk factors for the disease and how to effectively predict susceptibility. They have been trying to fine-tune an approved genetic risk score assessment to include more recent data regarding islet autoantibodies, age, and metabolic factors used to track disease progression. Calculating a genetic risk score that encompasses many different pieces of information and parameters may help researchers improve predictive modeling. In turn, this may help with prevention efforts.

There are a lot of different factors that may contribute to the development of T1D, and all of this has helped researchers generate more focused studies to support prevention. The Diabetes Research Connection (DRC) has raised funds for numerous early-career scientists pursuing research in this area, but more funding and research are needed to keep moving forward. As new cases of type 1 diabetes continue to rise, there has been a greater push for prediction and prevention efforts. Learn more about current DRC projects and how to help by visiting https://diabetesresearchconnection.org.

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

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Gut Microbiome

Examining Gut Microbiome Differences

The composition of gut bacteria – both good and bad – differs in everyone. Each person has their own makeup dependent upon diet, environment, geographical location, and other factors. In an effort to better understand potential risk factors for type 1 diabetes, researchers are taking a closer look at the role gut microbiomes may play.

The way that the body responds to various bacteria may influence autoimmune responses such as the one that triggers the destruction of insulin-producing beta cells and leads to the development of type 1 diabetes (T1D). According to researchers, “gut microbiota functions like an endocrine organ.” This organ-like structure is one that scientists still have a lot to learn about.

A recent study compared the gut microbiomes of 31 children who had recently been diagnosed with T1D and 25 healthy controls without the disease. None of the participants had gastrointestinal issues or had taken probiotics or antibiotics within one month prior to the study. A brief medical history was taken in addition to measuring C peptide levels. The control group provided fecal samples as well.

Data were analyzed using the MicrobiomeAnalyst tool in combination with two machine learning algorithms. The results showed that the children who had been recently diagnosed with T1D had “significantly higher relative abundance” of seven key taxa compared to the healthy children. In addition, the relative abundance of 5 other taxa was notably lower than in the control group. There was also a negative correlation between multiple taxa and the presence of anti-insulin autoantibodies.

Overall, the researchers determined that “our data showed that controls had higher alpha diversity than children with T1D.” However, it is important to note that they also concluded that “it is currently not possible to clearly state if gut microbiota diversity represents a cause or a consequence of autoimmunity in patients with T1D.” More research is necessary to determine if controlling or altering gut microbiota may be an effective method of preventing or treating T1D.

Studies like these are essential for building a stronger understanding of how T1D may develop, as well as how it impacts the body. Prevention is an area of interest that continues to grow and where more funding is needed. Though not involved with this study, the Diabetes Research Connection (DRC) provides critical funding to a wide range of projects led by early-career scientists, including those focused on prevention. It will continue to allocate donations to this area as well as others related to the treatment, management, and cure of type 1 diabetes. Learn more about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org.

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

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Nanoparticles

Leveraging Nanoparticles in Diagnosing and Treating Type 1 Diabetes

Leveraging Nanoparticles in Diagnosing and Treating Type 1 Diabetes

Medical technology has seen significant advancements over the years helping to improve healthcare in many ways. An area of recent focus has been nanotechnology. Researchers have been exploring opportunities to use nanomedicine to expand upon current diagnosis and treatment options for type 1 diabetes, which affects millions of people around the world.

For instance, scientists know that a key marker for type 1 diabetes (T1D) is the destruction of insulin-producing beta cells. But oftentimes these cellular changes are not noticed until they become severe enough that symptoms of high blood sugar are apparent. Being able to identify biomarkers earlier can improve the diagnosis of the disease and allow patients to receive treatment sooner.

A recent study examines the use of nanoparticles to support the diagnosis of T1D as well as treatment options. Pairing the nanoparticle ferumoxytol with current magnetic resonance imaging (MRI) technology may enable healthcare providers to better visualize where there is inflammation within pancreatic islets. These nanoparticles readily accumulate in inflamed islets but then are safely metabolized by the body without any harmful side effects. Inflammation is an early sign of the development of T1D.

In addition, nanoparticles can also be loaded up with various substances such as peptides and injected to specific locations to target key processes like the downregulation of immune cells. This may help slow or prevent the destruction of insulin-producing beta cells. Or, nanotechnology could be used to encapsulate cells or molecules with bioparticles to ward off immune system attacks.

While more research is necessary, there is a great deal of opportunity that may exist for using nanotechnology and nanoparticles in healthcare. It could one day open new doors for the diagnosis and treatment of conditions such as type 1 diabetes or improve existing therapies.

Funding research around T1D is vital. Diabetes Research Connection (DRC) is committed to providing early-career scientists with funding to support novel research studies focused on prevention and management of the disease as well as improving quality of life and reducing complications of T1D. Learn more about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org.

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Beta Cells

Enhancing Protection of Insulin-Producing Beta-Cells

Enhancing Protection of Insulin-Producing Beta-Cells

Insulin-producing beta-cells play a critical role in managing blood sugar by automatically releasing insulin in response to increased blood glucose levels. In individuals with type 1 diabetes, the immune system mistakenly attacks and destroys these cells, leaving blood sugar unchecked. Since the body no longer produces insulin on its own, individuals must regulate this process, often with the help of continuous glucose monitors, insulin pumps, and other devices.

For years, researchers have been trying to better understand why the immune system attacks these beta-cells and how they can prevent this process from occurring. A recent study found that the enzyme renalase may play a role. Stress is a key factor in cell destruction, and by inhibiting renalase, cells have greater protection against the effects of endoplasmic reticulum (ER) stress. This inhibiting may help enhance the survival of transplanted pancreatic beta-cells in the treatment of type 1 diabetes, and it may have the ability to help slow progression of the disease at its onset.

Researchers tested these processes on non-obese diabetic (NOD) mouse models as well as human cells. In the mice, the beta-cells that had the functionality of renalase disabled survived better against immune system attacks than fully functional beta-cells. In addition, certain T-cells were less likely to attack the pancreatic beta-cells without renalase function. The same results held true for human cells; they were better protected against ER stress.

Furthermore, the researchers found that there was already an FDA-approved drug that targets an enzyme similar to renalase and is used to treat hypertension called pargyline. They tested pargyline in a small clinical trial to evaluate its effects on pancreatic beta-cells and whether or not it could protect them against ER stress. Their results showed that it had a protective effect on both mouse models and human cells. The next step is to test the drug in human clinical trials.

More research and testing are needed to determine whether this drug could be used to protect against or slow the progression of type 1 diabetes or be used as the starting block for developing a new drug that specifically targets renalase. However, this is a step in the right direction toward improving prevention methods for type 1 diabetes.

Many studies are focused on treatment or potential cures for type 1 diabetes, but more funding is necessary for prevention efforts like the one above. The Diabetes Research Connection, though not involved with this study, supports research across all aspects of type 1 diabetes, including prevention. There are several current projects led by early-career scientists focused on disrupting the onset of T1Dblocking processes that contribute to the development of the disease, and preserving insulin secretion, which can potentially impact prevention efforts if fully funded. Learn more about these projects and how to help by visiting https://diabetesresearchconnection.org.

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Dr. Quandt

Detecting Diabetic Retinopathy Using Artificial Intelligence

Detecting Diabetic Retinopathy Using Artificial Intelligence

Managing blood sugar is not the only challenge that individuals with type 1 diabetes (T1D) face. There can be numerous complications that arise from the disease including conditions such as nerve damage, kidney damage, and eye damage. Diabetic retinopathy – or damage to the retinas – is caused by high blood sugar levels, which can weaken blood vessels and cause them to leak or bleed. If left untreated, it can lead to sight loss or even blindness.

To help prevent vision problems, individuals with T1D are encouraged to have a comprehensive dilated eye exam every year to check for issues. One of the challenges that healthcare systems experience is keeping up with evaluating each scan because it comes with a heavy human workload. However, a recent study in the United Kingdom may have found a way to significantly speed up the process without sacrificing the quality of results.

Researchers explored the possibility of using artificial intelligence (AI) to screen images for signs of damage. The screening technology, called EyeArt, was used to assess 120,000 images collected from 30,000 patient scans as part of the Diabetic Eye Screening Programme (DESP). According to the study, “The results showed that the technology has 95.7% accuracy for detecting damage that would require referral to specialist services, but 100% accuracy for moderate to severe retinopathy or serious disease that could lead to vision loss.”

Projections estimate that using AI screening technology could save the National Health Service (NHS) more than £10 million every year on more than 2.2 million screening episodes. It would greatly decrease the demand for human grading of scans and save time. This technology has the ability to be used outside of England as well, resulting in even more cost savings and the opportunity to reduce resource demands while also helping to protect the vision of millions of individuals with T1D. Diabetic retinopathy is treatable if caught early.

The current coronavirus pandemic has caused a backlog in cases, but AI has the potential to help healthcare providers catch up and continue providing quality care to reduce vision loss from diabetes. The technology was independently tested using more than 120,000 real-world patient images, helping to validate its effectiveness and benefits.

Individuals with T1D must be vigilant about their health and undergoing regular screenings to check for potential complications or issues. The use of artificial intelligence is one more way to enhance the quality and efficiency of testing and promote better health. Diabetes Research Connection (DRC) is interested to see how this study evolves, and if more countries will follow suit when it comes to using AI to grade diabetic eye screening images.

It is these types of advancements that help grow our understanding of type 1 diabetes and improve how this condition is treated and managed. The DRC supports these efforts by providing critical funding to early-career scientists pursuing novel research studies focused on T1D. One hundred percent of donations go to the scientists. To learn more about current projects and how to help, visit https://diabetesresearchconnection.org.

Please DONATE NOW so DRC can keep bringing you credible, peer-reviewed T1D news and research.

Thank you

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Detecting Diabetic Retinopathy Using AI

Enhancing Quality of Life and Time-in-Range Through Automated Insulin Delivery Systems

Automated Insulin Delivery Systems

Type 1 diabetes (T1D) is a condition that must be managed 24 hours a day, seven days a week, 365 days a year. Even with careful management, it can be difficult for patients to stay in range, especially overnight. Many individuals with T1D are awoken during the night by alarms from continuous glucose monitors (CGMs) or other devices because their blood sugar is rising (or dropping) to unsafe levels. That means they must wake up and be alert enough to administer the correct amount of insulin without overtreating.

However, several recent studies have found that the use of automated insulin delivery systems such as hybrid closed-loop systems may help patients better manage their blood glucose levels and reduce the risk of hypoglycemia and hyperglycemia. There are several companies testing out these types of systems, including Medtronic and Insulet.

With a hybrid closed-loop system, individuals spend less time manually controlling their diabetes management. A sensor tracks their blood glucose levels (or the sensor glucose levels), and then an insulin pump responds and doses an appropriate amount of insulin as needed. This takes a lot of the stress and burden off of individuals, especially overnight.

Studies have shown that these automated systems have also helped individuals increase their time spent in range. A trial involving 157 participants with T1D between the ages of 14 and 75 showed that overall average time-in-range increased from 54% to 73% when using Medtronic’s MiniMed advanced hybrid closed loop (AHCL) system. For even better control, the system has auto basal and auto bolus correction capabilities.

Another Medtronic study comparing 670G and AHCL use in 111 participants between the ages of 14 and 29 showed an increase in time-in-range from 12% to 22% for the 670G and to 32% for the AHCL system. Other automated insulin delivery systems showed similar results.

These findings are encouraging for youth and young adults who often have a harder time maintaining glycemic control. They are able to sleep better at night knowing their blood sugar is being automatically monitored and managed and not having alarms waking them up as often. Even during the day, they can focus more on other activities and less on constantly monitoring their diabetes. The longer individuals wear AHCL devices, they are often able to stay in auto-mode for longer periods of time and require less manual correction.

Technology has come a long way in supporting T1D management, and the Diabetes Research Connection (DRC) is excited to see how much further it goes. As scientists learn more about the disease and are able to fine-tune sensors and algorithms for tracking and managing blood sugar levels and insulin administration, it can lead to a higher quality of life and improved health for individuals living with type 1 diabetes.

The DRC supports early-career scientists in pursuing novel research studies related to T1D by providing critical funding. This helps to keep science moving forward and one day find a cure. To learn more about current projects and how to support these efforts, visit https://diabetesresearchconnection.org.

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Managing type 1 diabetes

Speeding Up Insulin Activation for Managing Type 1 Diabetes

Speeding Up Insulin Activation for Managing Type 1 Diabetes

Individuals with type 1 diabetes (T1D) rely on daily insulin injections to effectively manage blood sugar levels and maintain glycemic control. Because blood sugar rises when eating, fast-acting (or rapid-acting) insulin is typically administered just before mealtimes to help curb this spike and begin lowering blood sugar more quickly.

Fast-acting insulin generally begins working within about 15 minutes, peaks within about 90 minutes, and lasts about four hours total. Of course, each person responds differently, and the effects can vary based on numerous factors including the amount of carbohydrates eaten, blood glucose level before eating, injection site, activity, and more.

Researchers have been searching for a way to expedite this process by activating insulin more quickly. Traditional insulin contains a combination of monomers, dimers, and hexamers, with monomers acting the fastest and hexamers taking the longest to break down. A recent study found that using monomeric insulin alone can start decreasing blood glucose levels almost immediately.

The biggest challenge is that these monomers are very unstable and are attracted to the top of the liquid in the vial. Once they hit the air, they aggregate within two hours and become inactive. By using a special polymer blend, scientists were able to create a barrier at the liquid’s surface and keep the monomeric insulin more stable, lasting for more than 24 hours under stress. Commercial insulin only remains stable for about 10 hours. With the addition of the polymer, even commercial insulin increased its duration of stability for up to a month.

The effectiveness of this ultrafast insulin was tested on diabetic pigs, and results showed that the “insulin reached 90 percent of its peak activity within five minutes after the insulin injection. For comparison, the commercial fast-acting insulin began showing significant activity only after 10 minutes. Furthermore, the monomeric insulin activity peaked at about 10 minutes while the commercial insulin required 25 minutes.”

Researchers are planning to apply for approval to test this ultrafast monomeric insulin in human clinical trials, but no trials are planned as of yet. The speed at which this insulin formulation activates as well as the increased stability could improve blood sugar management options for individuals with type 1 diabetes. In addition, this type of insulin could be beneficial in advancing artificial pancreas devices.

Although more testing is needed, this ultrafast insulin could be a game-changer for some individuals with type 1 diabetes if it performs safely and effectively in human trials. Diabetes Research Connection (DRC) is excited to see how these findings continue to unfold and what it could mean for the future of diabetes management.

Though not involved with this study, the DRC plays an active role in supporting research around T1D by providing up to $50K in funding to early-career scientists pursuing novel, peer-reviewed research. To learn more about current projects and how to help, visit https://diabetesresearchconnection.org.

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Pancreatic samples

Extending the Viability of Pancreatic Samples for Diabetes Research

Extending the Viability of Pancreatic Samples for Diabetes Research

When conducting research, scientists often try to use living samples so they can better see how various functions play out or how treatments impact cells. However, it can be difficult to keep organ and tissue samples alive for multiple days and reduce deterioration.  This can limit research opportunities and real-time results.

In a recent study, researchers reveal that they have found a way to prolong the life of pancreatic samples from donors allowing them to more effectively observe how beta cells regenerate in real-time. By using a special device that increases oxygenation to the tissue slice, they were able to keep the pancreatic sample alive for nearly two weeks in culture.

With this extended viability, they were able to more closely see not only how beta cells regenerated, but also how they responded when treated with BMP-7, a natural growth factor that may help stimulate the production of insulin-producing beta cells. This could eventually impact scientists’ understanding of type 1 diabetes and options for treating or managing the disease.

Though not involved with this study, the Diabetes Research Connection (DRC) is also committed to enhancing research around type 1 diabetes, including improving prevention and treatment, minimizing complications, and one day finding a cure. The organization is excited to see how the extended preservation of tissue samples may advance research capabilities. To learn more about how the DRC supports early-career scientists and to review current projects, visit https://diabetesresearchconnection.org.

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Glycemic control in young people

Concerns About Glycemic Control Among Youth and Young Adults with Type 1 Diabetes

Glycemic Control Among Youth with Type 1 Diabetes

Scientists have come a long way in their understanding of type 1 diabetes and in not only treatments used to manage the disease, but also technology. From continuous glucose monitors and insulin pumps to smart apps, there is a lot of diabetic technology that exists to support patients. But that does not mean that all patients are taking advantage of it or necessarily have access.

In a recent study by SEARCH, individuals with type 1 diabetes between the ages of 10 and 24 showed poorer levels of glycemic control between 2014 and 2019 than the study cohort from 2002 to 2007, despite improvements in treatment and management options. The SEARCH study encompasses more than 20,000 participants from sites in California, Colorado, Ohio, South Carolina, and Washington.

This particular study evaluated data from 6,492 participants and divided them into cohorts from 2002 to 2007, 2008 to 2013, and 2014 to 2019. Information was also categorized based on the duration of diabetes and whether the participant had type 1 diabetes or type 2 diabetes, with the majority of participants having type 1. Researchers then analyzed HbA1c levels over time, adjusting data for “site, age, sex, race, health insurance status and disease duration, both overall and for each duration group.”

Although average HbA1c levels remained consistent across cohorts (8.7% for 2014-2019, 8.9% for 2008-2013, and 8.6% for 2002-2007), when broken down by individual age ranges, those between the ages of 10 and 24 had poorer glycemic control in 2014-2019 than in 2002-2007.

These findings highlight the need for improved access to and use of diabetic technology as well as other interventions to support youth and young adults in enhancing glycemic control. Maintaining tight glycemic control and staying within target ranges can help reduce potential complications from the disease and promote better health.

Diabetes Research Connection (DRC) is committed to advancing research related to T1D and improving prevention, treatment, and management efforts as well as one day finding a cure. Early-career scientists can receive up to $50K in funding to support their peer-reviewed, novel research studies. Learn more about current projects and how to donate by visiting https://diabetesresearchconnection.org.

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Islet grafts

Reducing the Need for Systemic Immunosuppression for Islet Grafts

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 the 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 the 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 by providing critical funding to early-career scientists pursuing 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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Diabetic Patients

Reducing COVID-19 Deaths and Other Complications for Patients Hospitalized with Diabetes

CGM Use In Hospitals

Covid-19 patients who have diabetes experience a higher mortality rate than the general population. A new protocol incorporates the use of continuous glucose monitors (CGM) to track and manage hospital patients’ blood glucose (BG) levels before problems arise. Monitoring and treating glucose levels is critical for patients with diabetes.

 

A clinical study conducted by Scripps Whittier Diabetes Institute (SWDI),  Glucose as the Fifth Vital Sign:  A Randomized Controlled Trial of Continuous Glucose Monitoring in a Non-ICU Setting, was led by the Scripps Whittier Diabetes Institute’s (SWDI) Addie Fortmann, Ph.D. with support from the Diabetes Research Connection (DRC).  The use of CGM in hospitals has the potential to enhance care, reduce the length of stays, and yield improved outcomes, as well as greater patient satisfaction. “The current pandemic environment has greatly accelerated the need to find safe and effective ways to monitor the blood sugar of hospitalized patients without interfering with the necessary and often intensive interventions to treat COVID-19,” said Addie Fortmann, Ph.D., director of the diabetes service line at Scripps and the lead author of the paper. “Our study clearly demonstrates the value of CGM in community hospitals, and it offers a model for other health systems that are looking to use this technology in similar ways.”

 

“DRC’s funding helped to enable Scripps to evaluate effects of CGM in a hospital in a study setting and use the experience to expedite deployment of this important glucose monitoring system when the FDA provided emergency use authorization (EUA) in March of this year,” according to Dr. Alberto Hayek, Scientific Advisor at SWDI, endocrinologist, former T1D researcher at SWDI and UCSD, and President and co-founder of DRC. When individuals are hospitalized, diabetes management is more difficult. Not only are patients dealing with the condition which brought them to the hospital, their blood sugar levels must be continuously monitored, which is very difficult if the patient is on a ventilator or is unconscious.

 

The U.K. National Health Service (NHS) recently published research concluded hospitalized individuals with type 1 diabetes (T1D) are significantly more likely to die from COVID-19 than those with type 2 diabetes (T2D). Preliminary findings, recently published in Diabetes Care, determined a third of people with T1D and COVID-19 in the U.S. experienced diabetic ketoacidosis, from elevated BG, and half experienced hypoglycemia (low BG). Both of these serious conditions can lead to death. Individuals with T1D typically do not produce insulin which presents serious challenges to managing inpatient BG.

 

“Tracking vital signs is routine in many hospitalized patients,” said Athena Philis-Tsimikas, M.D., corporate vice president of Scripps Whittier and the senior author of the report. “This study demonstrates that blood sugar should be considered the fifth vital sign for hospitalized diabetes patients, joining temperature, pulse, respiration and blood pressure, as a potentially crucial metric for delivering the highest quality care.”

A CGM uses a small sensor that is inserted under the skin. It sends a glucose reading via Bluetooth every five minutes to hospital staff so that they can track glucose levels and receive alerts when levels start to rise or fall out of the target range.

 

David Winkler, co-founder of DRC, Chair of the Board, has been living with this autoimmune disease for more than 60 years. He has experienced several challenging hospital stays himself and said, “I strongly endorse Scripps’ exciting new CGM protocol to lessen the serious concerns T1Ds experience in the hospital environment. I applaud Scripps for this material paradigm shift.”

 

The DRC is excited to see how this clinical research will influence hospital protocols nationally to provide enhanced care for patients with diabetes by better managing their blood glucose levels during a hospital stay.

 

Dr. Hayek added, “Our non-profit funds novel T1D research nationally. DRC’s 80 member Scientific Review Committee peer-reviews all grants, including this breakthrough clinical trial.”

 

To learn more about the T1D research projects supported by DRC and how this charity provides hope for treatment and cure of this disease, please visit https://DiabetesResearchConnection.org.

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Beta cell function

Advances in Maintaining Beta-Cell Function in Relation to Type 1 Diabetes

Maintaining Beta-Cell Function with T1D

In healthy individuals, pancreatic beta cells respond to glucose levels in the blood and automatically increase or decrease the production and release of insulin. This occurs without individuals ever knowing it happened. But in those with type 1 diabetes (T1D), the immune system mistakenly attacks and destroys insulin-producing beta cells leaving the body unable to naturally regulate blood sugar levels. Instead, individuals must do this on their own by continually monitoring their blood sugar and administering the appropriate amount of insulin via injection or an insulin pump.

However, in the early stages of type 1 diabetes, the pancreas continues to produce insulin, just not enough to keep blood sugar entirely under control. Eventually, this function ceases and individuals become insulin-dependent. Researchers have been investigating potential treatment options to preserve beta-cell function and slow the progression of type 1 diabetes.

A recent study found that the drug golimumab has shown positive results when used to treat individuals newly diagnosed with T1D. When administered every two weeks, this anti-tumor-necrosis-factor (TNF) therapy helped preserve beta-cell function and reduced the amount of additional insulin required by patients.

After 52 weeks of treatment, “41.1% of participants receiving golimumab had an increase or less than 5% decrease in C-peptide compared to only 10.7% in the placebo group.” C-peptide only measures the amount of insulin produced naturally by the pancreas, not injected insulin. Participants receiving the drug were able to maintain better blood sugar control with less insulin and also experienced a decrease in incidences of hypoglycemia where blood sugar was less than 54 mg/dL.

Another treatment that has shown potential is the combination of anti-interleukin (IL)-21 and liraglutide. Participants were randomly assigned to one of four groups: anti-IL-21, liraglutide, anti-IL-21 and liraglutide, or a placebo. Anti-IL-21 targets IL-21-mediated inflammation while liraglutide may reduce cell stress and apoptotic cell death. Treatment was administered every six weeks for 54 weeks.

At the end of the trial, those participants who received the combination treatment showed statistically better beta-cell function than those receiving only liraglutide or the placebo. Beta-cell function was nonsignificant when compared to those receiving only anti-IL-21. In addition, results showed that “combination therapy resulted in the lowest on-treatment glucose levels, although this was not statistically significant, and a significant 32% reduction in insulin dose relative to placebo.”

A third treatment of note was the use of ladarixin, a CXCR1/2 inhibitor that blocks IL-8. Although this therapy did not slow beta-cell function decline during the three-month trial period, it did achieve a statistically significant decline after six months. However, these effects had disappeared again by 12 months. But individuals taking ladarixin did experience better HbA1c levels than those in the placebo group. More research is needed on potential uses and effectiveness of ladarixin.

In addition, researchers also conducted a study involving individuals who were not yet diagnosed with T1D, but who were at high risk due to family history and the presence of at least two autoantibodies. They wanted to see if they could preserve beta-cell function and delay onset of T1D through the use of an Fc receptor-nonbinding anti-CD3 monoclonal antibody called teplizumab.

