DRC & Research News

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

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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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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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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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Beta Cell Proliferation May Help Protect Against Type 1 Diabetes

In individuals with type 1 diabetes (T1D), the body’s immune system mistakenly attacks and destroys insulin-producing beta cells. For years, researchers have been looking at options for suppressing this immune system attack, as well as processes to replace beta cells or stimulate the body to produce more. A recent study by researchers at the Joslin Diabetes Center may have found a way to do both and increase protection against T1D.

Scientists found that by speeding up cell proliferation and flooding mouse models with beta cells, it stopped the immune system from destroying these cells. According to Dr. Rohit Kulkarni, HMS Professor of Medicine and Co-Section Head of Islet and Regenerative Biology at the Center, “We believe there are some alterations in the new beta cells where a number of cells being presented as autoantigens are reduced or diluted, and therefore, because of the slow presentation of the antigens, the number of autoreactive T cells are less pathogenic.” In addition, when these cells were transplanted into other mice, they appeared to have a greater resistance to stress, which could also help them to survive longer in adverse conditions.

Gaining a greater understanding of the role cell proliferation can play and determining when the ideal time to activate this process is could have a positive impact on improving protective factors against T1D. This process has not yet been tested in humans, and there would likely still be a need for some level of immune system suppression to manage lingering autoimmunity.

The Diabetes Research Connection (DRC) stays abreast of the latest developments regarding T1D and is interested to see how these findings impact future studies and treatment options for the disease. It is these types of projects that stimulate innovative studies from other researchers. The DRC provides critical funding to support early career scientists in pursuing novel, peer-reviewed research.

 

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Researchers Improve Cell Conversion to Support Diabetes Treatment

One of the methods of treating type 1 diabetes that researchers have been exploring is using patients’ own cells. They found that by converting stem cells into insulin-producing beta cells and then transplanting them into patients, it could stimulate the body to generate its own insulin. However, one of the challenges they faced is that beta cells only made up around 30 percent of the cells in the mixture following conversion.

Researchers in Douglas Melton’s lab at the Harvard Stem Cell Institute may have found a way to increase this percentage. A recent study found that by using single-cell sequencing, they were able to identify what the other 80 percent of cells in the mixture were. Then, by applying various molecular biology approaches, they could sort the cells based on expression patterns. Since beta cells contain a specific protein that other cells do not, they had another way to filter these cells out of the mix and increase the overall concentration that would be implanted into patients with type 1 diabetes.

Scientists at Semma Therapeutics also found a way to collect insulin-producing beta cells by separating all of the cells and then allowing them to cluster back together through their natural attraction to the same type of cell. This also increased the concentration of beta cells, and they could create a mixture that was around 80 percent beta cells versus the previous 30 percent.

The researchers are currently conducting more tests to determine what balance of beta cells versus other cells is most effective for regulating beta cell function and stimulating the production of insulin. However, now they have a greater understanding of the cell makeup during the conversion process and how to separate specific cell types.

This is another step toward improving treatment options for type 1 diabetes and potentially finding a cure. Advanced research is necessary for creating change. The Diabetes Research Connection provides funding for novel, peer-reviewed research studies focused on the prevention, treatment, and cure of type 1 diabetes, as well as improving quality of life for individuals living with the disease. Early career scientists can receive up to $50K to support their research.

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Enteroviruses May Be Linked to Higher Type 1 Diabetes Risk

As with many diseases, type 1 diabetes is triggered by both genetic and environmental factors. There is not a single cause that can be pinpointed when it comes to why insulin-producing beta cells are destroyed by the body. However, researchers are constantly discovering different factors that may contribute to this process. A recent study found that children diagnosed with type 1 diabetes (T1D) may have higher levels of enterovirus A (EV-A) in their gut than children without T1D.

In comparing faeces and plasma viromes and data for a birth cohort of 93 Australian children, results showed that 62 percent of children tested positive for at least one vertebrate-infecting virus. The researchers tested samples for all known vertebrate-infecting viruses, and five EV-A types came back as significantly abundant in children at the onset of T1D diagnosis than in control cases.

Viruses often survive longer in the gut than in the blood, so the prolonged presence of enteroviruses in the gut may increase the risk of these infections spreading to the pancreas. In turn, this may contribute to the body’s immune system attacking and destroying insulin-producing beta cells and triggering T1D.

The study opens doors for additional research regarding EV-A and viral load in general as it relates to T1D. These findings could potentially lead to the development of targeted vaccines for these identified viruses to help protect against the development of type 1 diabetes. It is yet another step toward understanding this complex disease and working toward a cure.

The Diabetes Research Connection (DRC), though not involved in this study, stays abreast of the latest research and discoveries in the field to support future advancements. The DRC provides critical funding to early career scientists to support novel, peer-reviewed studies related to the diagnosis, treatment, and prevention of type 1 diabetes.

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HbA1c Levels May Influence Preterm Birth Risk

Maintaining healthy HbA1c levels is essential for individuals with type 1 diabetes (T1D), but it may be especially critical for women seeking to have children. A recent study out of the Karolinska Institutet in Stockholm found that higher HbA1c levels during the periconceptional period may increase risk of preterm birth.

The study compared incidences of preterm birth for 2,474 babies born to women with type 1 diabetes, and 1,165,216 babies born to women without diabetes. They were all single births; no multiples. The researchers found that, overall, preterm birth occurred in 22.3 percent of babies born to women with T1D verses 4.7 percent of babies to women without diabetes. Broken down even further, the results revealed that the higher the woman’s periconceptual HbA1c level, the higher the risk for preterm birth. When the HbA1c level was below 6.5 percent, there was a 13.2 percent incidence of preterm birth compared to a 37.5 percent incidence when the HbA1c level was at or above 9.1 percent.

However, it is important to note that researchers found, “Preterm birth among women with T1D was strongly linked to periconceptual HbA1c levels, although women whose HbA1c levels were consistent with recommended target values were also at increased risk for preterm birth as well as other adverse pregnancy outcomes.”

This study helps to raise awareness about the risk of preterm birth for women with T1D and the importance of monitoring and managing blood sugar levels. T1D can impact many aspects of an individual’s life, and that includes pregnancy. Gaining a better understanding of these effects can support improved treatment and overall healthcare.

The Diabetes Research Connection (DRC) stays abreast of the latest industry findings and provides critical funding for early career scientists pursuing T1D-related research. Donations from individuals, corporations, and foundations make it possible for these projects to move forward and for innovative research to continue.

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Gestational Diabetes May Increase Risk of Type 1 Diabetes in Children

Over the years, researchers have identified a variety of potential risk factors and triggers for the development of type 1 diabetes. While they know that diabetes risk runs in families – having a parent with T1D puts children at increased risk – a recent study found that gestational diabetes may also be a risk factor. Women who develop gestational diabetes do not usually have a history of the disease, and it often resolves once they have given birth.

However, the development of this condition may put their offspring at greater risk for T1D.  The study found that when mothers had gestational diabetes, children were twice as likely to develop diabetes by age 22 than those children born to mothers without gestational diabetes. A limitation of the study was that it was unknown whether children were diagnosed with type 1 or type 2 diabetes, though type 1 is more common in children.

