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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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Metformin May Support Insulin Therapy for Type 1 Diabetes

Managing diabetes can be a very tedious process. Individuals must be vigilant about monitoring diet and exercise and how it affects their blood glucose levels. Insulin must be correctly dosed and administered to counteract these effects. Even with careful tracking, some individuals still have difficulty managing their type 1 diabetes and develop insulin resistance, metabolic syndrome, and other complications.

Typically metformin is a medication prescribed for those with pre-diabetes or type 2 diabetes to increase insulin sensitivity and insulin action. However, a recent study examined the effects of combining metformin with insulin therapy to treat individuals with type 1 diabetes who had poorly controlled blood glucose levels despite intensive insulin therapy. The study was small, involving 58 individuals with T1D who had comparable characteristics in terms of age, sex, BMI, blood pressure, lipids, hypertension, body weight, insulin dose requirement, duration of diabetes, and other factors.

Twenty-nine participants continued to receive insulin therapy alone, while the other 29 received a combination of metformin and insulin therapy. The study, which lasted one year, found that those in the metformin-insulin group required a lower dose of insulin after one year (a decrease of 0.03 IU/kg/d) compared to those in the insulin only group who actually required a higher dose of insulin (an increase of 0.11 IU/kg/d).  The metformin-insulin group also saw a decrease in metabolic syndrome prevalence, fasting plasma glucose (FPG), and postprandial plasma glucose (PPG) compared to the insulin only group.

A larger study is necessary to further evaluate long-term effects, glucose control, insulin sensitivity, and other factors related to effectively managing type 1 diabetes. However, the study sheds light on the potential benefits of combining metformin with insulin therapy for not just individuals with type 2 diabetes, but those with type 1 diabetes as well.

The Diabetes Research Connection (DRC) is interested to see what this could mean for future diabetes management strategies and approaches to helping those with poor glucose control despite intensive insulin therapy. The DRC supports novel research studies on type 1 diabetes by early-career scientists and provides critical funding for these projects. To learn more about current projects or find out how to help, visit Our Projects.

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Breaking Down the Prevalence of Type 1 Diabetes

Diabetes affects people of all ages and races throughout the United States, but just how many people are impacted? According to a self-report study of 33,028 adults with a response rate of 54.3%, approximately 21 million adults (8.6%) in the United States were living with type 2 diabetes in 2016, and approximately 1.3 million (0.55%) were living with type 1 diabetes.

The study, conducted by the Centers for Disease Control and Prevention (CDC) asked participants a variety of questions regarding being diagnosed with diabetes and what methods were used to manage it. Responses were classified as type 1, type 2, or “other” type of diabetes. There were 182 participants who reported having type 1 diabetes but did not claim to take any type of insulin, so they were categorized as type 2 respondents. Out of the 33,028 participants, 3,519 reported having diabetes, and 211 of those reported having type 1 diabetes. The study also found that T1D was more prevalent in men than women (0.64% vs. 0.46%), and as well as in non-Hispanic whites versus Hispanics (0.67% and 0.22% respectively).

Study authors hope that “knowledge about national prevalence of type 1 and type 2 diabetes might facilitate assessment of the long-term cost-effectiveness of public health interventions and policies aimed at improving diabetes management and help to prioritize national plans for future type-specific health services.”

Though it may seem like a small percentage who have T1D, it is still more than a million people who struggle each day with this disease, and more than a million people who would benefit from advanced research and treatment options. The Diabetes Research Connection seeks to further knowledge, research, and interventions regarding type 1 diabetes as well and supports novel research studies focused on this condition. Early career scientists can receive valuable funding through the DRC to support their research projects. Check out the current studies and support these efforts by visiting http://diabetesresearchconnection.org.

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Are Artificial Pancreas Systems Effective in Treating Type 1 Diabetes?

There are many options available for treating type 1 diabetes from regular finger pricks and injections of insulin to continuous glucose monitoring systems to artificial pancreases and more. However, each person must find what works best for them in the management of their disease.

One treatment method that has undergone recent study is the use of artificial pancreas systems. According to researchers led by Eleni Bekiari, MD, Ph.D., at the Clinical Research and Evidence-Based Medicine Unit at the Aristotle University of Thessaloniki in Greece, these systems can provide positive results for some patients in managing their T1D. Throughout a series of 40 studies encompassing 1027 participants, artificial pancreas systems were found to not only be safe but also an effective line of treatment.