In this trial, 44 participants received teplizumab, and 32 received a placebo. Treatment was administered for 14 days. The results showed that “the medium time to the diagnosis of type 1 diabetes was 48.4 months in the teplizumab group and 24.4 months in the placebo group.” Overall, T1D was eventually diagnosed in 43% of the teplizumab group and 72% of the placebo group, demonstrating that the treatment may have helped slow the progression of the disease and preserve beta-cell function in individuals at high risk of developing T1D.

All of these therapies are continuing to undergo research to determine their effectiveness and potential use in delaying or preventing the onset of T1D. Diabetes Research Connection (DRC) is dedicated to ensuring that this type of work continues and provides critical funding to early-career scientists pursuing novel, peer-reviewed studies related to type 1 diabetes. Dr. Kevan Herold, a Yale researcher and member of the DRC’s scientific review committee (SRC), was involved in the study regarding teplizumab. Learn more about how the DRC supports scientists and current research projects by visiting https://diabetesresearchconnection.org.

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CGM's

Evaluating the Benefits of Continuous Glucose Monitor Use

Benefits of CGM Use

Individuals with type 1 diabetes (T1D) have multiple options for managing their blood sugar, ranging from traditional finger sticks and insulin injections to continuous glucose monitors (CGM) and insulin pumps. Scientists are also continuing to work on more advanced technology including artificial pancreas systems.

CGMs are a popular device for individuals with T1D because they automatically measure and track blood glucose levels and send alerts when they begin to rise or fall too far. They tend to be worn most often by young children and adults ages 26 to 50. However, there are barriers to access for these devices including eligibility requirements and insurance coverage. Furthermore, not all primary care providers are well-versed in how to effectively manage care using these systems.

But recent studies show that CGMs may be especially beneficial for the groups that tend to wear them the least – teens and young adults, and older adults. When these devices are consistently used, they can help to improve glycemic control and reduce instances of hypoglycemia. These factors are essential for continued well-being.

One study followed a group of 153 adolescents and young adults between the ages of 14 and 24 for 26 weeks, then followed up at one year. All of the participants had HbA1c levels of at least 7.5% but not more than 11.0%. The control group contained 79 individuals who did not wear a CGM and conducted finger sticks four times per day to measure their blood glucose levels. The test group contained 74 individuals who wore a CGM and conducted finger sticks twice per day.

At the end of 26 weeks, HbA1c levels for the CGM group dropped from 8.9% to 8.5%, while levels for the control group remained steady at 8.9% throughout. In addition, the CGM group’s time in target glucose range increased from 9 hours per day to 10.3 hours per day, whereas the control group actually dropped from 8.7 hours per day to 8.3 hours per day. However, over time, the CGM group wore their devices less frequently, going from 82% to 68% of participants wearing the device at least five days per week.

At the end of one year, the results remained relatively consistent. Within the CGM group, HbAc1 levels improved slightly from 8.5% to 8.3%, while time in target range decreased slightly from 43% to 41%. There was a noticeable difference when it came to low blood sugar, with the average time spent below 70 mg/dL improving from 49 minutes per day to just 16 minutes per day.

On the other end of the spectrum, adults ages 60 and older also saw positive results when it came to CGM use. This study involved 203 adults split into the same type of test and control groups as the adolescents/young adults. The older adults in the CGM group were more consistent with their device use with 81% wearing it continuously and 89% wearing it at least five days per week.

The focus of this study was on hypoglycemia and time spent with a glucose level below 70 mg/dL. After 26 weeks, the CGM group went from 73 minutes per day to just 39 minutes per day, while the control group saw very minimal change. These rates stayed approximately the same at the one-year mark. In addition, the CGM group spent an average of 2.1 hours per day more in the target blood glucose range than the control group at 26 weeks.

The findings from both studies are encouraging when it comes to helping individuals with T1D to better manage their blood sugar and reduce the risk of hypoglycemia. It is important to educate patients on the benefits of using a CGM while also working to reduce barriers and improve access to this technology.

Though not involved in these studies, the Diabetes Research Connection supports early-career scientists in conducting research related to preventing and curing type 1 diabetes, minimizing complications, and improving quality of life for those living with the disease. From an increasing understanding of how and why the disease develops to improving treatment and management options, scientists are working hard every day. Learn more about current projects funded by the DRC and how to support these efforts by visiting http://diabetesresearchconnection.org.

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Researcher looking at a new T1D drug

New Drug May Delay Onset of Type 1 Diabetes

In many patients, there is a slight delay between the time when type 1 diabetes (T1D) is first diagnosed, and when they become dependent on insulin. This is known as the “honeymoon phase” and often lasts for a few months or up to a year. During this time, insulin-producing beta cells continue to function relatively normally and are supported by a small amount of insulin. Over time, these cells stop functioning and patients become insulin-dependent.

A recent study reveals that scientists have developed a breakthrough drug that may delay the onset of clinical T1D by up to three years. The drug, teplizumab, was used to treat patients who were identified at high risk of developing T1D due to the presence of at least two autoantibodies. The drug was administered for two weeks, and following this treatment, insulin secretion rates and C-peptide levels remained higher than for those participants who received a placebo.

During the preliminary trial, patients who took teplizumab showed a delayed onset of T1D of two years, but during the latest phase 2 drug trial, this was extended to three years. Participants who took a placebo continued to experience decreased insulin and C-peptide production as the disease progressed. As a result of these findings, the drug was awarded Breakthrough Therapy Designation by the U.S. Food and Drug Administration (FDA) and PRIority MEdicines (PRIME) Designation by the European Medicines Agency (EMA) in 2019.

More than 18 million people around the world are living with type 1 diabetes, and this drug has the potential to make a positive difference in the lives of millions more who are at-risk for the disease. Diabetes Research Connection (DRC) is excited to see how clinical trials continue to progress for teplizumab and whether it eventually becomes an approved prevention therapy for type 1 diabetes.

The DRC is committed to growing understanding and improving treatment and prevention of type 1 diabetes through providing critical funding for early-career scientists so they can advance and execute their research. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org.

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COVID-19

Managing Type 1 Diabetes and COVID-19

Type 1 Diabetes and COVID-19

As cases of COVID-19 continue to spread across the United States and the globe, scientists are especially interested in how it affects specific populations, such as those with type 1 diabetes (T1D). T1D is considered an underlying health condition and already puts individuals at greater risk when it comes to illness and potential complications.

One positive sign is that preliminary data from a recent study shows that many patients with T1D who also test positive for COVID-19 or have COVID-19-like symptoms are able to effectively manage their recovery at home. Less than 25% of patients were serious enough to require hospital admission. In addition, there were only two reported fatalities, and those individuals had existing comorbidities.

According to the preliminary data, it appears as though patients who have higher A1c levels and poorer glycemic management tend to be more negatively impacted by the disease. In addition, higher body mass index may also be a risk factor. When it comes to age, about 65% of cases were in individuals aged 18 or younger (though many had COVID-19-like symptoms, not confirmed diagnoses), and the average age of all 64 participants was 20.9 years. This is not an issue that is only facing older adults.

According to the study, “Overall, 34.9% of patients were able to manage COVID-19 entirely at home, with 27.3% of the confirmed and 43.3% of the suspected cases able to do so. At the other extreme, 22.2% of patients overall were admitted to the intensive care unit; 30.3% of the confirmed versus 13.3% of suspected cases.” Other patients were seen at an urgent care or hospital but not admitted.

Of those who managed their recovery at home, many received support virtually through telemedicine where they able to consult with endocrinologists and infectious disease specialists. There were also many who did not need to seek care and had their symptoms improve.

Since the initial study was conducted, more patient data has been submitted, and there are now 220 patients as opposed to 64. This data is still being analyzed and reviewed, but at first glance, researchers have found that results continue to be similar to the original group. Researchers are looking at A1c levels, glycemic management, comorbidities, mortality, telemedicine access and use, and more to better understand how COVID-19 is impacting individuals with T1D. They are also digging deeper into risk factors. A new paper reflecting this latest data is in the works.

There are still a lot of unknowns when it comes to COVID-19, but researchers are striving to understand how it may affect more vulnerable populations such as those with type 1 diabetes. The Diabetes Research Connection (DRC) continues to follow these studies and trends to stay up-to-date on the latest information. In addition, the DRC provides critical funding for early career scientists to conduct their own novel, peer-reviewed studies around T1D, whether related to COVID-19 or any other facet of the disease. To learn more and support current projects, visit http://diabetesresearchconnection.org.

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Costs of Diabetes

Exploring the High Costs of Diabetes Management

High Costs of Diabetes

Discussions around type 1 diabetes care and affordability often focus on the cost of insulin. While insulin prices can be extremely high and add up quickly depending on how much is needed to effectively control blood sugar levels and what is covered by insurance, this is not the only diabetes-related expense that individuals incur.

Insulin is only one part of managing diabetes. Patients also must pay for the supplies necessary to test and monitor their blood glucose levels and to administer insulin. Many people use continuous glucose monitors and insulin pumps to assist, and even if they don’t, they need syringes and other testing supplies.

A national study of 65,199 patients between the ages of 1 and 64 who had private, employer-sponsored insurance coverage found that the average out-of-pocket cost for managing diabetes was $2,500 a year. But only 18% of that cost was insulin. The rest was other supplies like those aforementioned. Furthermore, families with children who had type 1 diabetes were more likely to use CGMs and insulin pumps to help manage their child’s condition, and their annual out-of-pocket costs exceeded those of adults at $823 versus $445 respectively.

While steps have been taken to reduce the cost of insulin in recent years, and especially during the coronavirus pandemic, not as much has been done to improve the affordability and access of other diabetes-related supplies. CGMs and insulin pumps can play an integral role in helping patients better manage their diabetes and reduce complications, especially for children; in turn, this may help decrease additional medical expenses.

More focus is needed on the overall costs of diabetes management and how to better support patients in affording the care they need for improved health. The Diabetes Research Connection (DRC) stays abreast of the latest changes in the industry and advancements in research and treatment to help individuals with type 1 diabetes. Scientists are always working on ways to improve care and reduce the burden of the disease, and the DRC provides critical funding for these efforts. Learn more about current projects and how to support early-career scientists by visiting https://diabetesresearchconnection.org.

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COVID-19 testing

COVID-19 Symptoms in Individuals with Type 1 Diabetes

COVID-19 Testing

COVID-19 has taken our country by storm, and it is affecting individuals of all ages. No one is immune, and unfortunately, individuals with underlying health conditions tend to be at higher risk for complications. People with type 1 diabetes are already more severely affected by infections than individuals without the disease, and therefore they may be at higher risk for contracting COVID-19 and having poorer health outcomes.

A recent study looked at a group of 64 people with type 1 diabetes, 33 of whom had confirmed cases of COVID-19, and 31 of whom had COVID-19-like symptoms but no confirmed diagnosis. The median HbA1c levels were 8.5% and 8% respectively, and the average age was 24.8 years in the confirmed COVID-19 group and 16.8 years in the COVID-19-like symptom group.

Participants were part of a T1D Exchange Quality Improvement Collaborative (T1DX-QI) study and completed a 33-item questionnaire about their health and symptoms. They all had one or more symptoms that aligned with the Centers for Disease Control and Prevention’s (CDC) symptom profile for COVID-19.

The results showed that for both groups, high blood glucose, fever, and dry cough were the top three symptoms. Diabetic ketoacidosis (DKA) was reported in 45.5% of participants who tested positive for COVID-19 and 13.3% of those with COVID-19-like symptoms. This was a small study using data collected up to May 5, 2020. Additional research is needed to better track results as more is learned about the disease and its impact on individuals with type 1 diabetes. Also, since the average age of participants was teenagers and young adults and type 1 diabetes tends to develop in childhood, conducting pediatrics studies could also be beneficial to learn more.

As researchers continue to study COVID-19 and individuals with type 1 diabetes, they can better understand risk factors, complications, and therapeutic treatment options to deal with this novel coronavirus. The Diabetes Research Connection (DRC) is an organization dedicated to funding research around type 1 diabetes and will continue to stay abreast of the latest findings in regard to T1D and COVID-19. To learn more about the work conducted through the DRC and support these efforts, visit http://diabetesresearchconnection.org.

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insulin-producing

Protecting Insulin-Producing Islets Through Cell Editing

Protecting Insulin-Producing Islets Through Cell Editing

A hallmark of type 1 diabetes is the destruction of insulin-producing beta cells in the pancreas. These cells are crucial for producing and releasing insulin in response to rising blood glucose levels. Without them, glucose levels go unregulated and can become potentially fatal. Individuals with type 1 diabetes must be vigilant about testing their own blood sugar and administering insulin via syringe or an insulin pump as necessary.

However, a recent study aims to transform diabetes management in children with type 1 diabetes by using cell editing to produce healthy, functioning T cells that would intervene in the destruction of insulin-producing beta cells. Effector T cells and regulatory T cells (Treg) work together to balance the body’s immune response. When effector T cells attack, regulatory T cells keep them in check and limit the damage. But in individuals with type 1 diabetes, regulatory T cells do not function normally.

Researchers at Seattle Children’s Research Institute’s Center for Immunity and Immunotherapies and the Benaroya Research Institute at Virginia Mason (BRI) have discovered a way to edit patients’ T cells so that they function like regulatory T cells and protect pancreatic islet cells. Through gene editing, they turned on the FOXP3 gene in the cells and attached a T-cell receptor to make them antigen-specific to pancreatic cells.

According to Dr. Jane Buckner, president of BRI and co-investigator of the study, “We want to identify T-cell receptors that will create engineered Treg that will go on to and protect the pancreas. This type of therapy could then be used to stop the destruction of cells that produce insulin in the pancreas to slow the progression and ultimately prevent type 1 diabetes.”

The team recently received additional funding and is moving toward gaining approval to start a first-in-human clinical trial at Seattle Children’s. There are currently no other laboratories in the world conducting this same type of experimental therapy. The engineered cells have been tested in animal models and tissue cultures with positive results, but this would be the first human testing.

Diabetes Research Connection (DRC), though not involved in this study, is excited to see how the study advances and if human clinical trials are approved. This could be a major step forward in treatment and prevention options when it comes to type 1 diabetes. The DRC is committed to supporting these types of efforts and provides critical funding to early-career scientists pursuing novel, peer-reviewed research around type 1 diabetes. To contribute to these efforts and learn more about current studies, visit http://diabetesresearchconnection.org.

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Research Study for type 1 diabetes

Proactively Identifying Type 1 Diabetes

Identifying Type 1 Diabetes Development

Type 1 diabetes develops when the body mistakenly attacks and destroys insulin-producing beta cells. As the number of cells depletes, the body is unable to adequately control blood sugar levels. Researchers have been striving to find a way to prevent this destruction from occurring or to find a way to replace these cells so that the body can once again manage its own blood sugar.

A recent study took a closer look at exactly when this transformation begins to take place and beta cells begin dying off. They found that in many participants, the decline started at least six months prior to when patients would meet clinical requirements for a type 1 diabetes diagnosis. Diagnostic thresholds are currently a “fasting glucose of ≥126 mg/mL or 2-hour glucose of ≥200 mg/dL.”

The study involved 80 patients split into three categories: younger than age 11, ages 11 to 20, and older than age 20. All participants were first- or second-degree relatives of someone with type 1 diabetes and were diagnosed themselves while undergoing oral glucose tolerance tests (OGTTs) every six months. The results showed that across all age groups, C-peptide levels started declining around 12 months before diagnosis but showed the most significant changes in function in the 6 months prior to and 12 months following diagnosis.

By tracking these changes in individuals who are considered at-risk of developing type 1 diabetes, doctors may be able to catch declining beta-cell function early on and intervene with treatment before patients reach diagnostic thresholds for the disease. This could potentially be a way to prevent or slow the onset of type 1 diabetes through proactive immunotherapy.

More research is needed to further explore these findings and expand them to a larger group of participants. However, it provides researchers with insight on when type 1 diabetes may begin to develop and some changes to focus on. Diabetes Research Connection (DRC), though not involved with this study, supports early-career scientists in pursuing novel research studies around type 1 diabetes to help advance prevention and treatment efforts as well as minimizing complications, improving quality of life, and finding a cure. Learn more about current studies and how to support these projects by visiting https://diabetesresearchconnection.org.

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Medical Technology

Helping Drive Technology Advancements

Diabetes Patients Are Helping Drive Technology Advancements

Managing type 1 diabetes is an around-the-clock job. Patients must always be aware of what their blood sugar level is, whether it is trending up or down, whether or not to administer insulin, and if they do need insulin, how much. While there have been many advancements in technology to help with monitoring and insulin administration, the development and approval process is often long and drawn out. There are a limited number of devices approved by the government for use.

Patients with type 1 diabetes have begun taking their health into their own hands and improving treatment options. There are free directions online for how patients can connect their continuous glucose monitor (CGM) and their insulin pump with their smartphone to create a closed-loop system that tracks their blood glucose and automatically administers insulin as necessary. This type of artificial pancreas is something that researchers and pharmaceutical companies have been working on for years, but to date, there is only one commercially available closed-loop system available for use in Canada.

Jonathan Garfinkel, a Ph.D. candidate in the Faculty of Arts at the University of Alberta, took his chances and used the patient-created instructions for setting up the closed-loop system two years ago, and it has been life-changing. Previously, he was having a lot of difficulty managing his blood sugar overnight, and it would drop dangerously low. With the closed-loop system, his blood sugar has become much stabler overnight, and he is not tasked with regularly doing finger pricks and figuring out insulin dosing on his own.

These advancements in technology that patients with diabetes are developing have prompted pharmaceutical companies to quicken their own pace when it comes to getting devices created and approved for commercial use. Patients are becoming increasingly more comfortable with technology and relying on smartphones, sensors, and other devices to help them stay abreast of their health.

Garfinkel himself is also working on a project to advance technology for diabetes treatment. He is in the process of developing “a more affordable glucose sensor that would sit on top of the skin, rather than being inserted subcutaneously.” It was a project he began in collaboration with Mojgan Daneshmand, an engineer and Canada Research Chair in Radio Frequency Microsystems for Communication and Sensing, who was unfortunately killed in a plane crash in January 2020. Garfinkel is continuing the work that they started together and was awarded a U of A seed grant to help.

There are so many young researchers with incredible potential who can benefit from funding that will allow them to carry out their plans and see the results. The Diabetes Research Connection provides up to $50K in funding to early-career scientists to empower them in moving forward with their novel research projects focused on type 1 diabetes. These opportunities open doors to improving the prevention, treatment, and management of type 1 diabetes, as well as improving quality of life, minimizing complications, and one day finding a cure. Learn more by visiting https://diabetesresearchconnection.org.

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Sleep Disturbances with Type 1 Diabetes

Sleep Disturbances Common with T1D

Type 1 diabetes is a disease that must be monitored around the clock. When children are awake, it is easier to tell when blood sugar may be spiking too high or dropping too low. At night, this is more challenging, and it is essential to continue testing blood sugar levels to stay within the target range and administer insulin as necessary.

Children typically rely on their parents to manage their diabetes and monitor blood sugar, whether done manually or through a continuous glucose monitor (CGM). A recent study found that children who use a CGM often sleep better at night, but it is their parents who have more disturbances in their sleep due to reacting to CGM data.

As part of a larger study, researchers evaluated the sleep quality of 46 parents of children with type 1 diabetes. The children were between the ages of 2 and 5, and some used CGMs while others did not. Parents reported on the time their children went to bed, woke up, and how long they slept. The average was 10.4 hours per night. Also, all 11 families who used CGMs wore accelerometers that tracked their sleep patterns for a minimum of four nights. The accelerometer showed an average of 9.8 hours of sleep per night for children.

According to the study, “Among the full cohort, 63% of parents reported checking their child’s blood glucose levels at least a few nights per week. Parents of children using CGMs reported a higher frequency of nighttime blood glucose monitoring compared with parents of children without a CGM.”

The percentage of parents who experienced sleep disturbances concerning blood glucose monitoring was noticeably higher than the percentage of children, at 78.3% and 17% respectively. Parents of children with CGMs reported higher levels of sleep disturbance, especially when the child’s diabetes was more difficult to manage. Additional research with a larger group of participants across a longer period of time is necessary to better understand the impact of diabetes management on sleep for parents and children.

It is important for physicians to keep in mind not just the impact a CGM or other device could have on the child’s health and quality of life, but also on the parent. Parents benefit from having proper support systems in place and information to help them cope with the challenges of managing their child’s type 1 diabetes.

Diabetes Research Connection, though not involved in this study, is committed to supporting early-career scientists focused on studying type 1 diabetes and ways to improve prevention, treatment, and quality of life, as well as one day finding a cure. One hundred percent of donations go directly to the scientists for their research. To learn more about current projects and how to help, visit https://diabetesresearchconnection.org.

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Enhancing Protection for Islets

Enhancing Protection for Islets Following Transplantation

One treatment approach for type 1 diabetes that researchers have been experimenting with and refining for more than 20 years is islet transplantation. The goal is to take insulin-producing islets from cadavers (or another source) and transplant them into individuals with type 1 diabetes so that these cells will thrive and allow the body to begin producing insulin once again.

A common challenge with this approach is protecting the cells from immune system attack or cell death from lack of oxygen. A recent study has found a way to overcome some of these obstacles by encapsulating the islets in a jelly-like substance made of collagen. This helps create a scaffolding that will not initiate an immune response yet contains the islets while allowing them to grow new blood vessels that will ultimately provide them with oxygen. Since this blood vessel regrowth can take time, the researchers also injected the scaffolding with calcium peroxide. As the calcium peroxide breaks down, it releases oxygen which is used to keep the cells alive as they settle in and begin working.

In traditional organ transplantation, the organ is surgically connected to the circulatory system meaning that the organ automatically begins receiving the oxygen and nutrients it needs for survival. Islet transplants do not work this way since the cells are not a solid organ. In addition, the cells are typically injected into the liver rather than the pancreas where they would normally occur. There is a greater risk of the pancreas having a negative reaction and destroying the islets than the liver.

The researchers tested this new bioscaffold in diabetic mice. Some mice received islets on their own, some received islets in the bioscaffold, and some received islets and calcium peroxide in the bioscaffold. The diabetic mice who received the islets and calcium peroxide demonstrated greater blood glucose control over four weeks than the other two groups. The team is now looking at the possibility of injecting the scaffolding with stem cells as well to further enhance islet survival and function.

These types of advancements in treatment are encouraging when it comes to type 1 diabetes. It is expected that the U.S. Food and Drug Administration (FDA) will approve islet transplantation as a valid treatment for T1D, rather than an experimental treatment, this year. This could increase the number of options available to patients for effectively managing the disease.

Diabetes Research Connection continues to stay abreast of changes in the field and provides critical funding for early-career scientists pursuing novel research around T1D. Learn more about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org.

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Reduced Out-of-Pocket Insulin Costs for Seniors Through Medicare

Out-of-Pocket Insulin Costs for Seniors

The cost of buying insulin can quickly add up, but this medication is life-sustaining for individuals with type 1 diabetes. Many seniors are on a fixed income, and some may struggle to afford the out-of-pocket costs for insulin, which can lead to rationing their supply. This can be incredibly dangerous to their health.

The Centers for Medicare & Medicaid Services (CMS) recently announced that it would implement measures to help curb these costs for seniors. Many Medicare Part D prescription drug plans and Medicare Advantage plans with prescription drug coverage will now be offering lower insulin costs to seniors, capping the copay at $35 for a month’s supply. This is part of the new Part D Senior Savings Model and will cover “both pen and vial dosage forms for rapid-acting, short-acting, intermediate-acting, and long-acting insulins.”

Insulin manufacturers and Part D sponsors are working together to offer this market-based solution that enables them to provide deeper discounts to seniors and fixed, predictable copays in the coverage gap. According to CMS, “beneficiaries who use insulin and join a plan participating in the model could see an average out-of-pocket savings of $446, or 66 percent, for their insulins, funded in part by manufacturers paying an estimated additional $250 million of discounts over the five years of the model.”

Seniors will be able to go on to the CMS website and compare their prescription drug plan options to find a participating sponsor and plan that fits their needs. Enrollment would begin in the fall for coverage starting on January 1, 2021. There have also been numerous actions that have been taken in response to COVID-19 to support individuals with type 1 diabetes in accessing and affording insulin.

It is encouraging to see drug manufacturers and insurance companies making changes to improve access and affordability of life-sustaining medications such as insulin. Diabetes Research Connection (DRC) will continue to stay abreast of these trends and how they impact diabetes management. DRC provides critical funding for researchers focused on type 1 diabetes to find a cure and improve prevention and treatment options as well as the quality of life. To learn more, visit https://diabetesresearchconnection.org.

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Preserving Endogenous Insulin Production

Preserving Endogenous Insulin Production in Newly Diagnosed Type 1 Diabetes Patients

A hallmark of type 1 diabetes is the body loses its ability to naturally produce enough (or any) insulin to effectively manage blood glucose levels. This is due to the mistaken destruction of insulin-producing beta cells by the immune system, a process that researchers are continually learning more about. In many cases, when type 1 diabetes (T1D) is first diagnosed, there is a short window of time (up to about six months) where the body still creates insulin, but not enough to meet demand.