The study involved 73,180 groups of mothers, fathers, and offspring who live in Quebec, Canada. If there was a previous history of diabetes, heart failure, or cardiovascular disease in either parent, the group was excluded from the study. Factors such as the mother’s gestational age and other maternal demographics were also adjusted for when analyzing risk and results.

Understanding the potential risk may help parents to be more alert to potential signs of diabetes in their children such as abnormal thirst, frequent urination, unusual weight loss, or fatigue if the mother experienced gestational diabetes. This can allow children to be tested and diagnosed sooner so that they can better manage their health.

Additional research is needed to address limitations of this study and also to further explore the severity of the disease in children born to a mother with gestational diabetes versus those who were not. Researchers are unclear at this point whether there is any significant difference.

It is these types of studies that stimulate new research and questions in regard to type 1 diabetes. The Diabetes Research Connection (DRC) strives to provide critical funding for early career scientists so that they can carry out research related to the diagnosis, treatment, and prevention of T1D, as well as improving quality of life for those living with the disease. To learn more about current projects and support these endeavors, visit http://diabetesresearchconnection.org.

 

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Researchers Identify Key Protein Fragment that May Trigger Type 1 Diabetes

While the basics of type 1 diabetes (T1D) have been understood for years—the body’s immune system mistakenly destroys insulin-producing beta cells—the reasoning behind it has remained a mystery. Researchers have yet to identify exactly why this process occurs and what causes it. They may be a step closer as a recent study shows that an altered protein fragment may be the culprit.

The human body is filled with T cells that are constantly on the lookout for foreign bodies and infected cells. When their receptors sense these problems, they activate the immune system to destroy the affected cells. Normally, any T cells with receptors for proteins that occur naturally within the body are destroyed before they make it out of the thymus. This prevents them from attacking proteins that should be in the body, which in this case are insulin proteins. But scientists believe that some may escape before this process occurs, and therefore they mistakenly trigger an attack against insulin-producing cells which in turn leads to type 1 diabetes.

Researchers took a closer look at the structures that bind T cells to insulin fragments and found a specific fragment that may activate T cells to destroy insulin-producing cells. It is known as the B:14-22 fragment. They created a molecule where all of the pathogenic T cells and protein fragments fit very tightly together, but in order to improve their connection, they altered the insulin fragments. In doing so, they found that this activated the pathogenic T cells which led to an autoimmune attack on the cells.

They found that the body naturally creates altered fragments through a process called transpeptidation. When proteins are broken apart in the cell, they are recycled and may fuse together with other protein fragments. This generates a new configuration of proteins. Researchers believe that some of these new fragments could have just the right structure to activate T cells leading to the development of type 1 diabetes.

These findings may help scientists to create more effective methods for preventing and treating type 1 diabetes. Having a better understanding of what is happening on a cellular and molecular level allows for more targeted focus on coming up with a cure.

The Diabetes Research Connection (DRC) is excited to see where this study may lead and what it could mean for future diabetes treatment. It may also stimulate new studies from other researchers building on these findings. The DRC provides critical funding to early career scientists in order to support novel research on type 1 diabetes. Empowering more research could open new doors.

 

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The Untold Story of a Pediatric Endocrinologist – Dr. Alberto Hayek

Most people know me as a pediatric endocrinologist in San Diego, California. What most people do not know about me is that I was drafted into the US Army in my mid-20’s, soon after immigrating from Colombia to the US for postgraduate medical training. I was an ideal candidate to be drafted because I was young, single and a newly minted MD. I was sent to Vietnam to serve as a flight surgeon for an Army helicopter battalion.

Being the only MD for an Army flight battalion stationed in the heart of Mekong Delta put me in very close contact with all the pilots. My medical crew took care of those wounded during battle, mainly stabilizing vital signs before evacuating them to facilities for more definitive treatment. Part of my responsibilities included listening to the pilots’ private concerns because in their eyes, short of a minister, I had the capacity to understand and provide support. The rest of my time was spent caring for the many Vietnamese civilians hurt during combat operations.

I will never forget the soldiers suffering during the war or the wounded Vietnamese civilians of all ages. During the 40-plus years of medical practice after my war experiences, in a life dedicated to caring for children and their families, I have often relived an episode that touched me deeply. Civilians do not encounter the atrocities of war, but the pain of a family with an ill child confronting a difficult prognosis is akin to a missile sent from an unknown source.

In my clinical practice, I would ask each child I cared for, “If you could have one thing in the world, what would it be?” Their response was always the same, “I want a cure!” After years of receiving the same answer, I knew I had to do something different, so I went into research to try to find a cure. Witnessing the suffering of so many has profoundly impacted me which is why I cannot sit back and idly wait for a cure for Type 1 Diabetes (T1D).

As a T1D researcher, I was the first to show that it was possible to culture human fetal and adult islets. While we were able to replicate beta cells in vitro, we realized that they began to change into cells that could not produce insulin. However, when we re-aggregated them, they were able to make insulin again. By this time, human stem cells were developed and promptly directed to cells able to produce insulin. Important was to re-aggregate the cells, which is what my lab found. This discovery led to its use in protocols to facilitate the potential transplantation of insulin-producing cells from stem cells into T1D patients.

I founded the Diabetes Research Connection with David Winkler because we both believe there is more to do and are committed to funding early-career scientists with novel approaches to prevent, cure and better care for those with T1D.

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Exploring the Impact of Type 1 Diabetes on Standardized Testing

Though type 1 diabetes (T1D) can be diagnosed at any age, it is typically diagnosed in childhood. That means that thousands of children grow up and go through school while managing this disease. A recent study looked at the potential effects of T1D on standardized test scores of Danish children.

Researchers evaluated data on standardized reading and math tests from 631,620 Danish public school children in grades 2, 3, 4, 6, and 8. Of the more than 630,000 participants, 2,031 had T1D. After analyzing more than one million reading test scores and nearly 525,000 math test scores, they found that there was no significant difference in results between those children with diabetes versus those without. Adjustments were made for grade, test topics, and year, and comparisons were made both with and without adjusting for socioeconomic status. In both cases, there were no statistically significant differences in results.

It is encouraging to see that the presence of T1D has not had a major impact on standardized testing performance, at least for the Danish schoolchildren who participated in the study. T1D affects many aspects of a person’s life, and it can be difficult to effectively manage, especially for children.

The Diabetes Research Connection (DRC) stays abreast of diverse studies that look not only at how T1D develops and is treated but also its impact on quality of life. DRC provides funding that enables early-career scientists to pursue novel research studies on all facets of the disease in an effort to advance understanding and improve outcomes.

 

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Could Enteroviruses Play a Role in Type 1 Diabetes?

There is no single cause of type 1 diabetes (T1D). Though scientists know that T1D involves the body destroying insulin-producing islet cells in the pancreas, there is not one specific trigger. In fact, researchers believe that genetics, environment, and immunologic capability all play a role and put individuals at different risks for developing the disease.