The study compared several different factors of single and dual hormone systems but mainly focused on the percentage of time normal glycemic levels were maintained. These results were measured against patients using standard insulin-based treatments. The study found that those individuals using the artificial pancreas systems experienced higher durations of time where their blood sugar levels were in the normoglycemic range, including overnight – 15.15% for artificial pancreas systems versus 9.62% for insulin-based treatment. There was also less deviation between blood sugar levels.

The researchers found that “artificial pancreas systems are an efficacious and safe approach for treating outpatients with type 1 diabetes.” More research and clinical trials are necessary to further explore the benefits and long-term outcomes of these systems. The Diabetes Research Connection is committed to supporting early career scientists in advancing their research and delving more deeply into topics related to the diagnosis, treatment, and management of type 1 diabetes. The DRC provides essential funding for researchers to carry out peer-reviewed, novel research projects. To learn more about current projects and support these efforts, visit http://diabetesresearchconnection.org.

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Examining the Impact of Adding SGLT2 Inhibitors to T1D Treatment

For individuals living with type 1 diabetes, every day consists of checking their blood glucose levels, monitoring what they eat, and taking the appropriate amount of insulin to keep their blood sugar levels stable. However, long-term use of insulin can lead to undesirable dose-dependent side effects such as weight gain and hypoglycemia. Since there is currently no cure for T1D, these effects can be concerning because individuals must continue to take insulin for the foreseeable future.

Looking for a way to curb these effects, a recent study examined the efficacy of adding sodium-glucose cotransporter 2 inhibitors (SGLT2) to treatment for T1D. The medications used for the study were canagliflozin, empagliflozin, sotagliflozin, and dapagliflozin. Four different randomized controlled trials were conducted.

The results showed numerous positive changes when insulin use was combined with one of the four medications. There were statistically significant reductions in A1c levels as well as weight gain. In addition, the amount of insulin needed also decreased. While each medication led to different results, they all had similar effects on reducing these issues. Furthermore, the addition of these medications to treatment did not lead to any significant changes in risk associated with hypoglycemia, adverse events, or episodes of DKA.

This was a small study, so more extensive testing is necessary to evaluate the effects of SGLT2 inhibitors on T1D treatment on a larger scale. However, these initial tests show promising results and support for conducting more thorough investigations.

It is these types of forward-thinking research studies aimed at improving treatment and quality life for individuals living with T1D that the Diabetes Research Connection (DRC) is passionate about supporting. Though not involved in this study, the DRC has supported dozens of early career scientists by providing funding for novel research. These studies may lead to new breakthroughs or areas that can continue to be explored more deeply. To learn more about current projects and support these efforts, visit http://diabetesresearchconnection.org.

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Diabetes Research Connection 2016 Year in Review

This past year has been a big one for us at Diabetes Research Connection. Our donors have stepped up to the plate and helped us fund research towards treating, curing and preventing type 1 diabetes. In fact, in 2016 we were able to raise more than $490,000 thanks to the support of our donors.

We’re committed to keeping our backers updated on all projects and DRC happenings, so we wanted to take time at the beginning of 2017 to remind ourselves and our donors of all the amazing things that happened in 2016.

In January, Sangeeta Dhawan, Ph.D. at UCLA School of Medicine started off the year with her project, Making More and Better Insulin Producing Cells with Cell Regeneration. We were able to help her raise more than $30,000.

Dr. Sangeeta Dhawan

 

In February, we launched another project, Replacement Beta-Cells From An Unexpected Source, a research study conducted by Joseph Lancman, Ph.D. — Sanford Burnham Prebys Medical Discovery Institute. We were able to raise more than $45,000 in support of this project.

Dr.Lancman in Lab

In April, we celebrated World Health Day. This year’s theme was Beat Diabetes, and we encouraged our donors and supporters to get involved in the global fight against diabetes.

In May, another project launched, and we were able to help Peter Thompson, Ph.D. at University of California San Francisco raise more than $30,000 for his project, Regrowth of Beta Cells with Small Molecule Therapy.

Peter Thompson - Regrowth of beta cells with small molecule therapy

Another new project came online in July; Agata Jurcyzk, Ph.D. of the University of Massachusetts Medical School, What is the Connection Between T1D and Depression?

Agata-Headshot

August was a busy month for us at DRC. In mid-August, we partnered with the diaTribe Foundation for Brews & Blood Sugar. More than 100 people joined us to samples beer from one of San Diego’s premier breweries, to learn how different varieties of beer affect blood sugar and support efforts to find solutions for those with diabetes. We also launched our T1D resource center in August, where we’ve curated the best information out there pertaining to T1D. Lastly, we launched a project to raise funds for Gene-Specific Models and Therapies for Type 1 Diabetes, research being conducted by Jeremy Racine, Ph.D. of The Jackson Laboratory.

jeremy_racine_lab

In September, we were honored to be featured by The Huffington Post. We also launched our campaign on Gladitood, which helped us raise money and support for our General Fund as we began to close out the year.