A recent study explored a new way to try to preserve endogenous insulin production and reduce the amount of insulin newly diagnosed patients required. The study involved 84 patients ages 6 to 21 who had been diagnosed with T1D within 100 days of the start of the trial. Approximately two-thirds of participants were given the drug golimumab, while the other one-third received a placebo. Golimumab is an anti-tumor-necrosis-factor (TNF) therapy that is already approved by the Food and Drug Administration (FDA) for the treatment of rheumatoid arthritis, ulcerative colitis, and other autoimmune conditions. It has not yet been approved for use in patients with T1D.

The patients who received golimumab self-administered the drug via injection every two weeks. Results showed that these patients achieved markedly better glycemic control that patients receiving the placebo. After 52 weeks of treatment, “41.4% of participants receiving golimumab had an increase or less than 5% decrease in C-peptide compared to only 10.7% in the placebo group.”

Furthermore, patients who were still in the “honeymoon phase” of their diabetes, or the first 3-6 months after diagnosis where there is still some endogenous insulin production and not as much injected insulin is needed, also showed improvement once transitioning out this phase and continuing to take golimumab. Those patients showed a smaller increase in injected insulin than the placebo group requiring just 0.07 units per kilogram more per day versus 0.24 units per kilogram per day respectively. Another notable improvement is that patients between the ages of 6 and 18 experienced 36% fewer episodes of level 2 hypoglycemia, a condition that can be potentially life-threatening and negatively impact the quality of life.

Since golimumab is already FDA-approved for other conditions, these phase 2 study results play an important role in moving the process forward to show that it may be an effective treatment for T1D as well. This therapy may be able to help newly diagnosed patients retain some of their body’s natural insulin-producing abilities and decrease the amount of injected insulin needed to maintain good glycemic control.

Golimumab may become another option for patients with type 1 diabetes in the future and change how the disease is managed when caught and treated early on. It is encouraging to see new ways to preserve beta-cell function. Diabetes Research Connection (DRC) is interested to see how this study unfolds and whether golimumab is approved for the treatment of type 1 diabetes.

Although not involved in this study, DRC supports early-career scientists in pursuing studies like these and other projects related to preventing and curing T1D as well as minimizing complications and improving the quality of life for individuals living with the disease. Scientists can receive up to $50K in funding to advance their research. To learn more about current projects and support these efforts, visit https://diabetesresearchconnection.org.

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Pancreatic beta cell regeneration

Examining Pancreatic Beta Cell Regeneration Processes

Researchers often use cell cultures and tissue slices to study the function and processes of various cells. One of the challenges of this approach, however, is the viability of these samples. For instance, pancreatic tissue slices typically show significant cell death after less than 24 hours due to poor oxygenation. This means that only short-term studies are possible, using samples while they are most viable and representative of the integrity of the native organ.

But, researchers are looking to change that. In a recent study, scientists altered how human pancreatic slices (HPSs) are cultured and managed to preserve function for 10 days or more. This is significant when it comes to being able to conduct longer-term longitudinal studies. Studies were also conducted on tissue samples from non-transgenic mice.

Traditionally, HPSs are preserved in standard transwell dishes. In this model, tissue is placed on top of a liquid-permeable membrane and surrounded with an air-liquid medium. However, oxygenation begins to decrease within several hours, and signs of anoxia appear. A new approach uses perfluorocarbon (PFC)-based dishes. This model places tissue atop a liquid-impermeable membrane providing direct contact with oxygen. An air-liquid medium also surrounds the slice. A variety of testing shows that PFC-based cultures have improved oxygenation and lower levels of anoxia.

In turn, this allowed scientists to more effectively study pancreatic beta-cell regeneration processes. HPSs retain “near-intact cytoarchitecture” of the organ in its native state in the body. Combined with the longer-term viability of the samples in the PFC-based setting, researchers were able to focus in on how and where beta cells were regenerating. They used HPSs from non-diabetic individuals as well as those with type 2 diabetes to enhance their understanding of how to stimulate this regeneration and improve insulin production.

When samples were left to rest for 24 hours to reduce the impact of stress from slicing and then treated with Bone morphogenetic protein 7 (BMP-7) proteins, scientists found that they showed higher levels of beta-cell regeneration than controls that were not treated with BMP-7. Much of this cell development occurred in regions corresponding to pancreatic ducts. Some new cells emerged from existing beta cells, while others transitioned from alpha to beta cells.

Improved oxygenation methods are changing how scientists are able to interact with HPSs and the types of testing they are able to conduct. According to the study, “Our goal in refining the conditions for the long-term survival of HPS was to allow for the real-time detection and quantification of endocrine cell regeneration.” While more in-depth and extensive studies are needed, these findings may lead the way toward improved understanding of the pathology of pancreatic beta-cell regeneration and new treatment options for individuals with type 1 diabetes.

Diabetes Research Connection (DRC) is committed to supporting these types of advancements and efforts by providing critical funding to early-career scientists pursuing novel, peer-reviewed research related to type 1 diabetes. With adequate funding, scientists are able to bring their ideas to life and contribute to not only greater understanding of the disease, but improved methods and therapies for diagnosing, treating, managing, and eventually curing type 1 diabetes. Learn more about current projects and support these efforts by visiting https://diabetesresearchconnection.org.

 

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Could Insulin Management be Controlled with an App?

Determining the appropriate amount of insulin to administer in response to drops in blood sugar can be challenging, but it is something that individuals with type 1 diabetes must do daily in order to manage their health. If left untreated, low blood sugar (or hypoglycemia) can be potentially fatal.

A team of researchers and physicians at Oregon Health & Science University (OHSU) are looking to improve diabetes management through a new app called DailyDose. While there are similar types of apps that exist, what sets DailyDose apart is that has demonstrated statistically relevant outcomes through multiple clinical studies. The AI algorithm for the app was originally developed entirely through a mathematical simulator, but when real-world data was used, the recommendations generated by the app aligned with recommendations provided by physicians, or were still considered safe, more than 99% of the time. In addition, improved glucose control was achieved. This was determined after 100 weeks of testing conducted in four-week trials.

Each trial involved 16 patients with type 1 diabetes and combined information from a continuous glucose monitor or wireless insulin pen with the app. Nearly 68% of the time, the recommendations generated agreed with those of physicians.

These findings are important because they show that the app may be effective in supporting individuals with type 1 diabetes in reducing risk of hypoglycemia by better managing insulin administration and blood glucose levels between appointments with their endocrinologist. Larger clinical trials are needed over longer periods of time to further determine the accuracy and effectiveness of the app in relation to other treatment strategies.

Technology is becoming increasingly more popular and advanced in terms of managing type 1 diabetes. There are numerous devices and apps already available and more in the works. This gives individuals with type 1 diabetes a wider variety of options in order to determine what works best for their needs and lifestyle.

Though not involved with this study, the Diabetes Research Connection (DRC) strives to continue growing understanding of type 1 diabetes and improving prevention and treatment methods as well as one day finding a cure. Early-career scientists can receive critical funding through the DRC to pursue novel research studies around T1D. Learn more about current projects and how to support these efforts at http://diabetesresearchconnection.org.

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Could Advancements in Gene Editing Reverse Type 1 Diabetes?

Gene therapy is not a new approach when it comes to treating type 1 diabetes. Scientists have been experimenting with many different options in order to stimulate the body to once again produce its own insulin and reduce or eliminate the need for insulin injections. However, some of the problems that scientists often encounter when introducing new cells into the body are that patients typically require immunosuppressant drugs which can lead to a variety of complications, the body rejects the cells over time, or the cells stop working. Finding a long-term, effective solution has been challenging.

Scientists are making strides in their efforts, though. A recent study examined the potential of using the gene-editing tool CRISPR to correct genetic mutations and create induced pluripotent stem cells that can be transformed into pancreatic beta cells. In mouse models, after the new cells were injected, mice achieved normoglycemia within a week and maintained this status for at least six months.

This approach has not yet been tested in humans, however, because it comes with its own set of challenges. First, the study was done using cells from patients with Wolfram syndrome, a condition that causes diabetes and deafness. This condition can be pinpointed to a single genetic mutation, whereas type 1 diabetes cannot. Type 1 diabetes has been tied to multiple gene mutations, as well as environmental factors. Gene-editing would have to be personalized for each individual, which could take a lot of time.

In addition, it could take billions of cells to effectively reverse diabetes in a patient, and generating this massive number of cells could take months, so it could end up being a long process to treat even one person. Plus, scientists are not entirely sure where the best place to transplant these cells is yet. They must find the spot where they will be most beneficial and able to carry out their intended purpose.

Another study using CRISPR technology is being conducted by a different group of researchers and is focused on using stem cells from the human cell line rather than from individual patients. This would make it easier to produce mass quantities of cells in a shorter period of time. It also would not require scientists to correct specific genetic mutations. CRISPR would be used to edit cells to prevent them from being attacked and destroyed by the body’s immune system.

A challenge with these approaches is that there are a lot of questions and regulations when it comes to gene-editing and using CRISPR on human subjects. Clinical trials are still in very early stages. Studies involving induced pluripotent stem cells are also relatively new in the United States. There is still a lot of work, research, and testing that needs to be done before gene-editing therapy could potentially be used on humans.

Diabetes Research Connection (DRC) will continue to follow these advancements and what they could mean for future diabetes treatment. DRC supports early-career scientists in contributing valuable discoveries and information of their own to the field by providing critical research funding. All projects funded by the DRC are focused on the prevention, treatment, and cure of type 1 diabetes, as well as minimizing complications and improving the quality of life for individuals living with the disease. Learn more and support these efforts by visiting https://diabetesresearchconnection.org.

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Exploring the Impact of Type 1 Diabetes on COVID-19

For the past several months, the world has been struggling to contain the spread of COVID-19 and effectively treat patients diagnosed with this disease. It is a new strain of coronavirus that researchers continue to learn more about every day. One thing that is known about the virus is that individuals with underlying health conditions are at increased risk of developing severe illness and complications.

One such underlying health condition that researchers are paying closer attention to is type 1 diabetes (T1D). Preliminary research from small studies appear to show that individuals with T1D are at increased risk of poorer health outcomes than those with type 2 diabetes (T2D) or no history of diabetes. A recent study of 64 individuals with T1D and confirmed or suspected COVID-19 in the United States found that “more than 50% of all cases reported hyperglycemia, and nearly one-third of patients experienced DKA.” Both hyperglycemia and diabetic ketoacidosis (DKA) can be life-threatening conditions if not properly treated in time.

Furthermore, research released from the United Kingdom’s National Health Service (NHS) revealed that hospitalized individuals with T1D are significantly more likely to die from COVID-19 than those with T2D. Scientists believe that hyperglycemia may enhance the immune system’s overresponse thereby exacerbating the impact of severe infections.

Being hospitalized can make it more difficult for individuals with T1D to maintain glycemic control because their body is already trying to fight off infection, and they may not have the mental clarity or ability to effectively monitor their own blood sugar. Diabetes Research Connection (DRC) sponsored a study by Addie Fortmann, Ph.D., regarding the use of continuous glucose monitors (CGMs) in hospital settings, which found that these devices were pivotal to glycemic control. As a result, Scripps deployed this technology across all of their hospitals to better support diabetes management.

But not every hospital in the United States allows patients to use their CGM while admitted, and not all staff is adequately trained in diabetes care. This can complicate things for patients struggling with T1D as well as COVID-19 and contribute to poorer health outcomes. Not only are patients fighting against the effects of COVID-19 including fever, shortness of breath, dry cough, nausea, body aches, and fatigue, if their blood sugar should go too high or too low, this can add to more symptoms and complications. In both patients with confirmed and suspected COVID-19 as well as T1D, DKA was the most prevalent adverse outcome.

It is essential that attention is given to managing underlying conditions such as diabetes in order to provide more effective treatment tailored to patient needs. Since 2012, the DRC has been providing critical funding for early-career scientists pursuing novel, peer-reviewed research related to type 1 diabetes. This work is essential to advancing understanding of the disease, improving prevention strategies and treatment options, minimizing complications, enhancing quality of life, and working toward a cure. Learn more about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org.

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Taking Steps to Prevent Diabetic Ketoacidosis in Pediatric Patients with Type 1 Diabetes

There are many complications that can occur with type 1 diabetes, but one of the most serious is diabetic ketoacidosis (DKA). When the body does not produce (or have) enough insulin to help convert sugar to energy, it begins breaking down fat and using that as fuel instead. However, this releases acid known as ketones into the bloodstream, in turn leading to DKA when levels become too high.

A recent study found that DKA among newly diagnosed pediatric patients with type 1 diabetes is alarmingly high among patients around the world. During an 11-year study spanning from 2006 to 2016, researchers found that out of 59,000 children who had been diagnosed with T1D, 29.9% presented with DKA at diagnosis. The study examined data from children in Austria, the Czech Republic, Germany, Italy, Luxembourg, Norway, Slovenia, Sweden, Wales, Australia, New Zealand, and the United States.

Of these countries, prevalence rates in Luxembourg and Italy were found to be the highest at 43.8% and 41.2%, respectively, while Sweden and Denmark had the lowest rates at 19.5% and 20.8%, respectively. DKA at diabetes diagnosed increased over the 11-year study in the United States, Australia, and Germany. Overall, DKA tended to impact a higher proportion of females than males, except in Wales.

In order to help reduce risk of DKA at diagnosis, the researchers encourage improved screenings beginning with young children. For example, Bavaria, Germany tests for islet autoantibodies as part of a public health screening for children between the ages of 2 and 5. Studies showed that their prevalence of DKA at diagnosis came in at less than 5%. Increased screenings and education may be beneficial in raising awareness and catching potential problems early on before DKA develops.

Though not involved with this study, the Diabetes Research Connection (DRC) is committed to improving understanding, prevention, and treatment of type 1 diabetes by providing critical funding for novel, peer-reviewed research studies by early-career scientists. Find out how to support these efforts and learn more about current projects by visiting https://diabetesresearchconnection.org.

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Managing Blood Sugar During Exercise with Long-Acting Insulin

Engaging in regular physical activity is good for overall health. It helps with weight management, blood pressure, cardiovascular health, blood sugar, and more. Individuals with type 1 diabetes may find exercise helpful in improving insulin sensitivity and reducing the amount of insulin needed following activity. However, this can also be a challenge because they must carefully monitor their blood-glucose levels to ensure that they do not become too low or too high.

A recent study found that combining long-acting insulin (degludec) with the use of an insulin pump can be beneficial for managing glucose levels during and after exercise. Some individuals with T1D prefer to remove their insulin pump during exercise, and by administering degludec before starting exercise, they were able to remain in target range (70-180 mg/dL) for longer periods of time than when just using the insulin pump alone.

The study involved 24 physically active adults who participated in two phases of workouts that included five weeks of high- and moderate-intensity sessions. During one phase, they only used their insulin pump to control their basal insulin needs, and for the second, they used the insulin pump and the degludec. When using the insulin pump alone, they spent an average of 143 minutes (40% of the time) in target range, but when using the degludec, this time in range increased to 230 minutes (64% of the time).

The researchers found that “this was down to a significant 87-minute reduction in time spent in hyperglycemia, with no difference seen for hypoglycemia” as well. In addition, when using the hybrid insulin approach, blood sugar rose just 14.5 mg/dL after 30 minutes following exercise, compared to an 82.9 mg/dL increase using the insulin pump alone.

More than two-thirds of participants found the hybrid insulin regimen useful, and nearly half said they were somewhat or very likely to continue using this approach while exercising in the future. The researchers are looking at moving forward with a larger study to see if these results continue to be significant when more people are involved.

This study shows that there may be more than one effective option for improving glucose control during exercise for individuals with type 1 diabetes. They do not have to rely on the insulin pump alone, and some may find administering degludec beneficial when exercising without their insulin pump.

Diabetes Research Connection (DRC) is interested to see how this study plays out in the future and if more people can benefit from the hybrid insulin regimen while exercising. It is encouraging to see more options become available to help individuals better control their diabetes while improving their health and quality of life. DRC supports early-career scientists in pursuing novel research on type 1 diabetes by providing access to funding. The goal is to one day find a cure while also improving prevention, treatment, and management of the disease. Learn more by visiting http://diabetesresearchconnection.org.

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Could Benefits of Early Screening for Type 1 Diabetes Outweigh Costs?

Advances in science have improved the ability to identify warning signs for type 1 diabetes (T1D) early on. For instance, scientists can detect the destruction of insulin-producing beta cells before noticeable signs of diabetes emerge or conditions such as diabetic ketoacidosis (DKA) occur. They have also determined other key changes and factors that may put an individual at increased risk.

A recent study found that conducting health screenings on children can increase awareness regarding their risk of developing T1D, help prevent DKA occurrences, and encourage individuals to take better care of their health to reduce complications and impact of the disease.

Researchers at the Barbara Davis Center for Diabetes at the University of Colorado School of Medicine created the Autoimmunity Screening for Kids (ASK) study to determine if this type of health screening is beneficial. While it can be costly to conduct widespread screenings for children between the ages of 1 and 17, they found that there are a host of benefits such as those mentioned above. In addition, the long-term cost savings can quickly make up for screening expenses because when individuals know their risk and learn how to better manage their T1D, it can reduce complications and associated healthcare costs.

Now they are looking at how to effectively implement screenings, what the practice would look like, what the age schedule for screenings should be, and who would benefit most. Early detection can play an integral role in managing T1D and improving quality (and quantity) of life.

Diabetes research occurs at all stages of the disease, from the time patients are pre-symptomatic to those with the most serious complications. It covers everything from screenings to closed-loop systems for treatment to understanding the cellular and molecular impact of the disease. Diabetes Research Connection is committed to supporting a wide range of T1D research by providing critical funding to early-career scientists. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org.

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Study Affirms Safety and Effectiveness of U.S. Insulin Products

When an individual with type 1 diabetes (T1D) administers insulin to control their blood sugar levels, they want to feel confident that no matter what U.S. retail pharmacy they purchased their insulin from, it will work. Differences in consistency and potency of insulin could have a detrimental impact on patient health and their ability to manage their T1D.

A recent study looked at samples of human and analog insulin products from across manufacturers and found that they were all correctly labeled and contained the expected quantity of active insulin. Since individuals with T1D rely on insulin injections multiple times per day, it can be reassuring to know that the product they are using adheres to how it is labeled.

The study was a joint effort between JDRF, the American Diabetes Association (ADA), and the Leona M. and Harry B. Helmsley Charitable Trust. The study was conducted within a single year, so now the team is looking to expand to a second phase that measures for any variations again, this time looking at “potential seasonal variations in reported insulin activity.”

Diabetes Research Connection (DRC) is proud to see that manufacturers are producing quality insulin products that meet consistency and potency standards. Worrying about the quality of their insulin is not something that individuals with T1D should have to do. The DRC supports early-career scientists in pursuing novel, peer-reviewed research focused on the prevention and cure of type 1 diabetes as well as minimizing complications and improving quality of life for individuals living with the disease. To learn more, visit https://diabetesresearchconnection.org.

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Combination Therapy May Help Improve Blood Sugar Management

Maintaining stable blood sugar levels and minimizing complications is a constant challenge for many individuals living with type 1 diabetes. They must always be alert to whether their blood sugar is too low or too high and how much insulin to administer. However, researchers are continually exploring ways to improve blood sugar management by better understanding how diabetes affects the body.

In a recent study, researchers from Stanford University have taken a new approach by combining two FDA-approved drugs and developing a way for them to work in tandem as they naturally do in the body through a single injection. In addition to insulin, individuals with type 1 diabetes (T1D) would also take a drug based on the hormone amylin. This drug is already FDA-approved, but less than 1% of patients with diabetes take it. This could be because they do not want to administer a second shot every time they take insulin. When combined, insulin and the amylin-based drug work together just as they do when naturally occurring in the body. Amylin is produced by the same insulin-producing beta cells in the pancreas.

According to researchers, amylin works in three ways:

“First, it stops another hormone, glucagon, from telling the body to release additional sugar that has been stored in the liver. Second, it produces a sense of “fullness” at mealtimes that reduces food intake. Third, it actually slows the uptake of food by the body, reducing the typical spike in blood sugar after a meal. All three are a boon to diabetes care.”

However, in their current states, insulin and the amylin-based drug are too unstable to combine in one syringe. To combat this problem, the researchers have developed a protective coating that encompasses each molecule individually, allowing them to stably exist together. This molecular wrapper has a Velcro-like feature that “reversibly binds to both insulin and amylin separately, shielding the unstable portion of each molecule from breakdown.” Once administered, the coating dissolves in the bloodstream.

With this protective coating – known as cucurbituril-polyethylene glycol (CB-PEG) – the combination of insulin and the amylin-based drug showed stability for at least 100 hours. This could give it a shelf life that is long enough to be used with an insulin pump. Researchers have tested the combination therapy on diabetic pigs and are working toward gaining approval for human trials. Since both drugs are already FDA-approved, this could help to move things along more quickly.

Diabetes Research Connection (DRC) is excited to see what this could mean for the future of T1D treatment and blood glucose management. This combination therapy could help alleviate some of the challenges that patients face and improve management of the disease. Though not involved with this study, the DRC is committed to supporting research around type 1 diabetes in order to improve diagnosis, treatment, prevention, and the pursuit of a cure. The organization provides critical funding to early-career scientists to advance their research. Learn more about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org.

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Glucose-Sensing Neurons Work Together to Manage Blood Sugar

Whereas insulin is necessary to combat high blood glucose levels, a different hormone is necessary to manage low ones: glucagon. This hormone helps to regulate glucose production and absorption bringing glucose levels back into an acceptable range.

A recent study from researchers at Baylor University and other institutions found that there is a specific group of neurons in the brain that may play an integral role in blood sugar regulation and preventing hypoglycemia. Within the ventrolateral subdivision of the ventromedial hypothalamic nucleus region, there are estrogen receptor-alpha neurons that are also glucose-sensing.

What the researchers found particularly interesting was that half the neurons became more active when blood sugar levels were high (glucose-excited), and the other half became more active when blood sugar levels were low (glucose-inhibited). Furthermore, each group of neurons used a different ion channel to regulate neuronal firing activities. However, they both led to the same result – increasing blood glucose levels when they were low – even though they were activating different circuits in the brain. This leads to a perfect balance in managing blood sugar.

The next step in the study is to investigate whether the fact that all of the neurons in this specific group that expressed estrogen receptors play a role in the glucose-sensing process. In turn, this could lead to more gender-specific studies to determine differences in neuronal function when it comes to blood sugar regulation.

One important factor to note is that all of these studies were conducted on hypoglycemic mice. The researchers did not identify whether the process is believed to be the same in humans.

This is another step forward in better understanding how diabetes affects the body, brain, and functioning. Diabetes Research Connection strives to empower early-career scientists in pursuing novel, peer-reviewed studies related to type 1 diabetes by providing up to $50K in funding. Research is focused on the prevention and cure of type 1 diabetes as well as minimizing complications and improving quality of life for individuals living with the disease. Find out how to support these efforts by visiting https://diabetesresearchconnection.org.

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Targeting the Effects of Specific Drugs on Pancreatic Islets

The production of insulin and glucagon used to regulate blood sugar levels come from pancreatic islet cells. In individuals with type 1 diabetes, the immune system mistakenly attacks and destroys these cells leaving the body unable to naturally regulate blood sugar. That means that individuals must continuously monitor and manage these levels themselves.

A recent study examined the impact that specific drugs have on pancreatic islet cells and their function. Researchers were able to fine-tune single-cell transcriptomics to remove contamination from RNA molecules that could interfere with results and negatively affect reliability of the data.

Once they had created decontaminated transcriptomes, they tested three different drugs that relate to blood glucose management. They found that one drug, FOXO1, “induces dedifferentiation of both alpha and beta cells,” while the drug artemether “had been found to diminish the function of alpha cells and could induce insulin production in both in vivo and in vitro studies.” They compared these drugs in both human and mouse samples to determine if there were any differences in how the cells responded. One notable difference was that artemether did not have a significant impact on insulin expression in human cells, but in mouse cells, there was reduced insulin expression and overall beta cell identity.

Single-cell analysis of various drugs could help guide future therapeutic treatments for type 1 diabetes as researchers better understand their impact. Targeted therapies have become a greater focus of research as scientists continue to explore T1D at a cellular level.

Diabetes Research Connection (DRC) is interested to see how single-cell sequencing and the ability to decontaminate RNA sequences could affect diabetes research. The organization supports a wide array of T1D-focused studies by providing critical funding to allow early-career scientists to advance their research. To learn more and support these efforts, visit https://diabetesresearchconnection.org.

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Examining the Co-Occurrence of Asthma and Type 1 Diabetes

It is not uncommon for individuals to have more than one disease or condition at a time. Oftentimes, there is an underlying link between their development, even if it is not entirely understood. In addition, many conditions run in families, which can be due to genetics or even possibly environmental factors.

A recent study looked at data from more than 1.2 million children in Sweden to see if there was a potential association between asthma and type 1 diabetes. They examined risk both within individuals and within families, comparing information from full siblings, half-siblings (both maternal and paternal), full cousins, and half cousins as well.