A recent study from investigators at Columbia University’s Mailman School of Public Health has found that the presence of certain non-polio enteroviruses may impact islet autoimmunity and lead to type 1 diabetes. They looked at the abundance of these viruses in blood and stool samples from 93 Australian children. Forty-three of the children had type 1 diabetes precursor islet autoimmunity while 48 children were matched as controls.

Using an incredibly powerful viral sequencing tool, they found 129 viruses—including five enteroviruses—that were present in higher levels in children with islet autoimmunity than those in the control group. Individuals with strong immune systems tend to eliminate enteroviruses rather quickly, usually within three to four weeks. With a slower immune response, it could take up to three months.

Risk increases when these viruses spread to children’s pancreases. Scientists are exploring how they affect pancreatic islet cells and interfere with function potentially causing beta-cell destruction and type 1 diabetes. While more research is necessary to further understand the impact enteroviruses may have, these new findings help scientists to refine their studies of the disease and its development.

While not involved with this study, the Diabetes Research Connection supports novel, peer-reviewed research studies focused on the development and treatment of type 1 diabetes as well as improving quality of life for individuals living with the disease. Up to $75,000 in funding is available for early career scientists through support from individuals, corporations, and foundations.

 

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Oral Drug Could Help Manage A1C in Patients with Type 1 Diabetes

A major challenge for individuals living with type 1 diabetes (T1D) is reaching target A1C levels. Despite careful management of the disease and regularly checking blood sugar, many people’s A1C is still higher than recommended. While individuals with type 2 diabetes have a variety of medications they can take to help manage blood sugar, those with T1D must rely on insulin.

However, that may be changing. While insulin would still be necessary, a new oral drug may help individuals with T1D to achieve target A1C levels. The drug – sotagliflozin—prevents the kidneys from reabsorbing sugar and delays the absorption of glucose in the gastrointestinal tract. This means that there is less sugar in the blood because more of it is lost through urine output. According to researchers, there was a “two-fold increase in the number of patients who reached the target A1C level while on the drug.”

In addition to achieving improved A1C levels, many participants also experienced weight loss and a decrease in the amount of insulin needed to manage their T1D. This is a major breakthrough for patients with T1D as it would be the first ever oral antidiabetic drug for the disease in the United States. Three clinical trials encompassing 3,000 participants have been conducted so far to test safety and efficacy, and the drug is slated for a vote by the FDA for approval.

The Diabetes Research Connection (DRC) is excited to continue following this study and the potential approval of sotagliflozin as another option in the treatment of type 1 diabetes. It would give patients another resource for helping to manage this disease and its impact on their health. The DRC is committed to supporting research that improves the diagnosis, treatment, and prevention of type 1 diabetes and enhances quality of life for those living with the disease. Learn more about current projects and how to contribute to critical funding by visiting http://diabetesresearchconnection.org.

 

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Conversion of Alpha Cells to Beta Cells in Pancreas May Help Treat Type 1 Diabetes

In individuals with type 1 diabetes (T1D), the immune system erroneously destroys insulin-producing beta cells. In turn, this leads to an inability of the body to control blood sugar. As a result, individuals must monitor and adjust their blood sugar on their own using a combination of finger sticks, continuous glucose monitors (CGM), insulin pumps, or insulin injections.

However, in a recent study, researchers explored the potential of reprogramming alpha cells in the pancreas to either become or function as beta cells. They used an adeno-associated virus to administer two different transcription factors – Pdx1 and MafA – into the pancreases of diabetic mice. With the overexpression of these factors, alpha cells developed into beta-like cells.

Alpha cells are ideal for reprogramming for numerous reasons including the fact that they naturally occur in abundance in the pancreas, they already function alongside beta cells in islets, and there are no apparent negative effects on glucose metabolism from reducing alpha cell levels, among other reasons.

Upon administering the transcription factors, euglycemia was restored within two weeks and maintained for four months. In addition, glucose response improved as well. After four months, autoimmune diabetes returned. However, this sheds light on potential therapeutic approaches for treating and managing diabetes and could be used in conjunction with immunosuppression for improved insulin production and blood glucose management.

Further testing is needed to determine if this approach is as effective in human pancreatic cells as it is in mouse models, though there have been some studies involving human islets in which alpha-to-beta-cell conversion occurred.

It is these types of studies that increase understanding of T1D and potential therapeutic treatment options. The Diabetes Research Connection (DRC), though not involved in this study, strives to support early career scientists in pursuing novel research studies aligned with preventing and curing T1D as well as improving quality of life for those living with the disease. DRC raises critical funds to enable these projects to move forward.

 

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Pumps and CGMs Help to Manage A1C Levels for Individuals with Type 1 Diabetes

A1C tests show an average blood sugar level over the past two to three months. This is important not only for helping to diagnose type 1 and type 2 diabetes but also for managing the disease. Healthy individuals without diabetes should have an A1C level below 5.7%. For those with diabetes, a level of 7% or less while using insulin is the target and considered being well controlled. If A1C levels are higher, it may mean that changes are needed to the person’s treatment regimen.

A recent study of participants in the T1D Exchange Clinic Network found that even with high quality care, many people are still not meeting A1C goals. Out of more than 20,000 participants, only 21% of adults had an A1C below 7%, and only 17% of youth had an A1C below 7.5%. These statistics are likely to be even lower for the general U.S. population with T1D who do not participate in the T1D Exchange Clinic Network.

On a positive note, the study found that those who use continuous glucose monitors (CGMs) and insulin pumps tended to have better outcomes. Since the 2010-2012 study, use of CGMs increased by 30%, and use of insulin pumps increased by 6%. Compared to non-CGM users, those who used the device had A1C levels that were about 1% lower.

Furthermore, these devices also had an impact on hypoglycemic episodes and diabetic ketoacidosis (DKA). Only about 5% of CGM and pump users experienced severe lows compared to 7% of non-CGM users and 9% of non-pump users. CGM and pump users also had fewer incidences of DKA.

While there is still more work to be done to better control diabetes and A1C levels, the use of CGMs and insulin pumps seem to be beneficial for many individuals using them. With increased awareness and education about these options, as well as improved access, there is the potential to benefit even more individuals with T1D and help manage A1C.

The Diabetes Research Connection is always looking for new and innovative research projects to fund that support advancement in understanding T1D as well as preventing and curing this disease and improving quality of life for those living with it. Early career scientists can receive a grant ranging from $25,000 to $75,000 for their research project.

 

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Senescent Cells May Play Integral Role in Type 1 Diabetes

For years, the general consensus among scientists was that type 1 diabetes (T1D) was caused by the immune system erroneously destroying insulin-producing beta cells. Researchers have yet to determine exactly why the immune system reacts this way in some people but not others. A new study exploring cellular changes prior to the development of diabetes may have unlocked an important piece of the puzzle.

Research conducted by a team from the UCSF Diabetes Center has revealed that secretory senescence in some insulin-producing beta cells in the pancreas may be a trigger for this massive cellular destruction. When DNA damage causes cells to malfunction and harm surrounding cells, that is when the immune system kicks in and attacks the beta cells. But researchers have found this only occurs once the senescence has become widespread. If these senescent cells are eliminated early on, it may help prevent the onset of T1D because only damaged cells would be destroyed while healthy cells would remain.