In November, we celebrated National Diabetes Month. As a part of these celebrations, we launched our Double Your Dollars campaign, where every dollar donated to the General Fund was matched 100%. We upped the ante on Cyber Monday, doubling each match, making donations go even further. All told, we raised more than $80,000 in November. Additionally, we hosted a Crowdfunding Science event on Cyber Monday, where attendees joined three Rancho Santa Fe Foundation Donor Advised Fund families to learn about an exciting, successful and innovative crowdfunding platform for scientific research.

doubledollarsplaceholder

In December, we started a new blog series to help our donors meet the board, and we began by introducing you to Alberto Hayek, M.D., President of DRC.

This past year was monumental for DRC, and 2017 is already off to a great start with the launch of a new research project, Determining How Other Cells (Non-Beta) In The Pancreas Affect Diabetes by Jeffrey D. Serrill, Ph.D. of City of Hope, Los Angeles, California. We’re looking forward to seeing what the year holds as we fund research projects that will bring us closer to preventing, treating and curing T1D.

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ETH Researchers T1D

New Weapon Against Diabetes

Original article published by ETH Zurich on December 1, 2016. Click here to read the original article.

Researchers have used the simplest approach yet to produce artificial beta cells from human kidney cells. Like their natural model, the artificial cells act as both sugar sensors and insulin producers.

Researchers led by ETH Professor Martin Fussenegger at the Department of Biosystems Science and Engineering (D-BSSE) in Basel have produced artificial beta cells using a straightforward engineering approach. These pancreatic cells can do everything that natural ones do: they measure the glucose concentration in the blood and produce enough insulin to effectively lower the blood sugar level. The ETH researchers presented their development in the latest edition of the journal Science.

Previous approaches were based on stem cells, which the scientists allowed to mature into beta cells either by adding growth factors or by incorporating complex genetic networks.

For their new approach, the ETH researchers used a cell line based on human kidney cells, HEK cells. The researchers used the natural glucose transport proteins and potassium channels in the membrane of the HEK cells. They enhanced these with a voltage-dependent calcium channel and a gene for the production of insulin and GLP-1, a hormone involved in the regulation of the blood sugar level.

Voltage switch causes insulin production

In the artificial beta cells, the HEK cells’ natural glucose transport protein carries glucose from the bloodstream into the cell’s interior. When the blood sugar level exceeds a certain threshold, the potassium channels close. This flips the voltage distribution at the membrane, causing the calcium channels to open. As calcium flows in, it triggers the HEK cells’ built-in signalling cascade, leading to the production and secretion of insulin or GLP-1.

The initial tests of the artificial beta cells in diabetic mice revealed the cells to be extremely effective: “They worked better and for longer than any solution achieved anywhere in the world so far,” says Fussenegger. When implanted into diabetic mice, the modified HEK cells worked reliably for three weeks, producing sufficient quantities of the messengers that regulate blood sugar level.

Helpful modelling

In developing the artificial cells, the researchers had the help of a computer model created by researchers working under Jörg Stelling, another professor in ETH Zurich’s Department of Biosystems Science and Engineering (D-BSSE). The model allows predictions to be made of cell behaviour, which can be verified experimentally. “The data from the experiments and the values calculated using the models were almost identical,” says Fussenegger.

He and his group have been working on biotechnology-based solutions for diabetes therapy for a long time. Several months ago, they unveiled beta cells that had been grown from stem cells from a person’s fatty tissue. This technique is expensive, however, since the beta cells have to be produced individually for each patient. The new solution would be cheaper, as the system is suitable for all diabetics.

Market-readiness is a long way off

It remains uncertain, though, when these artificial beta cells will reach the market. They first have to undergo various clinical trials before they can be used in humans. Trials of this kind are expensive and often last several years. “If our cells clear all the hurdles, they could reach the market in 10 years,” the ETH professor estimates.

Diabetes is becoming the modern-day scourge of humanity. The International Diabetes Federation estimates that more than 640 million people worldwide will suffer from diabetes by 2040. Half a million people are affected in Switzerland today, with 40,000 of them suffering from type 1 diabetes, the form in which the body’s immune system completely destroys the insulin-producing beta cells.
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