According to their results, individuals with asthma were at increased risk of developing type 1 diabetes (T1D), but the presence of T1D did not increase their risk of later developing asthma. In addition, if an individual had either T1D or asthma, their full siblings were at increased risk of developing either disease. Full cousins were also at a greater risk.

Data was obtained from several Swedish registers held by the National Board of Health & Welfare and Statistics Sweden and encompassed 1,284,748 singleton children born in Sweden between January 1, 2001, and December 31, 2013. Of these children, 121,809 had asthma, 3,812 had T1D, and 494 had both diseases. Their findings suggest that there may be shared familiar factors that affect associations ranging from genetics to environment.

Understanding these potential associations may help healthcare providers with recognizing symptoms of either disease earlier on if one has already been diagnosed. It may also influence management or treatment of these diseases. More research is necessary to further explore possible connections between asthma and T1D and what that might mean for future care.

Though not involved in this study, the Diabetes Research Connection (DRC) is continually striving to advance research related to T1D by providing critical funding to early-career scientists for their studies. This can lead to improved diagnosis, treatment, and prevention methods, as well as one day finding a cure. To learn more about current research projects and how to help, visit https://diabetesresearchconnection.org.

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Using Saliva to Monitor Blood Glucose Levels

Traditional blood glucose monitoring for type 1 diabetes has involved using finger sticks to draw and test a small droplet of blood. This can leave fingers sore and calloused as testing occurs multiple times throughout the day to keep blood sugar in check. In addition, it requires a variety of supplies, and lancets used to draw blood must be disposed of safely and properly.

A recent study found that there may be a non-invasive method of monitoring blood sugar that is easier to collect and test: saliva. Researchers found that saliva contains numerous biomarkers that could make it a feasible alternative to blood. In addition, testing is conducted using Attenuated Total Reflectance Fourier Transform Infrared (ATR-FTIR) spectroscopy rather than the reagents that are necessary when blood is used. That makes saliva a more sustainable and eco-friendly option as well. In early testing, using saliva was 95.2% accurate in monitoring blood sugar.

Regular testing and monitoring of blood sugar is essential for individuals with type 1 diabetes to reduce risk of hypo- or hyperglycemia as well as diabetic ketoacidosis and other complications. However, many people do not enjoy constant finger sticks. Using saliva and ATR-FTIR spectroscopy or other technology could become a non-invasive, less painful option. This process is still in early stages of testing, and more research is needed to determine its efficacy and how exactly it could be used by patients.

Diabetes Research Connection (DRC) is excited to see how this form of blood glucose monitoring evolves moving forward and what it could mean for individuals living with type 1 diabetes. It is another step toward providing more management options and better meeting the needs of individuals with diabetes.

Though not involved with this study, the DRC is committed to providing critical funding for early-career scientists pursuing research related to type 1 diabetes. This could include topics focused on improved diagnosis, treatment, prevention, and management of the disease, as well as minimizing complications, enhancing quality of life, and finding a cure. To learn more and support these efforts, visit https://diabetesresearchconnection.org.

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Using Gene Editing as a Potential Type 1 Diabetes Treatment

It has been more than a decade since scientists began experimenting with CRISPR gene-editing technology to alter DNA sequences and gene function. This tool allows scientists to correct mutations or defects in genes and manipulate them to treat or prevent certain diseases. This technology has also been used with crops. Researchers are still exploring this tool’s potential and ethical use, but many studies have been conducted thus far using it in different ways.

A recent study examines the use of CRISPR-Cas9 in the treatment of diabetes. Scientists at Washington University in St. Louis corrected a mutation in the WFS1 gene which causes Wolfram syndrome, of which diabetes is one symptom. Then, they used CRISPR-Cas9 to edit human-induced pluripotent stem cells and target their differentiation into pancreatic beta cells. This creates an abundance of fully functional beta cells to be used in conjunction with gene therapy.

When the altered beta cells were transplanted into diabetic mice, blood glucose levels dropped and glycemic control was maintained for at least six months. Scientists are exploring whether this process can be used to effectively reverse or stop type 1 diabetes by editing a patient’s own beta cells. In addition, the abundance of cells created means that more testing can occur to develop specific medications or therapies to treat the disease.

More research is needed before gene editing can potentially be used as an approved treatment for type 1 diabetes, but researchers continue to learn more. Diabetes Research Connection (DRC) is interested to see what this technology may mean for the future of diabetes treatment and management and how it could evolve. Though not involved with this study, the DRC is committed to supporting research around type 1 diabetes and provides early-career scientists with critical funding for novel, peer-reviewed studies. To learn more about current projects and how to help, visit https://diabetesresearchconnection.org.

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Dexcom to Launch Patient Assistance Program to Support Type 1 Diabetes Care

Type 1 diabetes (T1D) does not take a break for a global pandemic, or for anything else. It is a chronic health condition that must be managed 24/7/365. Access to affordable medical and testing supplies is critical for patients. With unemployment skyrocketing as an effect of the coronavirus outbreak, many people have lost their employer-provided healthcare. Without insurance (or income from a steady job), paying for diabetes supplies can become difficult.

In an effort to better support individuals impacted by the loss of insurance due to COVID-19, Dexcom is launching a patient assistance program. The program will provide eligible participants with “two 90-day supply shipments, with each dispatch including one transmitter and three boxes of sensors at just $45 per 90-day shipment” according to the organization.

This will allow patients to continue following their normal management routine without fear of how they will afford their CGM supplies. The program will be rolled out over the next few weeks and last through the duration of the COVID-19 pandemic. U.S. residents who receive state or federal assistance through programs such as Medicare, Medicaid, or VA benefits are not eligible to participate.

Dexcom’s patient assistance program is just one more example of businesses stepping up to support individuals during this time of need. In recent weeks, pharmaceutical companies have also been providing assistance by reducing or limiting out-of-pocket costs for insulin. Diabetes Research Connection (DRC) is glad to see that individuals with T1D are receiving support to ensure their needs are met and their health is effectively managed during these challenging times. Until a cure for diabetes is found, the need for insulin and continuous glucose monitors remains a priority.

DRC continues to work toward finding a cure and improving treatment options by providing critical funding to early-career scientists. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org.

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Targeting Stem Cell-Generated Beta Cells for Type 1 Diabetes Treatment

In developing more effective treatment methods for type 1 diabetes, several approaches have targeted the disease at a cellular level. Scientists know that, on the most basic level, the disease stems from the destruction of insulin-producing beta cells. However, they are unsure exactly what causes the body to mistakenly attack and destroy these cells. There have been many studies looking at how to reintroduce or stimulate these beta cells within the body in order to produce insulin naturally, but this is a difficult process and one that is hard to sustain.

A recent study may have found a way to improve the number and quality of beta cells produced for cell replacement therapy. The differentiation of human pluripotent stem cells into targeted beta cells is a long, complex process that can take weeks. Even after the process is finished, there is an assortment of cells that have been produced because not all cells differentiate as desired. In addition, not all beta cells are fully functional.

Researchers found that by adding CD77, a monoclonal antibody, they can better control the differentiation of cells into specific pancreatic progenitors. Having these pancreatic progenitors present at the start of the differentiation process may lead to higher quality beta cells that are more responsive to glucose and have improved insulin secretion abilities. In addition, it may help direct differentiation meaning a more homogenous group of cells is created, which is beneficial for cell replacement therapy. Having more of the desired type of cell can also save time and money.

Being able to better control the differentiation process may improve beta cell replacement therapy options for individuals with type 1 diabetes. Developing ways for the body to once again generate its own insulin and manage blood glucose levels could change the way the disease is managed. This study was a partnership between Helmholtz Zentrum München, the German Center for Diabetes Research (DZD), Technical University of Munich (TUM), and Miltenyi Biotec.

Though not involved with this study, the Diabetes Research Connection stays abreast of the latest advancements in the field and how emerging research may impact the diagnosis, treatment, and management of type 1 diabetes, as well as the search for a cure. As more about the disease is understood, researchers can build on this information. The DRC provides critical funding for early-career scientists whose research is focused on type 1 diabetes. To learn more and support these efforts, visit https://diabetesresearchconnection.org.

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Could Vitamin D Help Protect Against Type 1 Diabetes?

One trend that researchers have noticed in type 1 diabetes (T1D) is that individuals with this disease tend to have some level of vitamin D deficiency. This impacts vitamin D receptor (VDR) expression, which may contribute to the development of diabetes.

A recent study found that higher levels of VDR may actually protect insulin-producing pancreatic beta cells and preserve some of their mass and function. They also found that as circulating glucose levels decreased, so did VDR levels. Maintaining a stable level of vitamin D may help counteract the disease.

Researchers are investigating the potential effectiveness of using vitamin D supplements as a prevention and treatment strategy for type 1 diabetes, and it may be beneficial for type 2 diabetes as well. They need to develop a clearer understanding of the negative regulation of VDR in individuals with the disease and how to improve VDR levels to a point where they would be more protective.

This study was conducted on mouse models, so it would need to be tested in humans as well to see if the same findings are true. However, this could be a step toward proactively reducing risk of T1D and protecting insulin-producing beta-cell function and mass. Researchers are continuing to learn more about VDR expression and its relationship to diabetes.

Diabetes Research Connection, though not involved with this study, is committed to supporting early-career scientists pursuing novel research on type 1 diabetes in order to expand the body of knowledge and help prevent or cure the disease in addition to reducing complications and improving quality of life for those living with the disease. Scientists are learning more every day. To support these efforts and find out more about current projects, visit https://diabetesresearchconnection.org.

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Supporting Diabetes Management Via Drone

Type 1 diabetes (T1D) affects people from all walks of life around the world. A challenge in managing the disease is regular access to healthcare and necessary supplies. Healthcare providers in Ireland recognized the impact of this problem even more when natural disasters such as snowstorms, hurricanes, and flooding made it difficult for patients to reach clinics for their appointments or to get medications.

As a result, researchers turned to technology as a way to potentially help patients receive the care they need. They spent more than a year working out the logistics and regulatory compliance of using drones to deliver supplies to individuals in remote areas or those cut off from access following natural disasters or other incidents such as COVID-19. The researchers had to ensure that when using the drone, they were following all aviation and aerospace regulations, as well as medical and safety regulations.

The first flight traveled around 20 km each way going from Galway, Ireland, to the Aran Islands on September 13. The Wingcopter 178 drone delivered insulin from a pharmacy to a patient’s clinician and picked up a blood sample for remote testing of HbA1c levels. This test flight demonstrated that autonomous delivery of insulin is possible.

There was a significant amount of planning, research, and collaboration that went into making the drone delivery possible, but it is a starting point for making this technology available in healthcare. The researchers needed to have backup plans in place for each step of the process, and they worked closely with a multidisciplinary team including aviation and medication regulators.

However, this successful test flight is a stepping stone toward making drone delivery a reality for patients with diabetes. This could allow patients to continue receiving life-saving insulin and other supplies even when they are unable to make it out of their home. Diabetes does not take a break during pandemics or adverse events, and there are patients who live in rural communities where access to healthcare is a challenge.

Diabetes Research Connection (DRC) is excited to see how technology continues to improve and whether drone delivery becomes a feasible option as part of diabetes management and healthcare in general. The DRC provides funding for novel, peer-reviewed research studies focused on the prevention, cure, and improved management of type 1 diabetes. To learn more and support these efforts, visit https://diabetesresearchconnection.org.

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Could There Be More than One Form of Type 1 Diabetes?

Researchers know that there are significant differences between type 1 diabetes (T1D) and type 2 diabetes (T2D), but now they are digging a little deeper. When it comes to T1D, the disease may not affect everyone in the same way. According to a recent study, there may be more than one endotype, and a major differentiator could be age of diagnosis.

The study looked at a small sample of 19 children diagnosed with T1D within the past two years and compared age of diagnosis against amount of beta cell destruction and levels of proinsulin and C-peptides. They also compared these ratios in a group of 171 adults with T1D based on their age of diagnosis. Their results showed that children who were diagnosed before the age of 7 had much higher levels of proinsulin-insulin co-localization than those diagnosed after age 13. Individuals between ages 7 and 13 were divided and fell into one group or the other.

The researchers also compared results against CD20Hi and CD20Lo immune profile designations for each participant. Children age 7 or younger tended to be CD20Hi, while those age 13 or older were CD20Lo, and the children in between were aligned with their respective groups based on whether they were CD20Hi or CD20Lo.

These differences in proinsulin and C-peptide concentrations demonstrate a distinction in how individuals are impacted by T1D, leading to at least two separate endotypes. Understanding whether an individual has T1D endotype 1 (T1DE1) or T1D endotype 2 (T1DE2) could enable more targeted and effective treatment of the disease based on how each group responds. Individuals with T1DE1 are identified as having higher levels of beta cell loss, therefore may have more difficulty regulating blood glucose. Those with T1DE2 may retain more beta cells, and determining ways to activate and protect these cells could support improved natural insulin production.

Recognizing that T1D affects people differently is a step in the right direction toward more personalized medicine and targeted therapies. Therapeutic trials could be aimed at groups depending on age of diagnosis and specific endotype in the future as larger studies are conducted to determine the significance of these findings.

Diabetes Research Connection (DRC) is committed to supporting advances in research around type 1 diabetes and provides early-career scientists with critical funding for their studies. Research is focused on preventing and curing type 1 diabetes, minimizing complications, and improving quality of life for those living with the disease. Learn more and support these efforts by visiting https://diabetesresearchconnection.org.

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Artificial Pancreas App Supports Type 1 Diabetes Management

Maintaining good glycemic control is challenging when living with type 1 diabetes. Individuals must carefully monitor their blood glucose levels throughout the day, then administer the appropriate amount of insulin to try to stay within target range. This can be more difficult than it sounds. Furthermore, many people with type 1 diabetes struggle with their blood sugar dropping overnight while they are asleep.

Patients living in the UK may have access to a new artificial pancreas app that takes away some of the stress and burden of constant blood sugar management. The CamAPS FX app works in conjunction with the Dana RS insulin pump and the Dexcom G6 continuous glucose monitor. Using a complex algorithm, the app tracks blood glucose levels, then automatically adjusts insulin administration accordingly. This reduces the demand for regular finger sticks to check blood sugar, and patients do not need to calculate how much insulin they require on their own.

The app has been approved in the UK for individuals age one and older, including pregnant women, who have type 1 diabetes. It was developed based on 13 years of clinical research conducted by Professor Roman Hovorka from the University of Cambridge and Cambridge University Hospitals NHS Foundation Trust and his team at the Wellcome-MRC Institute of Metabolic Science. In addition, data from the app can be shared with patients’ healthcare teams allowing them to provide more personalized diabetes care.

Technology has made some significant advancements in type 1 diabetes care, and this is one more example of how it can impact management of the disease and improve health outcomes. Artificial pancreas technology is an area that researchers have been focused on improving over the years in order to give patients more options and reduce the burden of managing the disease.

Diabetes Research Connection (DRC) is excited to see more results from use of the app and what it could mean for future diabetes management, not just in the UK but around the world. Currently the app is only available to patients at select diabetes clinics in the UK. Though not involved with this project, the DRC is committed to advancing diabetes research to help prevent and cure type 1 diabetes, minimize complications, and improve quality of life for those living with the disease. Early-career scientists can receive up to $50K in funding to support novel, peer-reviewed research projects. To learn more about current studies and contribute to these efforts, visit https://diabetesresearchconnection.org.

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Using Telehealth to Enhance Pediatric Type 1 Diabetes Management

Telehealth has come a long way in improving access to care. It has become even easier for patients to connect with healthcare providers without going to their office. Using available technology, a recent study out of the University of California, Davis (UC Davis) examined whether management of type 1 diabetes (T1D) in pediatric patients could be improved through telehealth.

Fifty-seven patients under the age of 18 participated in the study where they were connected with a member of the research team every four, six, or eight weeks via video conference for at least one year. This was in addition to quarterly clinic visits. All of the patients had suboptimal glycemic control before the study began, and most lived at least 30 miles away from the hospital.

The program was led by Stephanie Crossen, a pediatric endocrinologist at UC Davis Health. Prior to each video call, patients sent data from their diabetes devices for Crossen and her team to review. After one year, their findings showed that “83 percent of participants completed four or more diabetes visits within a year, compared to only 21 percent prior to the study,” and “mean HbA1c decreased from 10.8 to 9.6 among participants who completed the full year.”

In addition, 93 percent of participants were highly satisfied with the program, and more participants were using technology such as insulin pumps and continuous glucose monitors (CGMs). However, one area that did not change significantly was the number of diabetes-related emergency room or hospital visits.

Still, the study shows that telehealth could be a valuable intervention for children and youth with type 1 diabetes to help them better manage their disease and health outcomes. A reduction in HbA1c levels and an increase in frequency of care is encouraging. Telehealth may be one more tool for effectively supporting individuals with T1D.

Research continues to advance the understanding, treatment, and management of T1D. Though not involved with this study, the Diabetes Research Connection (DRC) supports these efforts as well by providing critical funding to early-career scientists studying the disease.  Researchers can receive up to $50K for novel, peer-reviewed projects aimed at preventing or curing type 1 diabetes, minimizing its complications, and improving quality of life for individuals living with the disease. To learn more, visit https://diabetesresearchconnection.org.

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Connect For A Cure: June 2020 Newsletter

The importance of research has been highlighted during this pandemic and our early-career scientists continue their ground-breaking, peer-reviewed research. Since November, we’ve funded 8 new research projects. Thank you for your support and for being a part of the DRC community.

Click on the link below to read more about what we’ve been up to and the impact we are making together. It takes a community to connect for a cure!

June 2020 Newsletter

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Recapping Current Research Regarding Type 1 Diabetes Development and Cardiovascular Risks

Our bodies are formed from an innumerable number of cells and molecules. Both DNA and RNA play a role in determining cells’ function and purpose. At a conference of the National Congress of the Spanish Diabetes Society, researchers revealed new studies regarding the potential role of long non-coding RNAs (lncRNAs) in the development of type 1 diabetes, as well as the risk of cardiovascular problems in individuals with the disease.

A recent study found that lncRNA, which are use in transcriptional and post-transcriptional regulation of cells and are not translated into proteins, may be involved in the destruction of insulin-producing beta cells. There may be some forms of lncRNAs that affect inflammation and cell death, which are factors in the development of type 1 diabetes.

Dr. Izortze Santín Gómez, a professor at the University of the Basque Country and a researcher at the Biocruces Bizkaia Research Institute is studying the fundamental characteristics of the lncRNAs and how they may affect pancreatic beta cells on a genetic-molecular level. Once this is better understood, researchers could begin modifying the lncRNAs to create a targeted therapy that increases survival rate and viability of the pancreatic beta cells.

Another study that was presented at the conference involved cardiovascular risk for individuals with type 1 diabetes. Joseph Ribalta, a professor at the Rovira i Vigili University of Reus, found that “more than 30% of heart attacks occur in people with apparently normal LDL cholesterol.” High cholesterol is a key risk factor for heart attacks. His findings have revealed that individuals with T1D may be at greater risk because “LDL particles are more numerous and smaller, that their HDLs work less effectively and/or that there are some lipoproteins (remnants) that the body has trouble eliminating.”

Identifying these potential risk factors and knowing how to test for or treat them could help reduce hidden cardiovascular risk in individuals with T1D. For instance, focusing on triglycerides rather than cholesterol may be beneficial for patients who meet certain criteria.

There is a lot of interesting work coming out of laboratories and universities around the world regarding type 1 diabetes. Researchers are constantly improving and refining their understanding of the disease and possible ways to prevent, treat, or cure it. Diabetes Research Connection (DRC) is committed to contributing to this wealth of knowledge by providing critical funding to early-career scientists pursuing novel research studies focused on type 1 diabetes. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org.

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Increasing Cell Protection Against Immune System Attacks

One of the challenges researchers have faced with using cell therapy to treat type 1 diabetes is that the body’s immune system may still attack and destroy transplanted cells. This process may be slightly delayed depending on the approach used, but it often still occurs. That means that patients may still need to rely on immune suppression medications in conjunction with cell therapy. However, immunosuppression can increase risk of infection or other complications.

A recent study found that targeting highly durable cells that have the ability to escape immune attacks and survive may be key in developing a more effective treatment for type 1 diabetes. Dr. Judith Agudo has identified stem cells with this “immune privilege” and is working to determine exactly what contributes to this level of protection and how to replicate it with beta cells. Dr. Agudo is an assistant professor in the department of immunology at Harvard Medical School and in the department of cancer immunology and virology at the Dana-Farber Cancer Institute.

If scientists can engineer insulin-producing beta cells that have the ability to avoid attacks from the immune system while still performing their intended functions, this could be a huge step forward in potentially treating type 1 diabetes. The beta cells would be able to stimulate insulin production without requiring the patient to take immune suppression medications, meaning their immune system could continue to function as normal and fend off infection.

Once Dr. Agudo is able to develop these durable beta cells, they will be tested in animal models, followed by humans a few years later. It is important to conduct thorough testing to ensure this method is both safe and effective. If it is, the goal would be to eventually make it available to anyone who requires the use of insulin.

Diabetes Research Connection (DRC) is excited to see how this study evolves and what it could mean for the future of diabetes treatment. While not involved in this study, the DRC plays an integral role in providing critical funding for early career scientists focused on research for type 1 diabetes. Scientists continue to advance understanding of the disease and potential approaches to improve diagnosis, treatment, management, and quality of life for individuals living with type 1 diabetes. Learn more about current DRC projects and how to support these efforts by visiting https://diabetesresearchconnection.org.

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Generating Pancreatic Islet Organoids to Treat Type 1 Diabetes

In individuals with type 1 diabetes, the immune system mistakenly attacks and destroys insulin-producing beta cells. Without a naturally occurring supply of insulin to manage glucose, blood-glucose levels can quickly spiral out of control leading to hypo- or hyperglycemia. If left untreated, this can become potentially fatal.

A recent study found a way to generate an abundance of pancreatic islet organoids that are glucose-responsive and insulin-secreting. As such, they can help with management and potential reversal of type 1 diabetes. Researchers identified a cluster of protein C receptor positive (Procr+) cells in the pancreas of adult mice. These cells have the ability to differentiate into alpha, beta, omega, and pancreatic polypeptide (PP) cells, with beta cells being the most abundant.

The Procr+ islet cells can then be cultured to generate a multitude of islet-like organoids. When the organoids were then be transplanted into adult diabetic mice, they were found to reverse type 1 diabetes. More research is necessary to determine if human pancreatic islets contain these same Procr+ endocrine progenitors and a similar process could be used to treat type 1 diabetes in humans.

As scientists delve deeper into the cellular impact of the disease and how different cells respond and can be manipulated, it opens new doors to potential treatments or cures for type 1 diabetes. Though not involved in this study, this is the type of cutting-edge research that the Diabetes Research Connection (DRC) is committed to supporting. Early-career scientists can receive up to $50,000 in funding through DRC for novel, peer-reviewed research aimed at preventing and curing type 1 diabetes, minimizing complications, and improving the quality of life for individuals living with the disease. To learn more and support these efforts, visit https://diabetesresearchconnection.org.

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Could Insulin-Producing Beta Cells Play a Role in Triggering Onset of Type 1 Diabetes?

Researchers know that type 1 diabetes (T1D) occurs when the immune system mistakenly attacks and destroys insulin-producing beta cells. This leaves the body unable to self-regulate blood glucose levels because it produces little or no insulin on its own. What scientists have been striving to understand is what causes the body to destroy these cells in the first place.

A recent study found that the beta cells themselves may play a role in signaling the attack. The insulin-producing cells may be sending out signals that increase M1 macrophages that cause inflammation and the resulting cell destruction. The M2 macrophages that reduce inflammation and help repair tissue are not as heavily expressed.

The researchers looked specifically at Ca2+-independent phospholipase A2beta (iPLA2beta) enzymes and the resulting iPLA2beta-derived lipids (idles) and how they are activated by beta cells.  The idols either stimulate M1 macrophages or M2 macrophages depending on the active signaling pathways.

The study involved two sets of mice – one group that had no iPLA2beta expression (knockout mice), and one group with overexpression of iPLA2beta.  Researchers found that even when M1 macrophage activation was induced, the knockout mice experienced an increase in M2 macrophages and a reduced inflammatory state. The mice that had overexpression of iPLA2beta, on the other hand, experience an increase in M1 macrophages and inflammatory eicosanoids.

According to Sasanka Ramanadham, Ph.D., research co-lead, “To our knowledge, this is the first demonstration of lipid signaling generated by beta cells having an impact on an immune cell that elicits inflammatory consequences. We think lipids generated by beta cells can cause the cells’ own death.”

As scientists continue to learn more about lipid signaling and the potential role it plays in the development of type 1 diabetes, this could lead to improved methods of delaying or preventing onset or progression of the disease. This is yet another approach that researchers are taking to understand as much as they can about how and why T1D develops and how to better manage the disease.