The scientists studied both mouse models and pancreatic tissue from deceased human donors with diabetes. By administering an FDA-approved second-line chemotherapy agent called ABT-199 or Venetoclax, they were able to selectively target and destroy senescent beta cells in the pancreas. In their study, only 30 percent of mice given this drug developed T1D, while 75 percent of control mice developed T1D. Furthermore, the drug did not have any direct impact on healthy beta cells or the immune system in general.

Overall, they found that the risk of developing T1D could be decreased through the use of ABT-199. Further studies are necessary to determine whether periodic administration of the drug continues to clear senescent cells and keep the disease at bay. If so, this could become a potential new treatment option in the fight against T1D.

The Diabetes Research Connection (DRC) is interested in seeing how this discovery plays out and impacts future diabetes research and treatment. It could open doors to new treatment therapies and approaches for decreasing the risk of T1D through early intervention. The DRC supports early career scientists in accessing critical funds to support novel research studies focused on the prevention, treatment, and cure of T1D as well as improvements in quality of life for individuals living with the disease. To learn more, visit http://diabetesresearchconnection.org.

 

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Removing Senescent Beta Cells May Help Prevent Type 1 Diabetes

Through data gathered in a DRC-sponsored research project, Peter Thompson, Ph.D., was able to secure additional funding that generated the results in this paper. Researchers explored the effects of senescent beta cells – or aging cells that no longer divide – on the development of type 1 diabetes (T1D).

In individuals with T1D, the body’s immune system attacks and destroys insulin-producing beta cells that are necessary for regulating blood glucose levels. However, researchers have found that senescent beta cells increase B-cell lymphoma 2 (Bcl-2) proteins, which in turn regulate cell death or apoptosis. By using a Bcl-2 inhibitor, researchers were able to eliminate senescent beta cells from the body which helps to stop the immune system’s destruction of insulin-producing beta cells and prevents the development of T1D.

This could be a major step forward in using the elimination of senescent beta cells as a therapeutic approach to treating or preventing T1D. More research is necessary to further explore the potential of this approach, but this study sheds new light on how the process impacts T1D and provides a greater understanding of the pathogenesis of the disease.

The Diabetes Research Connection (DRC) is proud to have played a role in providing the initial funding to enable Dr. Thompson and his team to collect necessary data to move forward and receive additional funding for the study. The DRC empowers early career scientists to pursue novel research studies on T1D through the support of individual, corporate, and foundation donations.

 

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Could Reprogrammed α-Cells Reverse Type 1 Diabetes?

For years, researchers have been exploring different ways to promote insulin production in individuals with type 1 diabetes (T1D). They have tried to protect insulin-producing beta cells, implant new cells, leverage remaining cells, and more, all with varying levels of success. Another approach is to use existing cells within the body, be it stem cells or islet non-β-cells.

A recent study examines α-cells and pancreatic polypeptide (PPY)-producing γ-cells and their potential to become insulin-producing cells. Researchers collected these cells from both diabetic and non-diabetic human donors who were deceased and inserted them into diabetic mice. Then, they used the transcription factors PDX1 and MAFA to reprogram the cells to produce insulin. They found that the cells had a great deal of plasticity and retained their expression of α-cells markers while reversing diabetes and continuing to generate insulin after six months. This method has not yet been tested in humans.

Though more research is needed, their findings show the potential for reprogramming α-cells to do the work of insulin-producing β-cells which the body’s immune system has destroyed. The conversion of α-cells may also hold potential for treating degenerative diseases.

The Diabetes Research Connection (DRC) follows the latest research in the field and supports early career scientists in pursuing novel, peer-reviewed studies to keep the understanding of T1D going. Researchers receive 100% of funds raised by the DRC to execute studies regarding the diagnosis, treatment, and prevention of type 1 diabetes, as well as improving quality of life for individuals living with the disease. Find out more about current projects and how to support these efforts by visiting http://diabetesresearchconnection.org.

 

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Influencing Cell Development to Support Type 1 Diabetes Treatment

One of the strategies researchers have been exploring for treating Type 1 Diabetes (T1D) is getting the body to generate new insulin-producing islet cells, or keeping it from destroying implanted cells. In individuals with T1D, the body does not produce enough insulin on its own to manage blood sugar levels because the immune system attacks and destroys these islet cells.

In a recent study, scientists at the University of Copenhagen (Denmark) and the Helmholtz Zentrum München (Germany) may have found a way to influence cell development in order for the body to produce more insulin-producing cells on its own. This could play an integral role in the development of improved treatment options for T1D.

The scientists closely examined a type of immature cells in the pancreas known as progenitor cells. They are similar to stem cells in that they can develop into different types of mature cells, but the variety is more limited, and they cannot divide and reproduce indefinitely. Mainly they become either endocrine beta cells or duct cells. Endocrine cells include islet cells.

By carefully studying the constant movement of these progenitor cells, researchers found that their development is strongly impacted by their environment and what types of structures they interact with. When they have greater interaction with the extracellular matrix laminin, they are more likely to become islet cells. When there is greater interaction with fibronectin, this leads to increased mechanical forces within the cell, in turn increasing the likelihood of development into duct cells.

Scientists believe they can transition this understanding to the development of stem cells in order to generate more insulin-producing islet cells by taking advantage of the mechanosignaling pathway. In terms of treatment options, this could contribute to the advancement of cell replacement therapies.

It is encouraging to see how researchers are enhancing and evolving their understanding of how cellular processes are related to type 1 diabetes and how these findings can support improved treatment options. Though not involved with this study, the Diabetes Research Connection strives to further these types of efforts by providing critical funding to early career scientists pursing research on T1D.

 

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Are Diabetes Alert Dogs an Effective Resource for Managing Diabetes?

Service dogs are nothing new. There are dogs that are trained to alert to seizures or allergies, provide mobility support, work with individuals with hearing or vision difficulties, and much more. Included in this group are diabetic alert dogs who are trained to alert to low or high blood sugars in individuals with diabetes. But how accurate are these animals when detecting changes in blood sugar?

A recent study analyzed data from 27 dogs trained by Medical Detection Dogs, a UK organization, for 4,197 episodes of hyper- or hypoglycemia. They used information and records provided by the individuals paired with each dog as well as training instructors at the organization familiar with each dog-client partnership. Their findings showed a median sensitivity to out-of-range episodes (blood glucose levels that were too low or too high) of 70%; this was further broken down to a median of 83% for hypoglycemic episodes and 67% for hyperglycemic episodes. Overall, the dogs correctly alerted an average of 81% of the time.  However, four dogs were accurate for 100% of alerts.

It is important to note that results varied greatly among the dogs, and this could be contributed to many different factors including whether the owner was an adult or child, whether the dog was previously an owner’s pet or selected specifically for training, family size and lifestyle, the nature of the individual’s diabetes and how quickly blood sugar levels change, consistency with rewards and training, and the owner’s attitude toward the dog and confidence in its capabilities.

