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Diabetes Research News
June 19, 2020

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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Diabetes Research News
June 18, 2020

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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Diabetes Research News
June 12, 2020

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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Diabetes Research News
June 12, 2020

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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Diabetes Research News
June 5, 2020

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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Diabetes Research News
June 4, 2020

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. Click to learn more about current projects and provide support.

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Diabetes Research News
May 28, 2020

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. Click to learn more about current projects and provide support.

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Diabetes Research News
May 26, 2020

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. Click to learn more about current projects and provide support.

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Diabetes Research News
May 21, 2020

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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Diabetes Research News
May 19, 2020

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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