It is this type of research that opens doors to advancements toward preventing or curing type 1 diabetes. Diabetes Research Connection (DRC) supports early-career scientists pursuing novel, peer-reviewed research studies focused on improving diagnosis, treatment, and prevention of T1D as well as improving quality of life for individuals living with the disease and one day finding a cure. Ensuring researchers receive necessary funding for their projects is critical. To learn more about current projects and support these efforts, visit https://diabetesresearchconnection.org.

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Redifferentiating Beta Cells to Treat Type 1 Diabetes

All cells serve a specific purpose, and each one plays an integral role in the function and survival of the human body. However, in individuals with type 1 diabetes, insulin-producing beta cells are destroyed leaving the body unable to self-manage glucose levels. Scientists have been trying to determine exactly why this occurs, and how to stop, prevent, or reverse it for years. Each day they learn a little more.

A recent study out of Germany examines dedifferentiation of beta cells as a potential cause for type 1 diabetes.  Researchers believe that insulin-producing beta cells may lose their identity, which in turns causes a regression in function.  They sought to target the affected cells using diabetic mouse models to see if they could redifferentiate the beta cells back to normal function, or at least preserve existing function if regression is caught early.

To do this, they invoked diabetes in mice using streptozotocin but left some functional beta cells. Then, they administered a combination of Glucagon-like peptide-1 (GLP-1) and estrogen in conjunction with long-acting insulin.  The drug was directed to the dedifferentiated beta cells, and results showed that this combination treatment helped to “normalize glycemia, glucose tolerance, to increase pancreatic insulin content and to increase the number of beta cells.”  They also found that when GLP-1/estrogen was used together, rather than each substance on its own, human beta cells also showed improved function.

The mice in the study showed no signs of systemic toxicity even when high doses of the drug were administered.  This could help to ease the way when the treatment is ready to be used in human trials. Researchers want to further explore whether this treatment could be used as a form of regenerative therapy to redifferentiate dedifferentiated beta cells and stimulate insulin production. If type 1 diabetes was detected early on, the therapy could potentially be used to slow or stop cell regression.

This study could change the way that some researchers approach their work and inspire new studies aimed at treating or curing type 1 diabetes. Diabetes Research Connection (DRC) supports early-career scientists in pursuing this type of work by providing necessary financial resources. With proper funding, scientists can move forward with their projects and improve not only understanding of the disease, but also treatment options.  The goal is to one day discover a cure. To learn more about current projects and how to help, visit https://diabetesresearchconnection.org.

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New Oral Treatment May Help with Managing HbA1c for Type 1 Diabetes

Keeping HbA1c levels within a healthy range can be challenging for those living with type 1 diabetes. It requires constant vigilance when it comes to monitoring blood sugar levels and administering the appropriate amount of insulin. Even with careful management, there can be complications.

A recent study found that a once-daily pill used in conjunction with insulin may help reduce HbA1c levels by as much as 0.32% after 12 weeks.  The pill, known as TTP399, activates glucokinase in the liver.  This, in turn, stimulates the body to improve glucose utilization which can lead to lower blood glucose levels. Overall, this could help improve HbA1c levels as well as time spent within a healthy glucose range.

A randomized, double-blind, adaptive study compared participants taking the TTP399 pill versus those on a placebo.  Those who received the pill showed improved glucose response and fewer symptomatic hypoglycemic episodes.  The average improvement in HbA1c was 0.21%, and there was also an average of an 11% reduction in the dosage amount of total daily mealtime bolus insulin needed.

On the other hand, the placebo group showed a 0.11% increase in HbA1c after the 12-week trial period.  Neither group reported any incidences of diabetic ketoacidosis, and there was only one incident of severe hypoglycemia, which occurred in the placebo group.

This phase 2 study involved 85 participants. They were all currently either administering daily injections or using an insulin pump.  If they were using a continuous glucose monitor (CGM), they had to be on it for at least three months prior to the start of the study to be included.

According to Steve Holcomb, president and CEO of vTv Therapeutics, “Consistent with FDA guidance, a 0.3% improvement in HbA1c is considered clinically meaningful and coupled with the well-controlled population of patients and favorable safety data from our clinical trials to date, this provides a strong basis for moving this potential first-in-class program forward.”

The pill could be used in conjunction with insulin therapy as a way of further managing and reducing HbA1c levels. This an exciting step forward in terms of type 1 diabetes management and supporting individuals in staying within healthy ranges for HbA1c and daily blood sugar levels.

Diabetes Research Connection (DRC), though not involved with this study, is interested to see how it evolves moving forward, and what it could mean for the future of oral treatment involving noninsulin products.

Research for type 1 diabetes continues to improve and advance every single day, and DRC helps makes this possible by providing critical funding to early-career scientists pursuing novel research studies on type 1 diabetes.  Through generous donations from individuals, corporations, and foundations, they are able to provide researchers with up to $50K in funding to support studies aimed at improving prevention measures, enhancing quality of life, reducing complications, and finding a cure. Learn more by visiting https://diabetesresearchconnection.org.

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Type 1 Diabetes Cases Continue to Rise

Type 1 diabetes (T1D) is a well-known disease, but it is one that scientists have yet to find a way to prevent or cure. The exact cause is unknown because it is believed that both genetics and environment play a role. While significant advances have been made in understanding and managing T1D over the years, it is still a disease that affects nearly 1.6 million Americans.

A recent study from the Centers for Disease Control and Prevention (CDC) reveals that the number of people diagnosed with T1D has increased by 30 percent since 2017. That is an alarming change. Breaking things down even further, it appears that the greatest increases have occurred among African American, Hispanic, and Asian/Pacific Islander children, with each group seeing an approximate 20 percent rise in cases between 2002 and 2015. When it comes to age, new diagnoses of T1D occurred most frequently in children between the ages of 5 and 14.

Overall, the CDC reports that approximately 1.4 million adults and 187,000 children in the United States are currently living with T1D. Unlike type 2 diabetes, T1D is not related to diet or lifestyle. For reasons that are not yet entirely understood, the immune system attacks and destroys insulin-producing beta cells leaving the body unable to effectively regulate blood sugar levels. Researchers have found many ways to support individuals in better monitoring and managing the disease, but they have not found a way to stop it from occurring or to cure it once it does.

That is why ongoing research and clinical trials are so important. They are vital to improving how the disease is managed and reducing complications, as well as one day finding a cure. Diabetes Research Connection provides early-career scientists with up to $75,000 in funding so that they can move forward with novel, peer-reviewed research studies focused on type 1 diabetes. This funding makes it possible for them to continue building the body of knowledge around the disease and exploring new treatment options. To learn more about how to support these efforts, visit https://diabetesresearchconnection.org.

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Exploring the Impact of Type 1 Diabetes on Bone Health

The body continually goes through a cycle of bone formation and bone resorption. As bone tissue is broken down and calcium is released, new microstructures are formed to support bone growth. Issues with bone metabolism, such as low bone mineral density (BMD), can lead to osteoporosis and other conditions. Studies have shown that adults with type 1 diabetes often have lower BMD.

A recent study found that individuals with type 1 diabetes may be at risk for decreased BMD compared to individuals without the disease. In a study of 173 children and adolescents with T1D compared to 1,410 non-diabetic peers, there was a significant difference in bone turnover markers in participants with T1D. Researchers looked at three different markers based on BMD measurements and blood samples and found that individuals with T1D had fewer of all three types of markers. However, there was no significant difference between bone turnover markers and diabetes duration, or in BMD levels between the two groups.

According to Dr. Jens Otto Broby Madsen, a physician in the department of pediatrics and adolescent medicine at Herlev Hospital in Denmark, “Decreased bone turnover markers might be the first warning of a negative effect of type 1 diabetes on bone health. Bone turnover markers might be a way of screening for early changes, long before changes can be seen by DXA scans.”

This may help improve health, quality of life, and disease management in the future to decrease risk of other conditions in conjunction with T1D, or at least improve early detection. Diabetes Research Connection (DRC) strives to support novel research studies by providing critical funding to early career scientists to help them move forward with their work. It is these types of efforts that increase understanding about the disease and can improve diagnosis, prevention, treatment, and management of T1D. To learn more about current projects and how to help, visit https://diabetesresearchconnection.org.

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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.

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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

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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.

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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. Learn more at https://diabetesresearchconnection.org.

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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. Learn more about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org.

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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.

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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.

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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.

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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. To learn more about current projects and donate, visit https://diabetesresearchconnection.org.

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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.

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Genetic Testing May Improve Prediction of Type 1 Diabetes Risk

The cause of type 1 diabetes is complex. There is not a single gene responsible for the disease, and both genetics and environment play a role. Plus, there is currently no way of preventing the disease from occurring. However, scientists believe that they can better predict which children and teenagers are at higher risk so their health can be monitored more closely and treatment started before they develop potentially life-threatening diabetic ketoacidosis.

A recent study found that a simple genetic test that compares an individual’s gene profile to 82 genetic sites that are known to be associated with type 1 diabetes can identify those who are most at risk. The test only costs $7 and uses a saliva sample, so no blood draws or painful testing are required. If an individual is flagged as high risk, they can then have autoantibody screening conducted to look for the presence of four islet autoantibody biomarkers of the disease. The presence of two or more autoantibodies further identifies an individual at increased risk. Autoantibody tests are slightly more expensive at $75 each.

While family history does increase risk of type 1 diabetes, it is not a guaranteed indicator, and more than 90% of people who develop the disease do not have a family history. This genetic test could help to differentiate between those at high risk and those at low risk so there are fewer unnecessary tests that occur, and individuals who could benefit from closer monitoring can be more accurately identified.

According to the study, “The general population risk of type 1 diabetes is about 4 out of 1000, and those with a positive genetic test now have a risk of about 4 out of 100.” Testing may allow doctors to provide more targeted care and treatment for the disease and support individuals in better managing their health. As research continues to advance, scientists learn more about the risk factors, biomarkers, genetic sites, and environmental factors that all contribute to the development of type 1 diabetes. In turn, this can enhance prediction, prevention, and treatment of the disease.

Diabetes Research Connection (DRC) supports early-career scientists in growing the body of knowledge that exists regarding type 1 diabetes by providing critical funding for research projects. Studies are focused on preventing and curing the disease as well as minimizing complications and improving quality of life. Learn more about current projects and how to support these efforts by visiting https://diabetesresearchconnection.org.

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Type 1 Diabetes Poses Significant Financial Burden

Managing type 1 diabetes (T1D) is not only time consuming, it is also expensive. Costs include not only the basics to manage the disease such as testing supplies, insulin, continuous glucose monitors, and insulin pumps, but also those related to hospital care for complications or outpatient care. In addition, there are lost wages due to disease-related situations, as well as indirect costs. These expenses can quickly add up.

A recent study looked at the estimated lifetime economic burden for individuals with T1D versus those without. The results showed that the difference between the two groups over the course of 100 years (a lifetime), was $813 billion. The model projected costs for 1,630,317 individuals with T1D and the same number without. It followed simulated patients year by year from the time they were diagnosed until they passed away.

According to the study, “Diabetes contributes $237 billion in direct medical costs per year or 7% of the nation’s $3.3 trillion spent on health care, which is higher than the annual health care expenditures for other chronic diseases, such as cancer (5%) and heart disease/stroke (4%).”

Not only did individuals without T1D experience lower costs, they also had higher life expectancy rates. Patients with T1D are at increased risk for disease-related complications which can further impact life expectancy and financial burden. Currently, T1D is a progressive disease, and it is something that affects individuals for the rest of their lives because there is no known cure. It must be managed 24 hours a day, 7 days a week, 365 days a year.

The extreme difference in lifetime societal burden and economic burden between these two groups demonstrates the need for continued research related to T1D. The ability to prevent or delay disease development or progression, or to cure the disease, could have major financial cost savings. The results of this study were estimated given available data and modeling capabilities, so they may underestimate the true impact.

There were also certain limitations to the study, including data that was only recent up to 2016 and did not include costs associated with CGMs, insulin pumps, or hybrid artificial pancreas systems. Complication-related costs were derived from data on patients with type 2 diabetes because it was not available for patients with type 1 diabetes. However, the general message does not change: finding a way to delay, prevent, or eliminate disease progression is essential, in addition to minimizing complications.

Diabetes Research Connection (DRC) is committed to advancing research around type 1 diabetes by providing critical funding to early-career scientists. Through their novel, peer-reviewed studies, they can improve understanding of the disease as well as treatment options. To learn more about current projects and support these efforts, visit https://diabetesresearchconnection.org.

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Studying Environmental Factors Related to Type 1 Diabetes

While genetics do play a role in the development of type 1 diabetes (T1D), researchers also believe that environment contributes as well. There is no singular cause of T1D, and all of its risk and protective factors are yet unknown. However, one study is striving to build a comprehensive understanding of diverse environmental factors and the role they may play in children developing T1D.

Researchers launched The Environmental Determinants of Islet Autoimmunity (ENDIA) several years ago and recently received an additional $8.25M in funding to keep it going for another three years. Over the past seven years, they have enrolled 1,500 participants, which includes babies ranging from pregnancy up to six months in age who have at least one immediate relative with T1D. The babies are seen every three to six months until they reach at least age three.

The study looks at a wide range of environmental factors in an effort to gain a better understanding of what increases or decreases risk of developing type 1 diabetes. Factors include “growth during pregnancy and early life, the method of delivery (natural birth versus caesarean section), the mother’s nutrition during pregnancy, infant feeding (breastfeeding and/or formula), the duration of breastfeeding and the child’s nutrition, the child’s immune system and when the child received vaccines and exposure to viruses during pregnancy and early life.”

Not only did it take a long time to recruit participants, it will take several years to gather and analyze the long-term data in order to identify potential risk or protective factors and how each child was affected. With millions of people living with T1D, this study may help to improve treatment and prevention in the future, possibly leading to a vaccine one day.

Diabetes Research Connection (DRC) will continue to follow this study and see how results progress and what discoveries are made. In the meantime, the organization provides critical funding for early career scientists pursuing research on various facets of T1D. Studies are focused on preventing or curing diabetes, as well as reducing complications and improving quality of life for individuals living with the disease. Visit https://diabetesresearchconnection.org to learn more about current projects and support these efforts.

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Scientists Found a Way to Generate Insulin-Producing Beta Cells

More than one million people in the United States are living with type 1 diabetes according to statistics from the Centers for Disease Control and Prevention. There is a strong push to improve management of the disease and find a cure. The more researchers learn about T1D, the more precise their prevention and treatment methods become.

A recent study reveals that improvements in stem cell therapy have reversed T1D in mice for at least nine months and, in some cases, for more than a year. One of the challenges that scientists have faced with using human pluripotent stem cells (hPSCs) is that it can be difficult to zero differentiation in one specific type of cell. Often multiple types of pancreatic cells are produced. While there may be an abundance of cells that scientists want, the infiltration of excess cells that are not needed diminishes their impact (even though they are not harmful).

Scientists at the Washington University School of Medicine in St. Louis have found a way to generate insulin-producing beta cells without creating as many irrelevant cells. Their approach focuses on the cell’s cytoskeleton, which is its inner framework. Through this process, they were able to produce vast amounts of beta cells that are able to normalize blood glucose levels.

When transplanted into severely diabetic mice (blood glucose levels above 500 mg/dL), the cells effectively reversed the effects of diabetes and brought blood sugar levels down into target range within two weeks. Normoglycemia was maintained for at least nine months.

This is a major step forward in stem cell therapy and the use of hPSCs to potentially cure diabetes one day. There is still more testing and research that needs to be done before this approach is applied to human trials.

Ongoing research is essential for finding a cure for T1D. Diabetes Research Connection supports these efforts by providing critical funding to early-career scientists pursuing novel research studies on the disease. By giving them the means to complete their projects, these researchers can continue to advance knowledge and treatment options. Learn more about current studies and how to help by visiting https://diabetesresearchconnection.org.

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Improved Beta Cell Function of Transplanted Islet Cells in T1D

One of the major challenges of using transplanted islet cells in the treatment of type 1 diabetes is cell death. Due to cellular stressors, poor oxygenation or vascularization, autoimmune response, and other factors, not all transplanted cells survive, and this can make treatment less effective. The body needs functional insulin-producing islet cells in order to effectively regulate blood sugar levels.

A recent study found that coculturing allogeneic islet beta cells with mesenchymal stromal cells (MSCs) may improve not only cell survival, but function as well. After donor cells are procured, they must be cultured and tested before being transplanted. This can generate significant cellular stress including hypoxia or low oxygenation, which can in turn lead to cell death. However, researchers found that MSCs support islet cells during this culture period by improving oxygenation and insulin secretion.

They also found that in response to these stressors, MSCs actually initiate mitochondria transfer to the islet beta cells.  This may improve mitochondrial ATP generation which plays an integral role in controlling insulin secretion. As a result, as glucose levels around the beta cells increased, so did their production and secretion of insulin.

Researchers experimented with this coculturing process with both mouse cells and human cells and found that human cells have a greater response and higher level of MSC-mediated mitochondria transfer that occurs. Though more extensive testing is necessary, these results show that MSCs may be an essential part of clinical islet transplantation and improved efficacy of beta cell function in treating individuals with type 1 diabetes.

Diabetes Research Connection (DRC) is interested to see how this study evolves moving forward and what it may mean for future therapeutic treatments for the disease. The DRC, though not involved in this study, provides critical funding for early career scientists pursuing novel, peer-reviewed research projects for type 1 diabetes. Learn more about current projects or how to support these efforts by visiting https://diabetesresearchconnection.org.

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Type 1 Diabetes Vaccine Shows Positive Results

In an effort to prevent or delay the onset of type 1 diabetes, researchers have been striving to create an effective vaccine. One of the challenges is that there are many different subgroups of type 1 diabetes, meaning not all patients respond the same. A recent study found that patients who had a specific human leukocyte antigen (HLA) showed a “positive and statistically significant dose-dependent treatment response” to the Diamyd vaccine, especially when given four doses rather than two.

Compared to patients who received a placebo, those who received a higher number of doses of the Diamyd vaccine had a “statistically significant treatment effect of approximately 60%” within 15 months. These findings may help to advance the development of antigen-specific immunotherapy options for individuals with type 1 diabetes leading to improved treatment or management of the disease.

Diabetes Research Connection (DRC) is interested to see how this vaccine continues to evolve moving forward and what it could mean for the prevention of type 1 diabetes in the future. Though not involved with this study, the DRC provides early career scientists with funding necessary to conduct novel, peer-reviewed research projects around type 1 diabetes in an effort to improve understanding, prevention, treatment, and management of the disease. To learn more or donate to a current project, visit https://diabetesresearchconnection.org.

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Improved Protection for Transplanted Stem Cell-Derived Islets

Insulin-producing beta cells are essential for effective blood sugar control. However, in individuals with type 1 diabetes, these cells are mistakenly destroyed by the immune system. That means exogenous insulin must be used instead to manage blood sugar. For years, scientists have been researching ways to replace or reproduce these islet cells. Two of the most common challenges faced, however, have been the need for long-term immunosuppression to protect transplanted cells from rejection, and limited availability of donor cells.

A recent study found that an improved source of encapsulation may protect islet cells from an immune response without decreasing their ability to secrete insulin. By using a conformal coating that is only a few tens of micrometers thick (as opposed to hundreds of micrometers thick), not only could insulin flow more freely through the encapsulation, so could oxygen, nutrients, and glucose as well. Yet larger immune cells were still unable to penetrate the barrier. In addition, the thinner coating allowed for more cells to be contained in a smaller space, and the capsule could be implanted in a wider range of locations so long as there was strong vascular function.

The encapsulated cells were implanted in NOD-scid mice and compared with non-coated stem cells as well as human islets. There were no statistically significant differences in performance of the cells and their ability to regulate glucose levels. The mice all showed a reversal in diabetes with the transplanted cells and returned to hyperglycemia once the cells were explanted.

The use of a microencapsulation method allows for more variability in placement of transplanted cells and helps protects against hypoxia-induced islet death and cell rejection. Furthermore, the thinner coating enabled islets to obtain better oxygenation because they are closer to blood vessels. It also allowed insulin to be secreted more quickly because it flowed more freely through the barrier.

One drawback that researchers noted was that encapsulated islets are unable to shed dead cells because they are contained within the capsule and have a lower absolute quantity of insulin secretion when compared to non-coated stem cell-derived islets.

Through this study, the researchers concluded that, “CC (conformal-coated) mouse islets can reverse diabetes long-term in a fully MHC-mismatched model.” While additional research is necessary to explore the effectiveness of this process in humans, it is a step in the right direction toward one day potentially curing type 1 diabetes.

Though not involved with this study, Diabetes Research Connection (DRC) stays abreast of the latest advancements in the field and provides critical funding to early career scientists pursuing novel research studies for type 1 diabetes. It is through these types of projects that researchers are able to improve quality of life for individuals living with the disease and move closer to finding a cure. To learn more about current DRC-funded projects or support these efforts, visit https://diabetesresearchconnection.org.

 

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Exploring Why the Immune System May Attack Insulin-Producing Beta Cells

Insulin-producing beta cells are essential for effective blood sugar control. However, in individuals with type 1 diabetes, these cells are mistakenly destroyed by the immune system. That means exogenous insulin must be used instead to manage blood sugar. For years, scientists have been researching ways to replace or reproduce these islet cells. Two of the most common challenges faced, however, have been the need for long-term immunosuppression to protect transplanted cells from rejection, and limited availability of donor cells.

A recent study found that an improved source of encapsulation may protect islet cells from an immune response without decreasing their ability to secrete insulin. By using a conformal coating that is only a few tens of micrometers thick (as opposed to hundreds of micrometers thick), not only could insulin flow more freely through the encapsulation, so could oxygen, nutrients, and glucose as well. Yet larger immune cells were still unable to penetrate the barrier. In addition, the thinner coating allowed for more cells to be contained in a smaller space, and the capsule could be implanted in a wider range of locations so long as there was strong vascular function.

The encapsulated cells were implanted in NOD-scid mice and compared with non-coated stem cells as well as human islets. There were no statistically significant differences in performance of the cells and their ability to regulate glucose levels. The mice all showed a reversal in diabetes with the transplanted cells and returned to hyperglycemia once the cells were explanted.

The use of a microencapsulation method allows for more variability in placement of transplanted cells and helps protects against hypoxia-induced islet death and cell rejection. Furthermore, the thinner coating enabled islets to obtain better oxygenation because they are closer to blood vessels. It also allowed insulin to be secreted more quickly because it flowed more freely through the barrier.

One drawback that researchers noted was that encapsulated islets are unable to shed dead cells because they are contained within the capsule and have a lower absolute quantity of insulin secretion when compared to non-coated stem cell-derived islets.

Through this study, the researchers concluded that, “CC (conformal-coated) mouse islets can reverse diabetes long-term in a fully MHC-mismatched model.” While additional research is necessary to explore the effectiveness of this process in humans, it is a step in the right direction toward one day potentially curing type 1 diabetes.

Though not involved with this study, Diabetes Research Connection (DRC) stays abreast of the latest advancements in the field and provides critical funding to early career scientists pursuing novel research studies for type 1 diabetes. It is through these types of projects that researchers are able to improve quality of life for individuals living with the disease and move closer to finding a cure. To learn more about current DRC-funded projects or support these efforts, visit https://diabetesresearchconnection.org.

 

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Understanding the Impact of GABA on Insulin Secretion and Regulation

In order to manage blood glucose levels, pancreatic beta cells release insulin in pulses. These bursts of insulin help the body to regulate and stabilize blood sugar. In individuals with type 1 diabetes, however, the pancreatic beta cells that normally secrete insulin are mistakenly destroyed by the body. This leaves the body unable to effectively regulate blood sugar on its own. Understanding the interaction between insulin-producing beta cells and other processes in the body may help researchers improve treatment and prevention options when it comes to diabetes.

A recent study examined the different roles gamma amino-butyric acid (GABA) plays in cell activity. In the brain, GABA is released from nerve cell vesicles each time a nerve impulse occurs. The GABA prepares cells for subsequent impulses by working as a calming agent. Researchers previously believed that this process worked in much the same way in the pancreas.

However, in the pancreas, GABA is evenly distributed throughout the beta cells rather than contained within small vesicles, and it is transported via the volume regulatory anion channel. This is the same channel that helps stabilize pressure inside and outside of cells so that they maintain their shape. Furthermore, research showed that GABA is released in a similar pattern and frequency as pulsatile in vivo insulin secretion. Just like in the brain, GABA plays an integral role in preparing and calming cells to make them more receptive to subsequent insulin pulses.

Scientists are interested in learning more about how GABA signaling can support the regulation of insulin secretion and potentially protect cells from autoimmune activity. This opens new doors for biomedical research that has the ability to impact diabetes care.

It is encouraging to see different types of researchers all coming together and learning from and building upon one another’s work in order to advance understanding, prevention, and treatment of various diseases, including diabetes.