While owners should not rely solely on diabetic alert dogs to manage blood sugar, these animals can play an important role in improving quality of life. Some dogs are able to alert to decreasing or increasing blood sugar before they reach levels that are considered out of range. In addition, they can be beneficial for those who have decreased awareness of hypoglycemic episodes so that they know to check their glucose levels.

With so many factors that can influence a dog’s performance and abilities, each case is different. Using a diabetic alert dog in conjunction with a CGM or other system can provide more comprehensive support. There are few studies that have been done on the effectiveness and accuracy of medical alert dogs for diabetes, so more research is necessary to obtain a better understanding.

Organizations like the Diabetes Research Connection (DRC) support early career scientists in moving forward with novel research studies for type 1 diabetes by providing critical funding. Without these resources, some scientists may not be able to execute their work. Learn more about current projects and how to help by visiting http://diabetesresearchconnection.org.

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Emily Smith’s Diaversary Wish

I was in seventh grade listening to my physical education teacher talk about the symptoms of type 1 diabetes (T1D), when I realized that I had been experiencing the same for months. When I spoke with my mother about what I had learned and how I was feeling, she immediately made an appointment with my doctor. At the appointment, the doctor took my blood sugar and it was in an extremely high glucose range, sending me to the hospital. That day I was diagnosed with T1D and the doctors expressed that it was a miracle that I caught it early. I was 12 years old when I diagnosed myself with a disease that forever changed my life.

Since my freshman year in high school, playing golf at the collegiate level has been one of my top goals. I am a junior at Point Loma Nazarene University and have been playing college golf for three years now. I have had to learn to be a busy student athlete, as well as a healthy diabetic. Living with T1D has not stopped me from doing the things I love, but it has a lot of challenges. Being a full-time student, having a job and long practice hours puts a toll on my body. Diabetes doesn’t make life easier for me. I constantly have to stop what I’m doing to check my blood sugar and make sure I’m taking care of myself. It is frustrating when my blood sugar affects the way I study, work and practice. I have learned to adjust to such a busy schedule, but I wish I didn’t have to which is why I find hope in research.

Knowing there are people researching ways to cure T1D keeps me going through the difficult times and provides me with hope. When I play golf, my goal is to win. I want the same thing for T1D. I want to beat this disease and see it be cured in my lifetime. I believe research is the path to a cure!

As a young diabetic, I believe it takes a community to connect for a cure, which is why it’s so important to raise awareness about research and fund new projects. My one wish on my Diaversary is to inspire the community to fund research so that we can find a cure for T1D in my lifetime. Together, we will make the difference!

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Evaluating the Prevalence of Type 1 Diabetes Diagnoses in Older Adults

Many people still refer to type 1 diabetes as juvenile diabetes because approximately 85% of individuals with T1D are diagnosed in childhood. When diagnosis occurs in adulthood, it is often type 2 diabetes. However, T1D can occur at any age, and more adults are being diagnosed after age 30. Though it still only accounts for approximately 4% of T1D cases, a correct diagnosis is imperative for proper treatment of the disease.

Because a higher proportion of adults develop T2D, some who actually have T1D may be misdiagnosed. A recent study compared data for 379,511 white European individuals registered with UK Biobank.  Of those individuals 13,250 developed diabetes by age 60. When divided between those with high versus low genetic risk of T1D, there were 1,286 more people diagnosed with T1D in the high-risk group than in the low-risk group.

Compared to individuals with T2D, those with type 1 tended to have lower BMIs, relied on insulin use within the first year after diagnosis, and were at higher risk for developing diabetic ketoacidosis. Some type 2 individuals were actually found to have type 1 diabetes instead when it was realized that their diabetes was not well managed using strategies other than insulin, and that they required increasingly higher doses.

There have been very few studies conducted on the prevalence of T1D diagnosis in older adults because so many individuals are diagnosed at a young age. Testing for autoantibodies and C-peptide can be very beneficial, but it is not always accurate in confirming a diagnosis because some people have false positives. However, it can be used to help differentiate between T1D and T2D and more accurately diagnose adults.

“I recently diagnosed someone with new-onset T1D at 82 years old. We are definitely seeing more of this. Especially when we test for the antibodies as soon as possible,” says one of the Diabetes Research Connection’s esteemed Scientific Review Committee members, Dr. Athena Philis-Tsimikas.

The combination of genetic susceptibility and antibody testing has helped to raise awareness of the number of adults being newly diagnosed with T1D, though more research is still needed. It is essential that individuals be correctly diagnosed as soon as possible in order to receive the most effective treatment for managing their diabetes.

The Diabetes Research Connection (DRC) strives to provide valuable funding for early career scientists who are researching type 1 diabetes so that they can advance understanding, diagnosis, and treatment of the disease and one day find a cure. Learn more about current research projects and how to help by visiting http://diabetesresearchconnection.org.

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Diabulimia: Battling Type 1 Diabetes and Eating Disorders Together

In managing type 1 diabetes (T1D), individuals can become very focused on the numbers associated with their condition – blood sugar levels, A1C, weight, insulin dosage – as well as what they eat. The food they consume impacts blood sugar and insulin needs. Some people struggle with not just T1D, but an eating disorder as well.

Dealing with diabetes can cause changes in weight. Some people lose weight quickly before diagnosis and gain it back once they begin treatment to help their body. This can be difficult to deal with, and individuals may begin restricting their insulin in order to control their weight, a condition known as diabulimia.

This can be very dangerous as their blood sugar levels can spiral out of control and increase risk of diabetic ketoacidosis, bacterial infections, muscle atrophy, dehydration, delayed wound healing, peripheral neuropathy, kidney disease, and more. These issues can become potentially fatal if not properly treated.

Researchers recently evaluated 11 online blogs of individuals with diabulimia to explore their experiences with this condition and the challenges they have faced. The bloggers expressed a variety of motives for choosing to restrict their insulin, as well as diverse complications from doing so. However, they found that having a strong support system, recognizing triggers for relapse, and improving diabetes self-management were beneficial to recovery.

Treating diabulimia can be difficult because rapidly altering blood glucose levels can be dangerous. It must be done carefully under medical supervision. In addition, treatment cannot only address diabetes management. It must also focus on eating disorders and improving the person’s relationship with insulin, food, and self-perception. There are many underlying issues that should be taken into consideration. Treatment providers should be well-versed in both T1D and eating disorders.

More in-depth research is necessary to gain a better understanding of effective interventions and treatment approaches for diabulimia. Organizations like the Diabetes Research Connection (DRC) provide critical funding for peer-reviewed, novel studies regarding T1D. Early career researchers can make strides in advancing diabetes management and eventually finding a cure. To learn more about current projects or support these efforts, visit http://diabetesresearchconnection.org.

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Exploring Collagen as a Minimally Invasive Approach to Managing Type 1 Diabetes

Diabetes management is a full-time job. Individuals with type 1 diabetes (T1D) don’t get a day off; they must be constantly monitoring their blood sugar and administering insulin as necessary. There are many devices that can assist with this process, but it is still a constant concern. However, researchers from Purdue University and the Indiana University School of Medicine may have developed a new approach that could manage glucose levels for up to 90 days at a time.

By combining pancreatic cells with collagen – a natural protein in the body already – they may be able to decrease rejection and enhance insulin independence. Previous methods have focused on injecting islet cells directly into the pancreas because it has a strong blood flow to transport insulin and glucose.  This tends to be a rather invasive procedure, though, and the body still destroys a significant portion of the transplanted islet cells.

This new treatment is administered under the skin just like other injections. The collagen solution solidifies and the body recognizes the collagen, so it does not destroy it. Instead, it provides blood flow that helps transport the insulin released by the islet cells contained within the solution. The procedure is minimally invasive and could be done in an office setting rather than an operating room.

Initial studies were conducted on mice, and now the researchers are ready to test this approach on naturally diabetic dogs and eventually humans.  Diabetes occurs in dogs very similarly to how it does in humans. The researchers will work with the College of Veterinary Medicine at Purdue for these clinical trials.

In mice with diabetes, pre-clinical trials found that diabetes was reversed for at least 90 days when a twin mouse donor was used to collect islet cells, and at least 40 days when a non-twin mouse donor was used for islet cells.  In addition, virtually all of the cells survived the transplant regardless of donor type. This could potentially eliminate the need for multiple donors which are required for current treatments due to the destruction of transplanted cells by the immune system. Giving individuals with T1D a shot every 40 to 90 days to maintain blood sugar could provide a great deal more freedom than they currently have.

It is these types of studies that have the potential to change the lives of individuals living with T1D for the better. Researchers have made significant advancements over the years in better understanding the disease and developing treatment strategies that could lead to an eventual cure. Diabetes Research Connection (DRC), though not involved in this study, is interested to see how the clinical trials progress and what it could mean for the future of diabetes management.

DRC is committed to supporting early career scientists pursuing novel research studies on type 1 diabetes to prevent and cure the disease as well as improve quality of life and minimize complications. Mainstream funding is highly competitive, and the DRC gives young researchers another option for receiving the support they need to drive projects forward. To learn more about current projects and support these efforts, visit http://diabetesresearchconnection.org.

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Australian Government Increases Support for Individuals with Type 1 Diabetes

Managing diabetes is expensive. It requires buying insulin, testing supplies, monitoring devices and supplies, emergency supplies, and more. There is also the cost of doctor visits, specialist visits, and emergency care in the event of severe hyperglycemia, hypoglycemia, or other issues. In some cases, poor diabetes management and overall health are a result of not being able to afford consistent care.

The federal government in Australia is taking steps to change this. The government has committed an additional $100 million over four years to increase access to free continuous glucose monitoring (CGM) devices for individuals with type 1 diabetes (T1D). This has the potential to save families thousands of dollars in out-of-pocket expenses each year. While there are some eligibility requirements, in general the expansion of services will include children and adolescents with T1D or conditions requiring insulin, pregnant women with T1D, and adults with T1D who have a high clinical need.

Patients can choose from a CGM sensor that is attached to the stomach or the arm. Arm sensors are used with the FreeStyle Libre Flash Glucose Monitoring System, and information is sent directly to the patient’s cell phone or diabetes management device. This allows closer tracking of glucose levels without constant finger sticks, and information can be easily shared with healthcare providers. In addition, having access to CGM devices may reduce patient anxiety and stress regarding diabetes management, as well as decrease emergency hospital visits.

It is encouraging to see the government recognizing the importance of quality diabetes care and stepping up to support patients living with T1D to make diabetes management more affordable and accessible. The Diabetes Research Connection (DRC) is interested to see the influence this could have on future diabetes care and the impact it will have on patients. The DRC is committed to raising funds for peer-reviewed, novel research studies on T1D by early career scientists. These projects play an instrumental role in advancing knowledge, treatment, and potential cures for the disease. Learn more about current research projects and support these efforts by visiting http://diabetesresearchconnection.org.

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Multiple Daily Injections May Improve Glycemic Control During Pregnancy for Women with T1D

Effectively managing blood sugar can be difficult in normal situations, but it can be even more challenging during pregnancy. Women must be cognizant of not only their own health, but also that of their unborn child. Infants are at risk for neonatal hypoglycemia. A recent study examined the impact of multiple daily injections (MDI) versus using an insulin pump on glycemic control during pregnancy for women with type 1 diabetes.

The study involved 123 women using MDI therapy and 125 women with insulin pumps. The researchers based the study on the treatment the women were already using prior to the trial; they did not assign a treatment method. Participants spanned multiple countries including the United States, Canada, England, Ireland, Scotland, Spain, and Italy. Women entered the study during their first trimester, and it lasted until they were at 34 weeks of gestation.

During this time, HbA1c levels were measured. The results showed that both treatment methods were equally effective during the first trimester with no statistically significant differences. However, at 34 weeks gestation, women who used MDI therapy showed a greater decrease in HbA1c levels versus women using insulin pumps. In addition, insulin pump users reported higher levels of gestational hypertension, neonatal hypoglycemia, and neonatal intensive care unit admissions for longer than 24 hours. However, these women also reported lower levels of hypoglycemia-related anxiety than those using MDI therapy, but also had lower levels of general well-being.

Overall, it appeared that MDI therapy resulted in greater decreases in HbA1c levels and improved glycemic control. There is still more research necessary, however, to verify these results. There were several factors that may have influenced findings and outcomes.

This study shows the importance of understanding the effects of T1D on different conditions such as pregnancy and the value of researching various treatment options to help women make more informed decisions regarding their health. Though not involved in this study, the Diabetes Research Connection follows the latest trends and developments in the field and supports early career scientists by providing critical funding for novel research regarding T1D. Continued funding is essential for advancing research and diabetes care. To learn more, visit http://diabetesresearchconnection.org.

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20 Years Later: The Impact of the Edmonton Protocol

Management and treatment of type 1 diabetes have advanced over the years, but it is interesting to see what has withstood the test of time. For instance, islet cell transplantation (ICT) was first used in humans in 1989. Though the protocol changed a bit in 2000, the concept has remained relatively the same ever since. It is known as the Edmonton Protocol.

Researchers have followed the Edmonton Protocol since 1999, tracking factors such as the number of procedures, adverse events, and insulin independence. Studies have shown that insulin independence rates have been fairly consistent from 1999 through 2015 with around 50% of patients maintaining insulin independence after one year, and 25% maintaining insulin independence after five years. In addition, fewer patients have experienced adverse events over the years, and whole-body immunosuppression has become more localized. However, the number of centers performing ICT and the number of patients receiving this treatment have also declined.

The Protocol continues to rely on the use of cadaver islet cells which are inserted into the body of a patient with T1D.  The transplanted cells are protected by immune suppression or some type of encapsulation to reduce the risk of the body attacking and destroying these cells.

One challenge that has persisted over the years is identifying a sustainable source of islet cells aside from cadavers. Researchers have been testing methods for using human stem cells or animal islet cells, but more tests are needed to potentially make these options feasible. Furthermore, the issue remains of protecting cells in the long-term. Currently, the best option is immunosuppression, but even that has limited effectiveness. While there have been advances made in the medications and encapsulation devices used, there is still work that needs to be done to address undesirable side effects such as decreased ability of the body to fight off diseases or infection.