Diabetes Research Connection stays abreast of the latest discoveries in the field and supports early career scientists in contributing to this body of work by providing critical funding for their projects. It is essential that scientists have the resources to pursue novel research in order to develop improved prevention, treatment, and management options for type 1 diabetes. Learn more and support current projects by visiting https://diabetesresearchconnection.org.

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Could Higher-Dose and Lower-Dose Insulin Glargine be Equally Effective in Managing Type 1 Diabetes?

In an effort to maintain greater blood-glucose stability throughout the day and minimize highs and lows, some individuals with type 1 diabetes use insulin glargine, which is a once-a-day, long-acting insulin. It is an analogue, or laboratory-created, insulin which has been modified to act more uniformly in managing glucose levels.

Insulin glargine comes in varying strengths, and a recent study found that there were no significant differences in safety or effectiveness between insulin glargine 100 U/mL and insulin glargine 300 U/mL when administered in children and adolescents. Data from 463 EDITION JUNIOR study participants between the ages of 6 and 17 were compared over 26 weeks. Of those participants, 233 were randomly assigned to insulin glargine 300 U/mL, and 228 were randomly assigned to insulin glargine 100 U/mL. Both groups continued to follow their normal routine for mealtime insulin but injected insulin glargine once per day.

Results showed that all participants experienced a reduction in HbA1c levels over the 26 weeks. However, there were fewer instances of severe hypoglycemia among participants using the insulin glargine 300 U/mL, though overall, results were comparable between groups. Both insulins were effective in achieving target study endpoints and did not demonstrate any unexpected safety concerns.

In comparing insulin glargine 100 U/mL and insulin glargine 300 U/mL, researchers may be able to use insulin glargine 300 U/mL as yet another treatment option for children and adolescents with type 1 diabetes. It is currently under review by the FDA, and researchers are evaluating data from a six-month safety follow-up.

It is encouraging to see that more options are being explored to meet the needs of individuals living with type 1 diabetes in order to maintain target glucose levels with fewer fluctuations. Diabetes Research Connection (DRC) will continue to follow these types of studies to see how they impact the future of diabetes management and accessibility to care.

DRC provides critical funding for early career scientists pursuing novel, peer-reviewed research studies for type 1 diabetes. Projects aim to improve prevention and treatment of the disease, as well as enhance quality of life and eventually find a cure. To learn more about current studies and support these efforts, visit http://diabetesresearchconnection.org.

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Advancements in Characterizing Type 1 Diabetes Heterogeneity

No two people with type 1 diabetes are exactly the same. Each experiences disease progression differently, and the genetic and biological factors that impact this process differ as well. This can make understanding how type 1 diabetes initially develops and the risk factors involved more challenging.

A recent study examined islet autoimmunity and heterogeneity across a group of 80 individuals diagnosed with juvenile-onset type 1 diabetes. Some had only been recently diagnosed while others had been living with the disease for many years. The study evaluated immunological, genetic, and clinical differences between individuals in order to create more detailed profiles and stratify findings.

Blood samples were taken and testing conducted to determine T-cell response to various beta cell antigens including GAD65, islet antigen-2 (IA-2), preproinsulin (PPI), and defective ribosomal product of the insulin gene (INS-DRIP). Results show that some individuals were high responders showing T-cell proliferation for all four beta cell antigens, some were intermediate responders showing proliferation to one to three beta cell antigens, and the rest were non-responders who did not show any T-cell proliferation response to the tested beta cell antigens.

In addition, more than 80 percent of participants were categorized as high risk by having an HLA-DR-DQ genotype that is associated with development of type 1 diabetes. High responders also had higher non-HLA genetic risk scores than the other two groups. Another interesting finding was that individuals who had longer disease durations also showed an increase in beta cell-specific T-cell proliferation.

Though a larger study is needed to further build out full immunological heterogeneity and explore the interactions between different variables, this study is a strong starting point. Better understanding the complete profile of individuals with type 1 diabetes and how their body responds to different factors could lead to more individualized treatment to help manage the disease. Researchers can tailor treatment toward which beta cell antigens a person responds to, whether they or not they have high HLA-DR-DQ risk or not, as well as other variables.

The body of knowledge surrounding type 1 diabetes is always growing and improving. This is critical to advance prevention and treatment options. Diabetes Research Connection (DRC) supports early career scientists in pursuing novel research studies in order to continue moving understanding forward. Learn more about current projects and how to help by visiting https://diabetesresearchconnection.org.

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Unraveling the Process of Fetal Pancreas Development

Cell replacement therapy has been at the forefront of type 1 diabetes research for many years. Researchers have explored different ways to reintroduce insulin-producing beta cells into the pancreas or stimulate the body to begin producing these cells once again. A major challenge is often rejection of the cells by the body, or limited sustainability due to poor vascularization or an autoimmune response.

However, a recent study looks at the function of human multipotent progenitor cells (hMPCs) during development of the pancreas in human fetuses. Scientists were able to safely recover live cells from fetal tissue during the second trimester of development. They found that hMPCs located within the tip of the epithelium contained both SOX9 ad PTF1A transcription factors. However, according to their research, “tip cells did not express insulin, glucagon, or amylase,” which demonstrated their lack of lineage-specific markers. That means that they were uncommitted cells and could potentially differentiate into any of the three major types of pancreatic cells: ductal, endocrine, or acinar.

The proportion of SOX9+/PTF1A+ cells greatly decreased during the second trimester, however.  They accounted for more than 60% of cells up to 13.5 weeks of gestation, but after that, there was a significant decrease over the following weeks to less than 20%. During the second trimester, hMPCs also begin the process of branching morphogenesis and divide between tip and truck cells.  Truck cells become ductal and endocrine cells, but tip cells become acinar cells.

As researchers gain a deeper understanding of how the pancreas develops and how cell expression and differentiation takes place, they may be able to enhance cell replacement therapy options. According to the study, “This first ‘snapshot’ of the transcriptional network of human pancreatic progenitors opens new avenue in understanding human pancreas development, pancreatic specification and supports our ultimate goal of understanding possible mechanisms for pancreas regeneration.”

Diabetes Research Connection (DRC) is interested to see how this research may influence future treatment options for individuals with type 1 diabetes.  By better understanding the pancreas at a cellular level, it could stimulate more advanced therapies. The DRC provides critical funding for novel, peer-reviewed research studies focused on the diagnosis, treatment, and eventual cure for type 1 diabetes. Early career scientists have the opportunity to move forward with their research and contribute to the growing understanding of the disease and treatment options. Learn more and support these efforts by visiting http://diabetesresearchconnection.org.

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Where is the Diabetes Research Connection Heading in 2020?

Our vision is to support innovative scientific inquiry until diabetes is eliminated. Since 2015, we have funded 24 innovative, peer-reviewed type 1 diabetes (T1D) projects and distributed over $1M directly to early-career scientists, building a pipeline of talented T1D researchers. 100% of funds designated for research go directly to the scientists’ lab and we are committed to continuing this in 2020.

Our main initiative in 2020, and the next decade, is to establish a foundation of sustainable funding. Two new ways we hope to accomplish it are:

  1. Blue Circle Leaders: Our current Blue Circle Leader Community includes 10 families who have pledged consistent support of our mission and vision. There are varying levels of partnership and all help us build a pipeline of new T1D researchers. As a Blue Circle Leader, you will have access to exclusive opportunities and resources. Read more about becoming a Blue Circle Leader here.
  2. Name a Research Project: Name an entire Research Project after your family, foundation or loved one affected by T1D. Funding an entire grant gives you exclusive access to the researcher for individual updates about the progress of their project and recognition in all published materials.

For a summary of the accomplishments in 2019, click here. We believe it takes a community to connect for a cure and together we make the difference!

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2019 Year in Review

With the generosity of our supporters, we funded seven innovative, peer-reviewed type 1 diabetes (T1D) projects, bringing the total to 24, and have several others in the pipeline that will go live on our website in early 2020. We are incredibly proud to share that one of our sponsored early-career scientists, Peter Thompson, Ph.D., is starting his own lab in Canada to further develop a significant breakthrough that may prevent T1D.

One of our new Scientific Review Committee (SRC) members, Holger Russ, Ph.D., from the Barbara Davis Center for Diabetes at the University of Colorado shared a note that sums up the past year for us, “Congratulations on the record number of submissions, word is spreading, attesting to your great work funding important projects driven by junior investigators in the T1D space.”

Our 225 supporters partner with us in giving of their time, energy and resources and we couldn’t be more grateful for everything they gave in 2019. Our 10 Blue Circle Members, including the first-ever named research project funded by the Tarson Family, joined us this past year to ensure sustainable funding for DRC.

Below are some highlights from 2019:

In January, A Sweet Life: The Diabetes Magazine, recognized one of our new projects as one of the 6 Diabetes Research Studies to Watch in 2019, Marika Bogdani, MD, Ph.D., of the Benaroya Research Institute’s project, “Offensive ‘Blocking’ to Defeat T1D Before it Strikes!” This project seeks to uncover changes taking place in human islets that will indicate how to block diabetes before at-risk patients begin to exhibit symptoms.

Several of our partners hosted fundraisers in March. ‘Harrigan’s Hooligans against Diabetes’ hosted a St. Patrick’s Day fundraiser in Chicago at an Irish pub and one of our favorite local Italian restaurants, Il Fornaio, gave back a portion of sales from one evening to support new T1D research.

We hosted our first ever Ladies Night in April. Women gathered to share their stories of life with or caring for someone with T1D. “I left that night with fresh hope in finding a cure and new energy to work together to achieve this.”

In May, the Rancho Santa Fe Foundation hosted a “Meet the Researchers” event where Peter Thompson, Ph.D., shared an exciting update about the research he’s been doing and the possibility of finding a way to prevent T1D.

In June, Youjia Hu, Ph.D., at the Yale University Diabetes Center, provided an update for his project, A Bacteria in the Gut May Predict T1D. “Our results not only support the recent findings by other investigators using fecal samples but also our results support our hypothesis that oral microbiota might be used as a predictive biomarker for human T1D. We are currently further analyzing the sequencing data (~3 million) and we are confident that we will have interesting findings in the next progress report.”

In July, we funded several new projects: A Safe and Cost-Effective Stem Cell Approach for Treating Diabetes, Haisong Liu, Ph.D., at the Salk Institute for Biological Studies; Looking Beyond Beta Cells for Management of T1D, Camila Lubaczeuski, Ph.D. at the University Of Miami; Mice to Men, YongKyung Kim, Ph.D., at the University Of Colorado Anschutz Medical Campus Barbara Davis Center For Diabetes.

The 2nd annual Del Mar Dance for Diabetes was in September. Over 350 people joined us in connecting for a cure and we raised nearly $400,000! Guests enjoyed the food, music, drinks, silent auction and dancing under the stars at the silent dance party.

In November, we partnered with Tiffany and Philip Rivers in the Change the Game campaign. Tiffany and Philip Rivers’ eldest son, Gunner, was diagnosed with T1D when he was just five years old. The Change the Game campaign raised funds for JDRF, Insulin for Life and DRC and helped raise awareness during National Diabetes Awareness Month.

In December, we completed our $1M research campaign by distributing $1M to new T1D research projects. We had a record number of submissions and will be posting the approved projects on our website soon. Check back to see the innovative projects approved in 2019 by our esteemed SRC. Our Co-Founder and Chair of the Board, David Winkler, spoke at the STEAM Leadership “Diabetes Day” at the Salk Institute for Biological Studies. The event focused on educating and empowering high school students from San Diego, including Southeastern San Diego, around healthy living and future careers in research. Click here to watch David’s speech.

We are committed to funding innovative scientific inquiry until diabetes is eliminated and could not do what we do without the continued support of our community. Thank you for being a part of the DRC family. It takes a community to connect for a cure!

 

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Is Cannabis Use Safe for Individuals with Type 1 Diabetes?

Cannabis use has been a hot topic in recent years with more states legalizing recreational use in addition to medicinal use. Just like any drug, cannabis has its risks and benefits which can vary from person to person depending on their individual situation.

A recent study looked at how cannabis use may impact individuals with type 1 diabetes in regard to diabetic ketoacidosis (DKA). DKA occurs when the body does not make enough insulin and ketones build up in the bloodstream due to the breakdown of fats instead of sugars.

The study found that moderate cannabis users with type 1 diabetes are twice as likely to develop DKA than non-users. Researchers used data from 932 adults who participate in the T1D Exchange clinic registry (T1DX).

It is important for individuals with T1D to understand the risks associated with using cannabis and how it can potentially affect their overall health and well-being, especially in regard to diabetes management. DKA can develop very quickly and can be potentially fatal if left untreated.

Though not involved in this study, the Diabetes Research Connection (DRC) supports early career scientists in pursuing novel research studies to advance understanding of T1D as well as improve diagnosis, treatment, and prevention strategies. Learn more about current projects and how to support these efforts by visiting http://diabetesresearchconnection.org.

 

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Controlling Beta Cell Proliferation and Apoptosis to Manage Type 1 Diabetes

A key indicator of type 1 diabetes is lack of insulin-producing beta cells in the pancreas. These cells are mistakenly attacked and destroyed by the immune system leaving individuals unable to naturally manage their blood sugar. With little to no production of insulin, the body cannot effectively process sugars and use them as fuel. Instead, individuals must constantly monitor their blood glucose levels and administer insulin as needed.

However, a recent study uncovered how an FDA-approved drug for treating breast cancer may also be effective in diabetes care. Neratinib is a dual inhibitor of HER2 and EGFR kinases, but researchers have also found that it is incredibly effective at blocking mammalian sterile 20-like kinase 1 (MST1) as well. MST1 plays a key role in regulating beta cell proliferation and apoptosis. By inhibiting MST1 expression, insulin-producing beta cells may be protected from this process leading to greater beta cell survival and improved function.

In addition, when mouse models and human islets were treated with neratinib, they showed a marked improvement in glucose control and maintained lower overall glucose levels. The drug also restored expression of specific transcription factors such as PDX1 that contribute to glucose metabolism and insulin production.

Neratinib is an FDA-approved cancer treatment drug currently being used for breast cancer, but its effectiveness in treating other forms of cancer is being explored as well. Now researchers are examining whether its indications could be expanded to include diabetes.  While it has been proven safe in cancer treatment, scientists are looking at ways to decrease its toxicity and improve specificity for diabetes.

In its current form, neratinib does not only target MST1 – it inhibits other kinases as well. Furthermore, there is concern that an extreme decrease in beta cell apoptosis could lead to increased expression of other cell types which could impact health. However, researchers can use this study as a foundation for exploring ways in which to refine the drug and improve beta-cell protection and function while minimizing other effects.

Diabetes Research Connection (DRC) is interested to see how this study impacts future treatment and prevention efforts in regard to type 1 diabetes. The DRC provides critical funding to early career scientists pursuing novel, peer-reviewed research projects focused on prevention, treatment, and improvement of quality of life for individuals living with the disease. This support can lead to scientific breakthroughs and have a significant impact on understanding of type 1 diabetes. To learn more about current projects and how to support these efforts, visit http://diabetesresearchconnection.org.

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Leveraging the Power of Light to Manage Type 1 Diabetes

A common problem in managing type 1 diabetes is maintaining relatively stable blood glucose levels. By the time a person realizes their blood sugar is rising or falling and begins to treat it, they may already experience spikes. This can be tough on the body and lead to over- or undertreatment in an effort to curb the highs or lows. Though technology has made it faster and easier to track blood glucose levels and more accurately administer insulin, it’s still not a perfect system.

A recent study reveals that researchers may have come up with a way to manage blood sugar without manually administering insulin. They engineered pancreatic beta cells to be responsive to exposure to blue light. By introducing a photoactivatable adenylate cyclase (PAC) enzyme into the cells, they produce a molecule that increases insulin production in response to high levels of glucose in the blood.

The molecule is turned on or off by blue light and can generate two to three times the typical amount of insulin produced by cells. However, it does not boost production when glucose levels in the blood are low. Furthermore, the cells do not require more oxygen than normal cells, which helps alleviate the common issue of oxygen starvation in transplanted cells.

The study was conducted on diabetic mice, so more research is needed to determine whether the process will be as effective in humans. If it is, this could mean that individuals with type 1 diabetes may have an option for controlling blood sugar levels without pharmacological intervention. When paired with a continuous glucose monitor (CGM) or other device as well as a source of blue light, it could create a closed loop model of managing the disease by functioning as a bioartificial pancreas.

This could be potentially life changing for individuals living with type 1 diabetes, and Diabetes Research Connection (DRC) is excited to see how the study progresses. Though not involved with this project, the DRC supports advancement of type 1 diabetes research and treatment options by providing critical funding for early career scientists pursuing novel research projects. Learn more by visiting http://diabetesresearchconnection.org.

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Improving Vascularization of Transplanted Islet Cells

One option that researchers have explored for treating type 1 diabetes is cell transplantation. By introducing new pancreatic islet cells, they aim to better control glucose levels and insulin production. However, there are still many challenges surrounding this approach including cell death due to poor vascularization.

Pancreatic islet cells are highly vascularized in order to quickly and easily transport insulin. If they are not able to establish blood vessel connections following transplantation, they cannot work as effectively and may not survive long-term. A recent study has found an improved method for promoting vascularization and enabling more effective cell transplantation.

A multidisciplinary team of researchers developed a biomimetic microvascular mesh that maintained its shape and promoted the survival of transplanted cells by stimulating revascularization. When transplanted into diabetic mouse models, they were able to maintain normoglycemia for up to three months.

The researchers created micropillars to improve anchoring of the microvascular mesh and decrease risk of shrinkage as cells matured. They had success using both human umbilical vein endothelial cells (HUVECs) and human induced pluripotent stem cell-derived endothelial cells (iPSC-ECs) in the meshes. Compared to a mesh without these cells, the mesh with the cells showed both anastomoses and vascular remodeling which are essential in vascularization during cell replacement therapy.

Though they have only been tested in mouse models, biomimetic microvascular mesh could one day be used to improve cell replacement therapy for humans with type 1 diabetes in order to improve glycemic control. This study opens doors for additional research and further refining islet transplantation methods.

Though not involved with this study, Diabetes Research Connection (DRC) supports novel research projects that strive to advance treatment for type 1 diabetes and one day find a cure. Early career scientists can receive up to $75K in funding from donations by individuals, corporations, and foundations to support their research. Learn more by visiting http://diabetesresearchconnection.org.

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Expanding Type 1 Diabetes Research Through Marmoset Models

It is not uncommon for researchers to use animal models for initial research before transitioning to human clinical trials. Many animals’ systems are biologically similar in nature to humans and respond in similar ways to various diseases and medications. Often mouse models are used for diabetes research, but other species such as nonhuman primates (NHP) are also advantageous. While various types of monkeys and baboons have been used to study diabetes pathogenesis and treatment, there was previously not a marmoset model.

In a recent study, researchers successfully induced type 1 diabetes mellitus in marmosets. They conducted a partial pancreatectomy and administered streptozotocin (STZ) to decrease and destroy insulin-producing beta cells. This led to the marmosets having higher sustained blood glucose levels (above 200 mg/dL) and the inability to manage their condition through natural insulin production. Instead, they were injected with exogenous human insulin which brought their glucose levels back into the target range. Researchers found that they had a high sensitivity to human insulin making them a valuable NHP model.

Multiple glucose and insulin tolerance tests were conducted to determine how the diabetic marmosets responded compared to normal marmosets and whether they would be suitable candidates for future testing regarding islet transplantation. Continuous glucose monitors (CGM) were used to compare normal marmosets with diabetic marmosets as well, further showing that diabetic marmosets had consistently higher blood glucose levels, especially following meals, much like humans with type 1 diabetes.

While additional research is necessary, researchers believe that marmoset models could play an integral role in type 1 diabetes research and the advancement of preclinical testing. They were able to effectively induce diabetes in the marmosets and control it using human insulin, so the next step would be to move to cell transplantation trials. Eventually these transplant models may translate to human clinical trials and enhance diabetes treatment options.

It is these types of studies and use of animal models that help to advance scientists’ understanding and treatment of type 1 diabetes and allow them to work toward a cure. Diabetes Research Connection (DRC) is interested to see how marmoset models will influence the future of diabetes care.

DRC is committed to supporting early career scientists in pursuing novel, peer-reviewed research regarding type 1 diabetes. Researchers can receive up to $75K in funding for their projects allowing them to move forward with their work. Learn more about current projects and how to help by visiting http://diabetesresearchconnection.org.

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Exploring the Use of Targeted Proteins in Managing Type 1 Diabetes

Currently, the most effective treatment for type 1 diabetes is the administration of insulin, but this is not a perfect solution. Since the body is unable to produce enough – or in some cases any – insulin on its own, individuals are tasked with carefully determining when and how much they need to keep blood sugar levels in check. This in itself can be challenging, and too much or too little insulin can lead to potentially life-threatening hyper- or hypoglycemia.

In addition to controlling blood sugar, insulin also helps regulate ketones within the blood. Ketones are created when lipids are broken down by the liver because the body is lacking glucose. Increased ketone levels can lead to diabetic ketoacidosis. Trouble controlling fat in the blood can put individuals at a greater risk for cardiovascular problems.

However, a recent study by researchers at the University of Geneva in Switzerland reveals that combining insulin with high doses of the protein S100A9 may improve regulation of glucose as well as lipids. Though it has only been tested in insulin-deficient diabetic mice thus far, the researchers are in the process of gaining approval for phase I human clinical trials. Other studies have already shown that there is a reduced risk of diabetes in individuals with higher levels of S100A9, so they are hopeful that this protein can play an integral role in diabetes management as well.

Another interesting discovery that the researchers made was that S100A9 was only effective when cells with TLR4 receptors were present as well. At this point, they are unsure exactly what the relationship is and why TLR4 is necessary for the process to work. However, their study leads the way toward reducing the amount of insulin necessary to effectively control blood glucose and ketone levels by combining it with the S100A9 protein.

Though not involved in this study, Diabetes Research Connection (DRC) is excited to see how it progresses once human clinical trials begin as it has the potential to impact treatment for millions of people living with type 1 diabetes. The DRC supports the advancement of research and treatment through providing critical funding to early career scientists pursuing novel research studies for the disease. Find out how to support these efforts and learn more about current projects by visiting https://diabetesresearchconnection.org.

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Islet Transplantation May Have Long-Term Benefits for Type 1 Diabetes.

Islet transplantation is not a new concept, but it is one that scientists are continually trying to refine and improve. A major challenge with this procedure is rejection or destruction of the transplanted cells. However, researchers followed up with a group of 28 patients who had undergone islet transplantation and found that 10 years later, there were still lasting benefits.

A recent study looked on how patients fared a decade after receiving transplants. Fourteen of the patients received only an islet transplant, while the other 14 had a kidney graft in addition to the islet transplant. Regardless of procedure, researchers found that “28% remained completely independent of exogenous insulin” after 10 years, a slight decrease from the 39% who were independent of insulin use after five years. However, even those participants who did return to needing insulin had improved glycemic control and a lower exogenous insulin requirement than prior to transplantation. In addition, they had fewer severe hypoglycemic events.

A major factor in the effectiveness of the transplant was graft function. Those individuals who had optimal graft function maintained insulin independence longer than those who had poorer graft function. Immunosuppression was used to help support graft survival, but there were some serious adverse events as a result. In the 28 participants, there were eight instances of infections or skin carcinomas and 11 diabetes-related events that were cardiovascular.

Five participants experienced symptomatic cardiovascular events and six experienced asymptomatic myocardial ischemia. One person died of a stroke. However, researchers report that “mortality rate in patients similar to those in the current study but who did not undergo islet transplantation is three to four times higher with causes of death largely being severe hypoglycemia or ischemic heart disease.”

It is encouraging to see that a decade after islet transplantation, participants are still experiencing positive outcomes in regarding to diabetes management, with some maintaining insulin independence. As researchers continue to learn more and are able to refine and improve islet transplantation, more patients may benefit long-term from this treatment option and potentially achieve insulin independence.

Diabetes Research Connection (DRC) stays abreast of the latest findings in the field and provides critical funding for early career scientists to pursue research related to type 1 diabetes. It is through this work that improved treatments become available and scientists enhance their understanding of the disease. Learn more about these efforts and how to support existing projects by visiting https://diabetesresearchconnection.org.

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Could Closed-Loop Systems Improve Blood Glucose Management?

One of the latest technologies being tested for managing type 1 diabetes is a closed-loop system. This system uses a continuous glucose monitor (CGM) to measure blood glucose levels. When blood sugar begins to rise outside of the target range, it sends information to an insulin pump to automatically administer insulin. When blood sugar begins to fall, insulin is not administered. It is a closed loop because the patient is not deciding when to inject insulin or how much, but rather the system does so automatically.

A recent study involving 168 individuals with type 1 diabetes between the ages of 14 and 71 were part of a six-month trial using a closed-loop system. One hundred and twelve people were randomly assigned to the closed-loop group while the remaining 56 people used a sensor-augmented pump and were considered the control group. All 168 participants completed the trial. There were no incidences of hypoglycemia and only one incidence of diabetic ketoacidosis, which occurred in the closed-loop group.