It is interesting to see how the Edmonton Protocol has remained the standard for ICT for 20 years, and the Diabetes Research Connection (DRC) continues to follow progress and changes related to this type of treatment for T1D. T1D continues to affect around 1.25 million Americans, and researchers are always looking for improved options for treating, managing, and potentially curing this disease.

The DRC provides necessary funding to early career scientists to conduct novel research studies related to type 1 diabetes. These projects are aimed at preventing and curing T1D as well as minimizing complications and improving quality of life for those living with this disease. To learn more about current research projects and support these efforts, visit http://diabetesresearchconnection.org.

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Where is Diabetes Research Connection headed in 2019?

Since 2015, we have funded 17 innovative, peer-reviewed type 1 diabetes (T1D) projects and distributed $700,000 directly to early-career scientists, building a pipeline of talented T1D researchers. In partnership with our community, the main initiative in 2019 is to raise $300,000 to fund 4-10 of the most promising T1D research projects.

This year, we want to complete our $1M research campaign and accomplish the following goals:

  1. Continue to fund the most promising and innovative science that will advance the continuum of T1D research for a cure and ways to better care for those with the disease.
  2. Be a catalyst in changing the paradigm for how diabetes research is currently funded in the U.S.
  3. Publish new research project findings online and in respected journals to advance the industry.
  4. Ensure transparency by allowing supporters to choose which research they believe to be the most promising and may eliminate this disease.

Since 2015, 100% of funds designated for research went directly to the scientists’ lab. We are committed to continuing this in 2019.

For a summary of the accomplishments in 2018, click here. We will update you throughout 2019 on the progress of our $1M research campaign. We believe it takes a community to connect for a cure and together we make the difference!

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2018 Year in Review

This year marked several important milestones and has been a time of growth. With the generosity of our supporters, we funded five innovative, peer-reviewed type 1 diabetes (T1D) projects, bringing the total to 17. Our sponsored early-career scientists developed data to show beginnings of proof of principle concepts that in turn precipitated substantial additional grants and publish their work in diabetes journals.

We’re committed to keeping our community updated, below are some highlights from 2018.

January was an exciting month, we launched our 13th project, Jane Kim, M.D., UCSD/Rady Children’s Hospital, What Type of Type 1 Diabetes Does Your Child Have?; our 14th project, Youjia Hu, Ph.D., Yale University Diabetes Center, A Bacteria in the Gut May Predict Type 1 Diabetes; our 15th project, Tamara Oser, M.D., Penn State College of Medicine, Using Technology to Improve Diabetes Self-Management; and our 16th project, Haisong Liu, Ph.D., Salk Institute for Biological Studies, A Safe and Cost-Effective Stem Cell Approach for Treating Diabetes.

In February, Peter Thompson, Ph.D., completed his DRC project and received a more substantial grant with funds up to 3 years from the Hillblom Foundation. The results obtained from the DRC project allowed him to secure additional funding which is exactly the purpose of DRC and why it’s important to continue building a pipeline of new T1D researchers.

The results continued In April. Jeremy Racine, Ph.D., completed his DRC project and publishes results in Diabetes. His research created a better animal model to study immune responses to beta cell transplants in T1D for the entire diabetes research field. The new mouse model from this study is now being used by others in T1D research because it better represents the diverse T1D population.

In May, there was standing room only at an event we hosted with the Jewish Community Foundation. Over 50 people heard Dr. John Glass, Dr. Duc Dong and Dr. CC. King share information on the latest scientific breakthroughs in T1D research. For those that took advantage of the lab tour, they felt hopeful after seeing tangible results in the lab!

We announced our partnership with Greater Than in June. Together, we created a fashionably-forward T1D t-shirt collection for our monthly supporters. All funds raised through the DRC Collection go to support early-career T1D researchers, 100% of funds raised go directly to the scientists.

In July, we ran our first social media contest. Stories were sent in from our 3,676 followers on Instagram and 23,631 followers on Facebook. The winning story was featured at our 1st annual event in September.

Joseph Lancman, Ph.D., completed his DRC project in August. His research enhanced the activity and the delivery of two transcription factors to significantly increase the efficiency of triggering an early endoderm like identity in muscle cells that remain in an animal’s body. Because of this key advance, his lab is positioned now to take advantage of cutting-edge technology that will advance his T1D research. Dr. Lancman produced a manuscript with his research results and submitted it to a top tier journal.

We hosted our 1st annual Del Mar Dance for Diabetes in September. There were 250 people who joined us in connecting for a cure and helped us raise over $350,000 for innovative T1D research. Guests enjoyed the food, music, drinks, silent auction and dancing under the stars at the silent dance party.

In October, Yo Suzuki, Ph.D., gains proof of concept through his DRC-sponsored research project and secures additional funding in the amount of $1.2M from a prestigious Foundation to continue his work. Dr. Suzuki is another example of how DRC and its supporters are building a pipeline of promising, new T1D researchers that are expanding the field of diabetes research.

We added a full-time member to our team at DRC in November, Casey Davis, Director of Development. We also launched our 17th research project, Marika Bogdani, MD, Ph.D., Benaroya Research Institute, Offensive “Blocking” to Defeat T1D Before it Strikes!

In December, we reached a few milestones. Our online community grew to over 30,000 and we doubled the number of financial supporters in 2018. On Facebook this year, 35 people created fundraising campaigns and helped us raised nearly $7,000. Due to the success of our fundraising efforts all year-long, we were able to fund the five projects launched this year, bringing the total to 17 new T1D research projects.

This past year was important for moving research forward and adding to the field of diabetes. We 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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Diabetic Ketoacidosis Risk May Increase with Cannabis Use

Legalization of recreational and medicinal cannabis use has increased throughout the United States, but that does not mean that it does not come with risks. While cannabis can have positive effects for certain conditions, it may also be dangerous for others. A recent study found that using cannabis may double the risk of individuals with type 1 diabetes of developing diabetic ketoacidosis.

In a small, self-reported study of 450 individuals in Colorado with type 1 diabetes, approximately 30% reported using cannabis within the past 12 months. Of that group, around 40% smoked, used edibles, or vaped at least four times per week. The study found that while 8.2% of non-users had been hospitalized for diabetic ketoacidosis within the last year, this jumped to more than 20% for cannabis users. Furthermore, individuals with type 1 diabetes who used cannabis also had higher average HbA1c levels than non-users. Researchers believe the increased risk may come from the fact that “cannabinoids alter gut motility and cause hyperemesis.”

However, there is still more research necessary to further explore this risk as the study had several limitations. Many of the participants who reported using cannabis were younger with lower income and lower use of diabetes technology such as insulin pumps and continuous glucose monitoring (CGM). In addition, access to healthcare was not taken into consideration. Furthermore, some participants may have had underlying conditions that also impacted their risk of developing diabetic ketoacidosis.