The results showed that the closed-loop group remained in the target range for glucose levels (70-180 mg/dL) a greater percentage of time than those in the control group. On average, their time in the target range increased from 61% to 71%, while the control group remained around 59%. In addition, the closed-loop group spent less time with glucose levels above 180 mg/dL or below 70 mg/dL. Throughout the duration of the six-month trial, participants in the closed loop group remained in closed-loop mode (with the system automatically managing glucose monitoring and insulin administration) a median of 90% of the time.

While the closed-loop system is not perfect, these findings show that it improved time spent in the target glucose range, which is desirable in diabetes management. It also reduces the manual tracking and input from individuals with type 1 diabetes in managing the disease. While more research and testing are needed, it is a step in the right direction toward developing what many refer to as an “artificial pancreas.”

Diabetes Research Connection (DRC) is interested to see how this system will continue to advance and improve diabetes management in the future and continues to follow its progress.  These types of devices play an integral role in supporting individuals with T1D and helping them to maintain more normal blood glucose levels. The DRC supports early career scientists in pursing novel research studies geared toward improving understanding, diagnosis, and treatment of T1D with the goal of one day finding a cure. Learn more about these efforts and how to help by visiting http://diabetesresearchconnection.org.

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Arielle Schube World Diabetes Story

My story began during the summer of 2016, the summer before my freshman year of high school. In July, I went to camp for three weeks in San Bernardino, California. The first week of camp I went on a four-day hiking trip to Sedona, Arizona in 100-degree weather. During the hiking trip, I felt a slight cold coming on, I assumed it was from heat and physical exhaustion. When I returned to camp after the hiking trip, I found myself in my own personal hell. At night, I lay on the cold, bathroom floor tile because my body was too hot for my bed and I was too weak to climb down from the top bunk every time I felt the urge to throw up. I could not take it anymore. I dragged myself to the nurse’s office and begged the nurse to take me to a hospital. After hours of convincing the camp nurse that something serious was happening to me, she finally agreed to take me down the mountain to the local hospital.

Not only was I screaming and moaning the entire drive down because the pain endured, but I was also experiencing small blackouts. By the time all the blood tests were completed, I was barely conscious. Soon, a doctor approached me and said, “You have type 1 diabetes.” I looked at him, then my counselor, and then the doctor again. I almost wanted to laugh and say, “What? This is a joke, this isn’t happening, right?” Then I looked at my counselor and said, “Where are my parents?”

The only memory I have after the doctor gave me the devastating news is lying in a helicopter with paramedics on either side of me. I spent the next five days in the hospital, the first two days in the ICU. When I was diagnosed, I was in a diabetic coma. I had Diabetic Ketoacidosis (DKA), a serious life-threatening complication of diabetes where the body produces excess ketones and if left untreated, can be fatal. My blood sugar was over 800 mg/dL and my blood tests showed that I’d been living with type 1 diabetes (T1D) for three months prior to my diagnosis. At the age of 13 years old I advocated for myself, for my life and for my future. If I did not have the will to fight, it is very likely that I would not be here today. My near-death experience has changed my life and will continue to shape my daily actions, thoughts and feelings. My desire to live life to the fullest and courage to speak publicly about my disease is what motivates me every day to push through the difficult days living with T1D.

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The Story of a Combat Veteran Making a Difference in the T1D Community – Naithen Schirmer

Today is a day we honor all veterans and give thanks for their sacrifice. As a combat veteran, I know firsthand the sacrifices made daily by those who serve or have served. When I was a young boy, I would sit around and listen to the men in my family share their stories about their time in the military and knew that I would follow in their footsteps one day.

In 2009, I joined the Army and soon after was deployed to Iraq with the 2nd Brigade Combat Team, 1st Infantry Division. While in Iraq, I advised and assisted in training the U.S. military personnel as well as the Iraqi Army and Iraqi Special Forces in night vision special electronics, thermal imagery and tactical satellite communications.

I’ll never forget a conversation I had with a local Iraqi towards the end of my time there. I was at Camp Liberty in Baghdad and the U.S. was shutting down the base and handing everything over to the Iraqi’s. During my time in Iraq, I did not interact much with the local civilians, but since we were transitioning this base over, I was able to. After connecting with one man in particular, I realized that we had the same goals. Even though we came from different cultures and were very different from each other, we both wanted the same things; love, to do right by our family and keep them happy, healthy and safe. Finding a connection like this in the middle of a war zone was rare and something I will always remember.

After four years of service with the storied 1st Infantry Division, aka the Big Red One, I was medically retired and pursued a Bachelor of Science degree in Marketing from Point Loma Nazarene University. My heart for service did not end with the military. After graduating with my degree, I began a career in the nonprofit sector. Several of my family members have diabetes so I know how devastating the disease is. Working with the Diabetes Research Connection (DRC) as the Administrative Assistant is incredibly rewarding because I have an opportunity to be a part of a community working hard to find a cure. The early-career scientists I have the pleasure of working with at DRC have innovative research ideas and it gives me hope that their scientific breakthrough may be what leads to a cure for my family members and all those affected by type 1 diabetes.

Being involved in the community is important to me so I also volunteer my time at the Veterans of Foreign War as a Junior Vice Commander, a mentor to children of military personnel who have either died in combat or due to PTSD-related suicide while serving on active duty at a local nonprofit called Active Valor, and as the Podcast Creator and Director for Triple B Adventures.

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Improved Transplantation of Islet Organoids May Support Type 1 Diabetes Treatment

One approach to treating type 1 diabetes is transplanting insulin-producing beta cells into the body, or cells that can develop to perform this function. However, there are still many challenges in getting the body to accept these cells without extensive immunosuppression. Even still, the cells often have a limited survival rate.

In a recent study, scientists examined the potential of creating insulin-producing organoids to regulate blood sugar and treat type 1 diabetes. They combined dissociated islet cells (ICs) with human amniotic epithelial cells (hAECs) to form islet organoids, or mini pancreas-like organs. These organoids, which can contain multiple types of cells and cell functions, were transplanted into the portal vein because the area is easily accessible and has a low morbidity rate.

In similar approaches, researchers have been faced with cell death due to poor revascularization of the transplanted cells as well as inflammation. However, in this study, they found that by introducing hAECs, they were able to curb some of these effects. hAECs not only secrete proangiogenic growth factors, but anti-inflammatory growth factors as well including insulin-like growth factors and associated binding proteins. Furthermore, they produce high levels of hyaluronic acid which suppresses tumor growth factor β and stimulates VEGF-A production which supports improved revascularization. They also found that hAECs improved protection of IC-hAEC organoids against hypoxic stress thereby reducing risk of cell death.

Results showed that 96% of diabetic mice who received IC-hAEC organoid transplants achieved normoglycemia within one month. The median rate for this process to occur was 5.1 days. In addition, at one-month post-transplant, the mice showed similar glucose clearance as non-diabetic mice.

While this study has only been performed on mouse models so far, the goal is to achieve similar results in human trials. Additional research and testing are needed to determine if the process is translatable. This approach has the potential to improve management of type 1 diabetes and could lead to a possible cure for the disease if results are sustainable in the long-term.

Though not involved in this study, Diabetes Research Connection (DRC) supports advancements in type 1 diabetes research and treatment by providing critical funding to early career scientists. It is these types of studies that assist in transforming the future of diabetes care. Learn more and support these efforts by visiting http://diabetesresearchconnection.org.

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Connect For A Cure: November 2019 Newsletter

The word is getting out, we have some exciting new research updates for you.

We had a record number of early-career scientists submit their research project proposals for funding this year. You can view the new projects in early 2020. We continue to see early-career scientists go on to do amazing things. Wendy Yang, Ph.D., was published for a second time, in the US National Library of Medicine National Institute of Health and as a result her DRC funded project is getting more exposure. Peter Thompson, Ph.D., one out of 20 early-career scientists DRC has supported was just given the opportunity to start his own lab in Canada.

Click on the link below to read more about what we’ve been up to and the impact we are making together. It takes a community to connect for a cure!

November 2019 Newsletter

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Rotavirus Vaccine May Reduce Risk of Type 1 Diabetes

There is no single factor that is entirely responsible for the development of type 1 diabetes. Scientists believe that both genetic and environmental factors play a role. One area that they are examining more closely is the impact of enteroviruses. Studies have found that since the introduction of two rotavirus vaccines in 2006 and 2008, the incidence of type 1 diabetes in children has decreased.

A recent study compared data from 2001 to 2017 for nearly 1.5 million infants in the United States. They looked at the incidence rate of type 1 diabetes in those who received the full series of either rotavirus vaccine (pentavalent RotaTeq or monovalent Rotarix), those who received only partial vaccination, and those who were unvaccinated either by parental choice or because the vaccinations had not yet been developed. They also looked at incidence rates among children who received both a rotavirus vaccine and the diphtheria, tetanus, and pertussis (DTaP) vaccines at the same time, and those who received only the DTaP vaccines.

While partial vaccination had no impact on risk of type 1 diabetes, infants who completed the rotavirus vaccine series showed a 33% reduction in risk, with those receiving the pentavalent vaccine experiencing a 37% lower risk. In addition, children who were vaccinated had lower hospital admission rates due to enteroviruses within 60 days of being vaccinated than children who were unvaccinated. According to the study, in terms of type 1 diabetes risk, “Overall, there was a 3.4% decrease in incidence annually in children ages 0-4 in the United States from 2001-2017, which coincides with the vaccine introduction in 2006.”

When the rotavirus and DTaP vaccines were administered together, there was a 56% reduction in risk of developing type 1 diabetes than when DTaP vaccines only were given. This leads scientists to believe that the rotavirus vaccine plays an integral role in risk reduction. While it does not entirely prevent infants from developing type 1 diabetes at some point in their life, it may reduce their risk of the disease.

Previous studies have shown that rotavirus infection may increase the destruction of insulin-producing beta cells in diabetes-prone mice. In addition, children who had multiple rotavirus infections had increased islet antibody levels which may contribute to islet autoimmunity, which in turn is linked to type 1 diabetes risk.

Though more research is necessary including longer longitudinal studies to determine if type 1 diabetes was prevented entirely or only delayed, this study is a step in the right direction toward potentially reducing diabetes risk. Encouraging families to get their children the rotavirus vaccine – which is covered at no cost under most health insurance plans – could be an effective strategy in decreasing risk of type 1 diabetes.

Diabetes Research Connection (DRC) is interested to see how these findings may impact the future of prevention efforts for type 1 diabetes and what additional research will discover. The DRC supports early career scientists in pursing novel research regarding type 1 diabetes including diagnosis, prevention, treatment, and management of the disease. To learn more about current projects and how to support these efforts, visit http://diabetesresearchconnection.org.

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Exploring C-Peptide Persistence in Type 1 Diabetes

In diagnosing diabetes, be it type 1 or type 2, one of the key factors doctors look for is C-peptide levels. Traditionally, scientists have believed that low C-peptide levels indicated type 1 diabetes as the body is unable to produce an adequate supply (if any) of insulin, while higher C-peptide levels were associated with type 2 diabetes as the body made insulin but was unable to effectively use it.

However, a recent study shows that this may not be entirely accurate. In a large cohort study in Scotland, there was a broad range of variability in C-peptide persistence across individuals of different ages and duration of disease. Individuals who were older when diagnosed and were close to age of diagnosis had higher C-peptide levels than those who were adolescents when diagnosed and had been living with the disease for a longer period of time. Scientists believe this may point toward there being multiple genetic networks that impact diabetes risk.

The findings also showed that similar C-peptide levels may be present in individuals with adult-onset type 1 diabetes who did not immediately require insulin treatment as those who were diagnosed with type 2 diabetes. Many people with higher C-peptide levels also have increased amounts of proinsulin, which is a prohormone precursor to insulin. However, the cells do not respond to primary stimuli which could mean that they are in a stunned state. If this is the case, there is a potential that they could recover and once again play an active role in insulin production.

The ratio of proinsulin to C-peptide may also be influenced by genetic risk of diabetes. Both genetics and environmental factors may come into play regarding damage to beta cells and their ability or inability to produce insulin.

This study challenges previous understanding about the differences in type 1 and type 2 diabetes when it comes to diagnosis and treatment. There may be the potential to stimulate pancreatic beta cell function in individuals with type 1 diabetes depending on their levels of proinsulin, insulin, and C-peptide.

Diabetes Research Connection (DRC) is interested to see how this may impact the future of diagnosis and treatment of diabetes. It could certainly lead the way to more in-depth research opportunities, and the DRC provides critical funding to support these types of initiatives. Early career scientists can receive up to $75K from the DRC to pursue novel research projects focused on type 1 diabetes. To learn more, visit http://diabetesresearchconnection.org.

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Could Improving Cell-to-Cell Communication Enhance Cell Replacement Therapy Options for Type 1 Diabetes?

Researchers have been exploring the potential of stem cell therapies for years, however this is a very challenging endeavor because there are many factors that influence cell development, differentiation, and fate. In the case of type 1 diabetes, researchers have been studying methods for preventing the destruction of insulin-producing beta cells, stimulating the generation of new cells, and directing differentiation of stem cells among other strategies.

In a recent study, scientists focused on enhancing cell-to-cell communication in order to influence differentiation of embryonic stem cells. They examined the role of Connexin 43 (Cx43) specifically, which is a gap junction (GJ) channel protein. Scientists found that by using the AAP10 peptide to activate Cx43 GJ channels, they could steer differentiation of cells toward definitive endoderm and primitive gut tube lineages. In turn, with improved communication between cells triggered by the AAP10 peptide, definitive endoderm cells were more likely to become pancreatic progenitors and pancreatic endocrine progenitors.

Pancreatic progenitors (PP) and pancreatic endocrine progenitors (PE) play a role in the development of pancreatic islet cells which produce insulin and glucagon. These are the same cells that the body mistakenly attacks and destroys in individuals with type 1 diabetes. The ability to influence the differentiation of human embryonic stem cells into PPs and PEs may support improved cell replacement therapies for diabetes.

There is still a great deal of research to be done as it is difficult to manipulate the mechanisms of cell communication in order to produce desired results. Scientists are also continuing to investigate whether improved intercellular communication could lead to an increased production of pancreatic islet cells.

Researchers involved in this study include Dr. Wendy Yang, Dr. Laura Crisa, and Dr. Vincenzo Cirulli. Yang’s research is funded by Diabetes Research Connection (DRC) and Crisa and Cirulli are part of the DRC’s scientific review committee. To learn more about the DRC and the funding it provides to support type 1 diabetes research, visit http://diabetesresearchconnection.org.

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Antibody-Drug Conjugate May Help Reduce Allograft Rejection.

Cell transplantation has been an area of focus in developing treatment for type 1 diabetes. Many studies have examined both autologous and allogeneic transplants and the benefits and risks they provide. A major challenge continues to be rejection and the body’s destruction of these cells, whether initially derived from its own cells or not.

However, a recent study found that an anti-CD103 antibody-drug conjugate (M290-MC-MMAF) may reduce pancreatic islet allograft rejection in mice. This drug decreased the amount of CD103+CD8+ effector T cells while at the same time increasing the amount of CD4+CD25+ regulatory T cells. This balance led to improved survival rate of the allograft and supported immunosuppression without causing systemic toxicity. When CD103+CD8+ levels were increased, allograft rejection quickly followed.

While this study has only been conducted in mouse models, it shows potential for pancreatic islet allografts in treating type 1 diabetes. Further research is necessary to determine how this process translates to human cells. M290-MC-MMAF could eventually be used as a therapeutic intervention to reduce risk of allograft rejection in humans.

Diabetes Research Connection (DRC), though not involved in this study, stays abreast of the latest discoveries in the field and supports early career scientists in pursuing novel, peer-reviewed research projects related to type 1 diabetes. Scientists receive funding that is critical to conducting research and improving the diagnosis, treatment, and management of the disease and one day finding a cure. To learn more about current projects and how to support these efforts, visit http://diabetesresearchconnection.org.

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Early Biomarker for Pancreatic Beta Cell Loss Related to Type 1 Diabetes Identified.

For years, researchers have known that pancreatic beta cell death plays a major role in the development of type 1 diabetes. They have been striving to detect this process early on in order to better assess risk for the disease and develop potential treatments to stop progression. When the body destroys insulin-producing beta cells, it is no longer able to effectively manage blood glucose levels resulting in type 1 diabetes (T1D), a condition that currently has no cure.

In a recent study, researchers used diabetic mice and serum samples from individuals with various stages of T1D as well as INS-1 cells and human islets “to detect an early biomarker of T1D-associated beta-cells loss in humans.” The enriched microRNA (miR-204) that they discovered is released by beta cells during cell death and is detectable in human serum. However, it is only present in elevated levels in individuals with T1D and those who are autoantibody positive, not in individuals with type 2 diabetes.

This discovery may play a role in improving early detection of pancreatic beta cell death prior to full onset of T1D. In turn, that may open doors to new research and developments in treatment in order to reduce risk of T1D.

Diabetes Research Connection (DRC) is excited to see what this discovery could mean for the future of T1D diagnoses and prevention efforts. The DRC supports early career scientists in pursuing novel, peer-reviewed research projects focused on the diagnosis, prevention, treatment, and eventual cure of type 1 diabetes. Learn more about current projects and how to support these efforts by visiting http://diabetesresearchconnection.org.

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Could Gluten Impact HbA1c Levels?

Researchers know that type 1 diabetes involves the body’s immune system mistakenly attacking and destroying insulin-producing beta cells, and that this can be affected by autoantibodies and antibodies. However, the body produces antibodies in response to many diseases, including celiac disease.

In a recent study, researchers explored the relationship between patients with celiac disease achieving antibody-negativity versus staying antibody-positive and the potential impact on type 1 diabetes. When individuals with celiac disease stop eating gluten, the body stops producing specific antibodies that react to gluten. Tight management of the disease may produce antibody-negative results during testing. If the person continues to eat some gluten, they will remain antibody-positive.

Scientists compared 608 pediatric patients with type 1 diabetes (T1D) and biopsy-proven celiac disease with 26,833 patients with T1D only. They found that those patients with both diseases who remained antibody-negative had lower HbA1c levels than those who were antibody-positive. The study also showed that, compared to patients with only T1D, those who had both celiac disease and T1D and were antibody-negative had lower total cholesterol, LDL-cholesterol, and frequency of dyslipidemia as well.

Though more research is necessary, achieving constant antibody-negative status may be associated with improved metabolic control and growth and have an impact on HbA1c levels. This could lead the way to advancements in treatment options for individuals with celiac disease and type 1 diabetes and perhaps type 1 diabetes alone as well.

Diabetes Research Connection (DRC) stays abreast of the latest developments in the field and supports early career scientists in pursuing peer-reviewed, novel research studies on type 1 diabetes. It is through these types of projects that researchers learn more about diagnosis, treatment, and prevention of this disease and move closer toward finding a cure. Learn more about current projects and how to support these efforts by visiting http://diabetesresearchconnection.org.

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Evaluating the Effect of Specific T Cells on Type 1 Diabetes Risk and Treatment

As researchers delve more deeply into trying to understand the origins of type 1 diabetes (T1D), they become increasingly aware that there is not a single disease pathogenesis, but rather multiple paths that vary from person to person. While they know that T1D results from the immune system attacking and destroying insulin-producing beta cells in the pancreas, there may be several different factors that contribute to this risk.

A recent study examined a variety of T cells, T cell receptors, antigens, and autoantibodies that may play a role in the development of T1D. One common factor they found was that individuals with an elevated level of islet autoantibodies in the peripheral blood are at increased risk of developing T1D within their lifetime. Researchers also know that in addition to risk genes, human leukocyte antigen (HLA) genes and the autoantibody glutamic acid decarboxylase (GAD) could vary from person to person and impact the effectiveness of targeted therapies. Children who possess two or more islet autoantibodies have around an “85% chance of developing T1D within 15 years and nearly a 100% lifetime risk for disease development.”

However, the mere presence of islet autoantibodies does not demonstrate disease state, because it could be years before clinical T1D presentation. In its early stage (stage 1), while the autoantibodies are present, beta cell function remains normal. As risk for T1D advances (stage 2), metabolic abnormalities develop. Finally, with T1D onset (stage 3), there is both a presence of autoantibodies and loss of beta cell function in regard to blood glucose. The staging paradigm was derived from data from the United States’ Diabetes AutoImmunity Study in the Young (DAISY), Finland’s Type 1 Diabetes Prediction and Prevention Study (DIPP), and Germany’s BABYDIAB studies.

Given the similarities of mouse models and human models when it comes to diabetes, mouse models are often used to study disease risk, evaluate pathogenesis, and assess potential treatment options. Researchers have found that specific antigens and T cells affect pancreatic islets differently. Understanding these antigen subsets could be critical in determining effective clinical therapeutics for prevention and treatment.

Thanks to the Network for Pancreatic Organ Donors (nPOD), more than 150 cases have been collected from organ donors with T1D since 2007, as well as more than 150 from non-diabetic donors and dozens of donors with autoantibodies but no clinical diabetes. These tissue donations have provided researchers with islets, cells, and data from multiple facets of the ody that contribute to T1D risk.

Understanding tissue specific T cells, antigens, and autoantibodies may help identify biomarkers of disease activity which could improve targeted therapeutic interventions. Eventually, this may help reduce risk of T1D by creating early intervention strategies.

While not involved with this study, Diabetes Research Connection (DRC) is focused on advancing understanding of T1D and improving prevention, diagnosis, and treatment options as well as progress toward a cure. Early career scientists receive critical funding to pursue novel, peer-reviewed research projects regarding multiple aspects of T1D. Learn more by visiting http://diabetesresearchconnection.org.

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Examining the Impact of Intensive Glucose-Lowering Treatment on Hypoglycemia Risk

One of the key indicators in effective diabetes management is HbA1c level. In healthy, non-diabetic adults, the target range is 4% to 5.6%, while in individuals with diabetes, the goal is to maintain an HbA1c level of less than 7%. However, some treatment guidelines aim for achieving levels of 5.6% or less, or between 5.7% and 6.4%.

Striving for these lower HbA1c levels through intensive glucose-lowering therapy may prove more risky than beneficial, though, especially for adults who are considered clinically complex, according to a recent study. These individuals may benefit from less intensive treatment and slightly higher target HbA1c levels to reduce risk of emergency department visits and hospitalizations for severe hypoglycemia.

The study included data from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014, and “participants were categorized as clinically complex if 75 years or older or with 2 or more activities of daily living limitations, end-stage renal disease, or 3 or more chronic conditions.” They were considered to be engaged in intensive treatment if their HbA1c level was below 5.6% and they took any glucose-lowering medication, or if their HbA1c level was between 5.7% and 6.4% and they took two or more glucose-lowering medications.

In addition to NHANES data, other population-level studies were included as well when comparing data and outcomes. Overall, overtreatment was estimated to occur in up to 50% of non-clinically complex patients and up to 60% of clinically complex patients.

For the study, 662 nonpregnant adults who had diabetes and maintained HbA1c levels of less than 7.0% were used to represent around 10.7 million adults with diabetes in the United States. Of these participants, 20.1% were age 75 or older, 21.5% were treated intensively, and 32.3% were considered clinically complex. The researchers estimated that over two years, there would be 31,511 hospitalizations and 30,954 emergency department visits for severe hypoglycemia, and that around 4,774 hospitalizations and 4,804 ED visits could be directly attributed to intensive glucose-lowering therapies.

The study found that aggressive treatment of diabetes to achieve lower HbA1c levels could actually have a negative effect on overall health, especially for clinically complex patients who experienced severe hypoglycemic events. It is recommended that many elderly and clinically complex patients avoid intensive treatments and follow relaxed glycemic targets. Recommended HbA1c levels should be evaluated on an individual basis and take into account patient health, comorbidities, and clinical complexity.

There were limitations to this study, and researchers note that “true numbers are likely to much higher” regarding hypoglycemic events and the number that are directly attributable to intensive glucose-lowering therapy.

Type 1 diabetes management is a complex process, and researchers are continually advancing their understanding of the disease and effective treatment options. Diabetes Research Connection (DRC) follows advancements in the field and potential impact on individuals living with T1D.

DRC supports novel, peer-reviewed research studies regarding the diagnosis, treatment, and quality of life for those living with the disease. Learn more about current projects and how to donate to these efforts by visiting http://diabetesresearchconnection.org.

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Could Peripheral T Helper Cells Be Linked to Type 1 Diabetes Risk?

Type 1 diabetes (T1D) is a complex disease. Researchers believe that both genetics and autoantibodies play a role in development of the disease. In individuals with T1D, the immune system mistakenly attacks and destroys insulin-producing beta cells in the pancreas. A new study has found that peripheral T helper cells may play a role in initiating this process.

The study showed that children with T1D, as well as those who were autoantibody-positive who developed the disease later on, both had an increase in the amount of peripheral T helper cells circulating in their blood. Researchers believe that much like follicular helper T cells, peripheral T helper cells may also be involved in activating B cells which target against proteins in pancreatic islet cells and contribute to the development of T1D.

The ability to identify children who are at increased risk for the disease due to genetics as well as the elevated presence of peripheral T helper cells may improve options for proactively monitoring and treating T1D. It could also support the development of new immunotherapies for the disease.

More research is necessary to better understand the role of this T-cell subset and how it impacts type 1 diabetes risk and development of the disease as well as how it could improve treatment or prevention options. Though not involved with this study, Diabetes Research Connection (DRC) follows the latest developments and advancements regarding type 1 diabetes understanding, treatment, and prevention.

DRC provides critical funding for early career scientists pursuing novel research studies related to the disease and hopes to one day find a cure. To learn more about current projects or how to help, visit http://diabetesresearchconnection.org.

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Does Timing of Exercise Affect Blood Glucose Levels for Individuals with Type 1 Diabetes?

Regular exercise is an important part of maintaining good health, and this goes for individuals with type 1 diabetes (T1D) as well. However, the question has often risen as to whether the time of day that individuals engage in exercise has an impact on their blood sugar management. A recent study compared results when resistance training was completed in the morning during a fasting state versus in the afternoon after blood sugar had been managed throughout the day.

The randomized study involved 12 participants between the ages of 18 and 50 who had been diagnosed with T1D for a least a year, did not take any medications (aside from insulin) that may impact their blood glucose levels, had no limitations on required exercises, and did not perform shift work. They were asked to keep a log of their food intake and insulin dosage because they were blinded to continuous glucose monitoring.

The results showed that engaging in resistance exercise in the morning (7 a.m.) led to a higher risk of hyperglycemic episodes than exercising in the afternoon (5 p.m.). Blood glucose levels tended to be higher during morning exercise and the 60-minute recovery period as well as during the next six hours. However, with afternoon exercise, blood glucose levels declined during exercise and returned almost to baseline during recovery. There was also less glycemic variability during the six hours post exercise.

It is essential that individuals with type 1 diabetes talk to their doctor before starting or changing their exercise routine, and that they carefully monitor their blood glucose before and after physical activity. Studies like these play an important role in helping individuals with T1D to better manage the disease and improve their quality of life.

Diabetes Research Connection (DRC) stays abreast of the latest developments in the field and supports early career scientists in pursuing novel, peer-reviewed research projects focused on prevention, treatment, and an eventual cure for T1D as well as improvement of quality of life. Learn more about current studies and how to support these efforts by visiting http://diabetesresearchconnection.org.

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Exploring the Potential Impact of Genetics and Infection on T1D Risk

There is no clear, concise explanation for why some people develop type 1 diabetes (T1D) and others do not, or what puts some people at greater risk for the disease. The origins and triggering factors for T1D are something that scientists have been studying for decades. A recent study looks at the possible relationship between genetic risk variants and viral infections and their impact on T1D development.

In some individuals, enteroviruses may trigger or accelerate disease development. However, in others, these same viruses may stimulate a variety of protective factors. Both genetic and environmental factors come into play, and researchers are exploring how to use these findings to improve treatment and prevention of T1D.

Scientists know that the destruction of insulin-producing beta cells plays a role in disease development. Some individuals present with autoantibodies long before T1D develops, and there are still beta cells present in many people even after living with the disease for many years. Yet they are still unsure about exactly what triggers beta cell destruction.

Studies have shown that around 50 percent of T1D risk is heritable. But just because a person carries this risk, does not necessarily mean they will develop the disease. There are around 60 different loci for single-nucleotide polymorphisms (SNP) that are associated with T1D and may contribute to risk.

Researchers believe that enteroviruses may also play a role. Many links have been found between enterovirus infections and the presence of various autoantibodies.  These infections may trigger beta cell autoimmunity in individuals who already have factors that put them at greater risk of developing T1D. By more effectively identifying individuals who have multiple risk factors, scientists may be able to create targeted antiviral treatments or preventive virus vaccines.

There is still a great deal of research to be done regarding the development of and triggers for T1D. Genetics, environment, and infection may all play a role, but their impact differs from person to person. There is also limited insight into factors such as ethnicity and gender, especially when looking at enteroviral etiology.

Though not involved with this study, the Diabetes Research Connection (DRC) contributes to current bodies of research through providing critical funding for early career scientists pursuing projects related to the diagnosis, prevention, treatment, and eventual cure for T1D. Scientists are learning more about the disease every day. Support these efforts by visiting http://diabetesresearchconnection.org.

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Asthma Medication May Help Treat Diabetic Retinopathy

A common complication associated with diabetes (T1D) is diabetic retinopathy. Poor blood sugar control can increase risk of this disease because it impacts the blood flow to the eye by blocking and damaging tiny blood vessels. It can eventually lead to blindness. Symptoms can be very mild and barely noticeable at first, so this is often a condition that is treated in later stages when the effects become more severe.

However, a recent study found that the administration of an FDA-approved asthma medication – montelukast, also known as Singulair – may help reduce damage to blood vessels and nerves in and around the eye. This indication has only been tested in mouse models so far, but because it is already an FDA-approved medication for use in children and adolescents, this may decrease the time it takes to shift into human clinical trials.

Researchers found that the medication suppresses inflammation enough to alter the signaling of inflammatory molecules and prevent pathology, but not enough to compromise the body’s innate immunity. If found effective in human trials, it could be used as a prevention method as well as to treat diabetic retinopathy in its early stages. This could be beneficial to children who are newly diagnosed with type 1 diabetes and even those who have been managing the disease for several years and are at risk for eye disease.

Though not involved with this study, the Diabetes Research Connection (DRC) is interested to see how it progresses and what findings show when used in human subjects. It is encouraging to see a potential new option for reducing risk of diabetic retinopathy and improving quality of life for individuals living with type 1 diabetes.

DRC supports early career scientists in pursuing novel, peer-reviewed research studies aimed at prevention, treatment, and an eventual cure for type 1 diabetes. To learn more about current projects and how to help, visit http://diabetesresearchconnection.org.

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Structured Mealtime Routines May Help Manage HbA1c Levels in Young Children with Type 1 Diabetes

Managing type 1 diabetes (T1D) can be challenging for anyone, but it can be especially difficult for parents of young children with the disease. They must carefully monitor their child’s diet and activity while regularly checking blood glucose levels. A recent study has found that those children who receive preprandial insulin and eat on a regular schedule tend to have improved HbA1c levels.

Researchers analyzed data from 22 Australian children age seven or younger. Their parents tracked the exact amounts and types of food and beverages offered and consumed by their children over a three-day period. They also answered 16 questions regarding mealtime routines and their child’s eating patterns, such as whether they grazed throughout the day or had set snack times and meal times. In addition, it asked about use of preprandial insulin.

The study found that 95% of children used preprandial insulin, and all children ate at least three meals per day. For 81% of children, their parent determined when they were offered food, but the other 19% followed child-led eating patterns. While there was no direct correlation between carbohydrate, protein, or fat intake on HbA1c, researchers did note that HbA1c levels were lower in those children who ate at regular mealtimes as opposed to grazing throughout the day.

Another interesting note was that the children with T1D ate similar diets as those children without the disease. Furthermore, none of the children in the study met the daily recommended vegetable intake, and only 28% ate recommended amounts of lean meats and protein. Additional research is necessary to evaluate the impact of diet quality on diabetes management.

It is these types of studies that provide further insight into improving management of type 1 diabetes. The Diabetes Research Connection (DRC) provides early career scientists with up to $75K in funding to support peer-reviewed, novel research studies focused on prevention, treatment, and management of type 1 diabetes as well as working toward a cure. To learn more and donate to current projects, visit http://diabetesresearchconnection.org.

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Nasal Glucagon Approved to Treat Severe Hypoglycemia

If you or someone you love is living with type 1 diabetes, you know that, in addition to blood sugar becoming too high, having it drop too low is a serious concern as well. When blood sugar falls below 70mg/dL, individuals often start feeling the effects such as shakiness, sweating, chills, lightheadedness, weakness, blurry vision, or tiredness.

If blood sugar continues to drop, it can lead to severe hypoglycemia where the person may be unable to treat their low blood sugar themselves due to confusion, seizures, or loss of consciousness. When this occurs, the individual with T1D often relies on medical personnel or a trained bystander to administer glucagon. Traditionally, glucagon is injected into the arm, thigh, or buttock. However, the medication must first be reconstituted, which involves injecting the contents of the syringe into a vial, mixing it together, then drawing it back into the syringe to inject into the person. In an emergency situation, this can be a lot of steps to follow and there is plenty of room for error.

In an effort to simplify the process, Eli Lilly and Company has manufactured the first ever FDA-approved nasal glucagon, Baqsimi. The device is pre-loaded with 3 mg of glucagon and ready to use for patients age 4 and older. The medication stimulates the liver to release glucose and was found to effectively reverse insulin-induced hypoglycemia based on three studies encompassing more than 200 participants. There were no major safety concerns, and the potential adverse reactions were similar to those of injectable glucagon with the addition of watery eyes and nasal congestion. However, nasal glucagon is not recommended for individuals with pheochromocytoma or insulinoma.

Nasal glucagon provides yet another option for individuals with T1D to quickly – and more easily – treat episodes of severe hypoglycemia. It is simple to use because there is no reconstitution, multi-step processes, or injections necessary. The drug is expected to hit the U.S. market around the beginning of September 2019.

We are excited to see this new product come to market and is interested to see how it impacts diabetes care and management for individuals who experience severe hypoglycemia.

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Researchers Identify a New Type of Diabetes

Many people are familiar with the two most common types of diabetes – type 1 diabetes and type 2 diabetes – but other forms exist such as gestational diabetes. According to a recent study, researchers have discovered another type as well: checkpoint inhibitor-associated autoimmune diabetes or CIADM.

Immune checkpoint inhibitors are often used in the treatment of advanced cancers to block programmed cell death-1 (PD-1) receptors. However, one of the potential adverse effects of anti-PD-1 therapy is CIADM. Patients who develop this condition experience a sudden loss of insulin as well as variable glycemic control and require insulin to manage the condition.

The retrospective cohort study included 538 patients who were treated for metastatic melanoma between March 2015 and March 2018. Patients had either received only anti-PD-1 therapy, a combination of anti-PD-1 and ipilimumab, or a combination of anti-PD-1 and either ipilimumab or a placebo. Of these 538 patients, six who received only anti-PD-1 and four who received anti-PD-1 and ipilimumab developed CIADM. Demographic information showed that 90 percent were male, the median age was 62, and only one patient had a prior history of diabetes. In addition, all 10 were negative for islet antigen 2 antibodies, insulin antibody, and zinc transporter 8 antibody.

These findings open doors for larger studies and more in-depth research into this condition, which is not the same as type 1 diabetes despite requiring insulin to manage blood glucose levels. The Diabetes Research Connection (DRC) is interested to see where this study will lead and what it may mean for the future of diabetes, treatment, and understanding of the disease.

The DRC provides essential funding for early career scientists focused on studying issues related to type 1 diabetes. These studies not only aim to advance understanding and improve diagnosis, treatment, and quality of life, but also to one day find a cure.

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Could Hybrid Immune Cell Be Linked to Type 1 Diabetes?

Scientists understand a lot about the foundational cells that make up the body, but even still, they are always learning and discovering more. For instance, the body’s immune system is made of up B cells and T cells. These cells identify foreign invaders in the body – such as germs – and then attack and destroy them or create antibodies. In individuals with type 1 diabetes, these cells mistakenly destroy insulin-producing beta cells.

However, a recent study shows that scientists have discovered a hybrid cell that is a combination of both B cells and T cells. Not only does the surface of the cell have B cell and T cell receptors, it also expresses genes from both types of cells. In addition, these cells contain a unique genome sequence in B cell receptors that was only found in the cells of individuals with type 1 diabetes. Though some healthy individuals had this hybrid cell, they did not present with this specific B cell receptor sequence.

Upon further investigation, they found that this dual expresser cell binds very tightly to the HLA-DQ8 molecule, which is believed to play a major role in triggering the body’s attack on insulin-producing beta cells. Since this occurs in the early stages of type 1 diabetes development, researchers are interested in the potential for this discovery to one day support early diagnosis or prevention of the disease.

However, there are still many unanswered questions that exist. Scientists do not yet understand exactly how, why, when, or where the hybrid cells develop. While T cells originate in the thymus, B cells come from bone marrow and lymph nodes. Scientists are unclear where the overlap may occur that would combine these two distinct cells. They are also unsure why these dual expresser cells would go on to target insulin production.

This is the first time that this type of cell has been identified, so there is still a great deal of research that needs to be done. No one is exactly sure what this could mean for future understanding of type 1 diabetes and treatment options. That will come as more studies are done and more in-depth research is completed.

The Diabetes Research Connection (DRC) is excited to see where this discovery leads and the type of studies it generates. Though not involved with this study, the DRC provides critical funding to early career scientists for novel research projects related to type 1 diabetes. This is an integral part of advancing understanding and treatment of the disease.

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Exploring the Link Between Disturbed Eating and Type 1 Diabetes

 

Managing type 1 diabetes requires careful monitoring of food intake, activity, blood sugar, and insulin administration. Depending on what a person eats and when, it impacts their blood glucose levels. A recent study found that around one-third of individuals between the ages of 16 and 28 experience issues with disturbed eating behavior (DEB). Furthermore, many report restricting or omitting insulin.

The study evaluated the responses of 300 participants to the Diabetes Eating Problem Survey-Revised (DEPS-R) as well as to questions regarding diabetes distress, depressive symptoms, and self-management of the disease. They were divided into four groups based on their DEPS-R scores for baseline and then one year later. The groups were low DEB (65.7%), increasing DEB (8%), decreasing DEB (7.3%), and persistent DEB (19%).

While mean DEPS-R scores were stable from baseline to one year later, the scores were higher in females than in males – 16.53 and 15.57 in females versus 8.71 and 8.96 in males. All groups reported varying levels of insulin restriction and omission, but it did not differ significantly between males and females.

Individuals who fell into the persistent DEB group showed the highest levels of diabetes distress and depressive symptoms while those in the low DEB group showed the lowest levels.  The low DEB group also had the lowest HbA1c levels, while the persistent DEB group had the second highest. The study also found that “self-management decreased when DEB increased, and vice versa.” This could in turn lead to poorer glycemic control and increased health care costs.

The researchers found overall that DEB can occur at any age and any stage of the disease, but that evaluating adolescents and young adults for DEB and eating disorders may be beneficial in supporting better diabetes management and glycemic control.

The Diabetes Research Connection, though not involved with this study, supports early career scientists in conducting research aimed improving prevention and finding a cure for type 1 diabetes as well as minimizing complications and improving quality of life for individuals living with the disease. Through donations from individuals, corporations, and foundations, scientists can secure the critical funding they need to move forward with their research.

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Could Type 1 Diabetes Slow Brain Development in Children?

Since type 1 diabetes occurs when the pancreas produces little to no insulin, it is often diagnosed in childhood when this deficiency become more apparent. The body is unable to naturally manage blood sugar levels since the immune system mistakenly attacks and destroys insulin-producing beta cells. This means that parents must take over this responsibility until children are able to effectively manage their condition on their own.

Many parents are hesitant to overtreat and end up allowing blood sugar levels to remain slightly elevated (hyperglycemia) rather than risk having them drop too low (hypoglycemia). Neither condition is desirable as they can both lead to health complications. The goal is to create a management plan that enables blood sugar levels to remain as normal as possible.

A recent study found that hyperglycemia in children with type 1 diabetes may actually slow brain development and impact brain structure, cognitive function, and sensory processing. The study followed 138 children with type 1 diabetes between the ages of four and seven. Participants had been living with diabetes for an average of 2.4 years. These children were compared to 67 age-matched controls without type 1 diabetes.

After approximately 4.5 years, researchers found that those children with type 1 diabetes had decrements in both full-scale and verbal IQ, which was associated with hyperglycemia and an average HbA1c of 8%. The target goal for children is an HbA1c of less than 7.5%.

However, a larger study found that although full-scale, verbal IQ, and vocabulary were lower in those with T1D, there was no significant difference in processing speed, memory, or learning scores compared to the control group. The brains of children with T1D seemed to compensate for areas where there were challenges, and executive function was similar between groups.

Nelly Mauras, MD, chief of the Division of Endocrinology, Diabetes, and Metabolism at Nemours Children’s Health System and part of the Diabetes Research in Children Network (DirecNet) noted, “We are not suggesting that these youngsters aren’t performing academically. So far, these differences have not translated into functional outcomes in performance, at least not yet.”

Researchers continue to follow these groups in order to gather more information and determine the impact over a longer duration of time. They are interested in learning more about whether advanced technology can make it easier to maintain near normal glucose levels and whether HbA1c guidelines should be lower than 7.5% for children with type 1 diabetes to minimize hyperglycemia.

The Diabetes Research Connection (DRC), though not involved with this study, will continue to follow study progress to see what future comparisons hold and how this may impact treatment options and guidelines for children with type 1 diabetes. Current results may stimulate new research opportunities and increase understanding of the greater impact of T1D on health and development. The DRC provides critical funding for early career scientists to pursue novel research projects related to type 1 diabetes.

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Later Onset Type 1 Diabetes Often Misdiagnosed as Type 2

Type 1 diabetes used to be commonly known as juvenile diabetes because it was often diagnosed in childhood. In individuals with this disease, the body mistakenly attacks and destroys insulin-producing beta cells, and eventually the body is no longer able to generate enough insulin to support normal blood sugar levels. Therefore, individuals must monitor their own blood-glucose and inject themselves with insulin.

However, research has shown that around 42% of people with type 1 diabetes were diagnosed after age 30. A recent study found that some people are mistakenly diagnosed with type 2 diabetes instead due to the late onset of the disease as well as clinical and genetic characteristics. This can make it difficult to properly differentiate between the two conditions.

The study examined data from 583 participants diagnosed with diabetes after age 30 who are part of the Exeter Diabetes Alliance for Research in England (DARE). Their data was compared to 220 DARE participants with the same study criteria but who were diagnosed with type 1 diabetes before age 30.

The researchers wanted to know how many of those diagnosed after age 30 had severe endogenous insulin deficiency (meaning their body naturally produced little to no insulin on its own), whether diagnosed with type 1 or type 2 diabetes. Severe insulin deficiency is a classic sign of type 1 diabetes but C-peptide and other tests are not always conducted to check for this condition in adults age 30 or older. However, the study found that 21 percent of participants who were treated with insulin had this condition, and 38% of participants not treated with insulin at diagnosis had it.

Individuals who required rapid insulin within one year of diagnosis or who were treated with insulin within three years of diagnosis had a higher likelihood of severe endogenous insulin deficiency; 85% and 47% respectively. This means that they likely had type 1 diabetes rather than type 2, regardless of what their initial diagnosis was. Participants diagnosed after age 30 shared very similar clinical and biological characteristics with the younger cohort.

It is critical that physicians conduct necessary testing to differentiate type 1 from type 2 diabetes regardless of age of onset. There are often different protocols for treating each of these conditions, and individuals with type 1 diagnoses have greater access to necessary resources such as continuous glucose monitoring (CGM) devices, insulin-pump therapy, and targeted diabetes education.

With more awareness of the frequency of type 1 diabetes onset after age 30 and associated characteristics, hopefully medical providers will be better able to assess and accurately diagnose this condition more quickly to provide essential treatment.

The Diabetes Research Connection (DRC) strives to support early career scientists in pursuing novel research studies that focus on the prevention, diagnosis, and treatment of type 1 diabetes as well as improving quality of life for individuals living with this disease. Research is critical to one day finding a cure.

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Is it Possible to Delay the Onset of Type 1 Diabetes?

Living with type 1 diabetes (T1D) is challenging. It requires constant monitoring and adjustment of one’s blood sugar. Since T1D is commonly diagnosed in childhood, it can put additional strain on parents who must carefully manage their child’s condition. However, a recent study reveals that scientists may have found a way to delay the onset of type 1 diabetes by two years or more.

An antibody drug developed by Jeffrey Bluestone, an immunologist at the University of California, San Francisco, helps to shut down activated T cells thereby reducing the body’s immune system attacks on insulin-producing beta cells. It is the destruction of these cells that triggers T1D. Bluestone partnered with Kevan Herold, an endocrinologist at Yale University, to begin researching the potential of this drug in delaying the development of diabetes.

They first experimented with the drug on mouse models who were at high risk of developing type 1 diabetes, and it was effective in staving off the disease in many of the mice. In 2000, they shifted their work to human trials. The key was figuring out exactly when to administer the drug. If they gave it too early, there was not enough T cell activation so there was not much to protect against. Too late and there was too much T cell activity to manage. They had to find the precise time when diabetes was on the verge of developing or had been newly diagnosed.

In a trial involving 12 patients, after one year, nine of the participants had maintained or increased their body’s natural insulin production. This meant that their body was better able to manage glucose levels on its own and required less insulin to be injected.

After some setbacks and skepticism, Bluestone, Herold, and their team arranged for another trial. This time, they included participants who were at a high risk of developing type 1 diabetes within five years. They recruited 76 participants, 44 of whom received the drug (now known as teplizumab), and 32 of whom received a placebo. The drug was administered via IV infusion over 14 consecutive days. The results showed that while individuals who received the placebo were diagnosed with diabetes after an average of two years, those who received teplizumab were diagnosed after an average of four years. In addition, 72% of placebo recipients developed diabetes after five years compared to only 43% who received the experimental drug.

There is still a great deal of research and clinical testing that must be done, but this is a step forward in delaying onset of type 1 diabetes and eventually perhaps preventing development of the disease all together in high-risk individuals. Even delaying the disease by two years as the current study showed is monumental in improving quality of life. It is two fewer years of daily disease management and potential complications.

This discovery could lead to a greater understanding of diabetes prevention or delaying disease progression. It could stimulate new research and studies from scientists as they seek to advance results. The Diabetes Research Connection, though not involved with this study, provides critical funding that allows early career scientists to move forward with novel research projects. There’s no telling exactly what impact their findings could have on the future of type 1 diabetes or when the next major breakthrough will occur.

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Scientists Uncover New Insight into Autoimmune Response

Autoimmune diseases are challenging to treat because the immune system plays a critical role in keeping the body healthy. However, when this system is destroying its own cells even without the presence of an infection, it can be problematic and potentially life-threatening. Millions of people suffer from autoimmune diseases such as type 1 diabetes (T1D), lupus, and scleroderma, and treatment options—as well as their effectiveness—are limited.

However, researchers at the University of Leeds and the University of Pennsylvania have made a new discovery that could change treatment in the future. They found two proteins—BRISC and SHMT2—that together are responsible for controlling the body’s response to infection or what it deems foreign invaders.

The team is aiming to figure out a way to target these proteins and keep the immune system from attacking and destroying the body’s own cells. This could eventually generate a new class of drugs for treating autoimmune disorders, though this type of treatment is still a long way off as a wealth of research and testing still needs to be conducted regarding this process.

It is encouraging to see new developments occurring and progress being made toward better understanding autoimmune diseases such as type 1 diabetes. With advanced research, scientists can formulate improved treatment options and perhaps one day a cure.

The Diabetes Research Connection, though not involved with this study, is part of the effort toward improving prevention, treatment, and quality of life for individuals living with T1D. Through donations from individuals, corporations, and foundations, early career scientists are able to receive critical funding to support novel, peer-reviewed research projects.

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Exploring Protective Factors Against Diabetic Kidney Disease

One of the complications that can stem from living with diabetes is the risk of developing diabetic kidney disease. The kidneys play a critical role in filtering waste and excess water out of the blood and sending it out of the body. Prolonged high blood sugar and/or blood pressure can damage the kidneys and prevent them from functioning effectively. Eventually, individuals may require dialysis or a kidney transplant if damage is too extensive.

However, a recent study from the Joslin Diabetes Center found that some people have biological protective factors that may be effective in reducing risk of diabetic kidney disease. Their bodies have certain enzymes that affect glucose metabolism and protect the kidneys. Researchers studied cohorts of individuals who have been living with type 1 or type 2 diabetes for more than 50 years with minimal or no complications. They are referred to as Joslin Medalists.

One key finding was that the Medalists had increased PKM2, an enzyme in the blood that protects against diabetic kidney disease. There were also other metabolites and proteins that appeared at higher levels as well in their plasma. An interesting discovery was that the presence of an amyloid precursor protein (APP)—which is known to signal increased risk of Alzheimer’s disease—may actually work as a protective factor against diabetic kidney disease.

Scientists need to conduct additional research to further understand these potential protective factors and how they can be used to improve diagnosis and treatment of diabetic kidney disease or diabetes in general. Diabetic kidney disease can be a potentially fatal complication, so the more researchers understand about how it develops and the biological protective factors that can decrease risk, the better they can support individuals living with diabetes and their health.

Though not involved with this study, the Diabetes Research Connection (DRC) stays abreast of the latest research regarding type 1 diabetes and ways to improve diagnosis, treatment, and quality of life for individuals with the disease. Through donations from individuals, corporations, and foundations, the DRC provides critical funding for early career scientists to pursue novel research studies and further understanding of type 1 diabetes.

 

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