Regardless, this study opens doors for more in-depth research regarding the effects of cannabis use on type 1 diabetes. It is important to understand how this drug may impact health, treatment, and quality of life.

The Diabetes Research Connection (DRC), though not involved with this study, strives to support novel research studies regarding all aspects of type 1 diabetes by providing essential funding to early career scientists. This is made possible by donations from individuals, corporations, and foundations, and 100% of research funds go directly to the scientists. To learn more about current projects and how to help, visit http://diabetesresearchconnection.org.

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Researchers Examine Gut Bacteria in Children for Risk Factors for T1D

In an effort to better understand how type 1 diabetes may develop, researchers took a closer look at how gut health changes from infancy through childhood and into adulthood. They used data collected through The Environmental Determinants of Diabetes in Youth (TEDDY) study, which utilized reports from Finnish, German, Italian, Mexican, American, and Turkish children. This particular study on gut bacteria focused on 783 children between the ages of three months and five years from Finland, Germany, Sweden, and the United States.

Some of the factors they examined were whether children were breastfed or formula fed and for how long, any illnesses they contracted, antibiotics they took, environmental changes, and life experiences. Their gut microbial profile was determined through stool samples. One interesting finding was that when there were more Bacteroides species and a decreased production of short-chain fatty acids, there was an increased susceptibility to islet autoimmunity (IA) or type 1 diabetes (T1D).

The researchers found that the gut microbiomes differed greatly between participants, and there was a marked difference in children who were breastfed versus those that were not, as well as once solid foods were introduced into their diet. Breastfeeding showed higher levels of an enzyme that helps with milk fermentation, while solid foods increased enzymes that help metabolize fiber. In addition, participants who had taken oral antibiotics showed disrupted microbial stability along with decreases in some strains of Bifidobacterium. However, early probiotic supplementation helped protect control subjects against islet autoimmunity.

All of these factors may play a role in the development of islet autoimmunity or T1D. This study has increased awareness of the role that environmental factors may play in T1D along with genetics. There are still numerous issues this study did not address, but it is a strong starting point for further research, especially when it comes to the influence of breastfeeding and oral antibiotics on the development of T1D.

The Diabetes Research Connection (DRC) is interested to see how this study may impact future research in T1D and furthering the understanding of factors related to disease development and prevention. The DRC supports early career scientists pursuing novel research related to the prevention and treatment of T1D as well as improved quality of life for individuals living with this disease. Learn more about current studies and how to help by visiting http://diabetesresearchconnection.org.

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Nasal Glucagon May Become New Option for Treating Hypoglycemia

When blood sugar drops and hypoglycemia occurs, it is critical for individuals with type 1 diabetes to receive immediate treatment to raise their blood sugar. If left untreated, it can lead to severe confusion, seizures, or even loss of consciousness. One of the main ways of treating hypoglycemia is administering glucagon.

Glucagon is a hormone that stimulates the body to convert glycogen into glucose. It also keeps the liver from consuming too much glucose so that it can be circulated in the bloodstream instead. Traditionally, glucagon is delivered through an intramuscular injection. A solution is mixed to dissolve the glucagon, then it is administered by syringe.

However, many caregivers – or even bystanders – may be hesitant to give someone else a shot of glucagon. Preparing the syringe and shot is a multistep process and can be confusing if the person is not properly trained. Plus, they are under considerable stress in emergency situations where it must be given, which can complicate things even further.

A new study has found that nasal glucagon may be just as effective as intramuscular glucagon in raising blood sugar levels during episodes of hypoglycemia. There is no preparation necessary before administering the medication. It is a powder that comes in a single-use device that is sprayed up the nose. It isn’t even necessary for the patient to inhale because the powder is absorbed on its own.

Both treatment methods were tested on 70 adult participants with type 1 diabetes. A state of hypoglycemia was induced, and then they were treated with either the intramuscular or nasal glucagon. One to seven days later, the process was repeated, and the other form of medication was administered. In 100 percent of cases, hypoglycemia was reversed and participants had no serious adverse events. In 97 percent of cases, treatment success was achieved within 15 minutes.

This new treatment option was presented at the European Association for the Study of Diabetes (EASD) by Leona Plum-Moerschel, MD, of Profil Mainz, Germany. According to Plum-Moerschel, “I think we can all agree that the safety profile is very much acceptable for an emergency treatment. I personally would expect that, due to its simplicity of use, nasal glucagon will create a greater community who can render quick aid in a rescue situation.”

The Diabetes Research Connection (DRC) is interested to see if this nasal formulation will be brought to market and how it will affect the treatment of hypoglycemia in children and adults. It is encouraging to see treatment options becoming more user-friendly so that even non-medical personnel can effectively administer emergency medications.

The DRC supports research geared toward the treatment and prevention of type 1 diabetes, as well as improvement of quality of life for those living with the disease. Access to funding is essential for scientists to continue advancing their research, and the DRC provides these types of resources. To learn more about current projects and donate to support these efforts, visit http://diabetesresearchconnection.org.

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More Adults May have Type 1 Diabetes Than Previously Thought

Type 1 diabetes (T1D) used to be known as juvenile diabetes because it is often first diagnosed during childhood. Since the pancreas produces little to no insulin, difficulty regulating blood sugar is typically noticed early on. However, that is not always the case. There are also many individuals who are not diagnosed with T1D until after age 30. In addition, they may be mistakenly identified as having type 2 diabetes rather than type 1.

A recent study compared data from the UK Biobank and also conducted clinical trials to determine how adults are diagnosed and treated when diabetes is suspected. Many people were initially diagnosed with type 2 diabetes and did not receive insulin treatment. They used an oral glucose-lowering medication in order to manage their blood sugar. But even when using rapid acting insulin, some still had difficulty with blood sugar control.

Approximately 5 percent of adults diagnosed with T2D actually have T1D. While this may not seem significant, proper diagnosis is critical to providing accurate treatment and education for patients. In addition, insurance may not cover the cost of supplies for those with T2D, but insulin pumps and continuous glucose monitors may be covered for those with T1D. This can make a major difference in care for many people.

The study involved nearly 600 adults from South West England who were diagnosed with diabetes after age 30 between 2007 and 2017. Results showed that 123 participants (21 percent) had type 1 diabetes with severe insulin deficiency requiring continuous insulin treatment within three years of diagnosis. There were 306 participants diagnosed with type 2 diabetes based on a peptide level of 600 pmol/L or greater for at least three years after initial diagnosis. Another 115 participants were not included in the analysis due to indeterminate results. The study also included 220 participants who had been diagnosed with T1D at age 30 or younger for comparison purposes.

While symptoms are often similar, the study found that “rapid insulin requirement was highly predictive of late-onset type 1 diabetes, with 84 percent requiring insulin within 1 year. And of all the patients treated with insulin within 3 years, 57 percent developed sever endogenous insulin deficiency consistent with type 1 diabetes.” Compared to participants with T2D, those with T1D typically had a lower BMI, were more likely to have a positive islet autoantibody test, and had higher genetic risk scores for T1D.

It can be difficult to differentiate between the two types of diabetes, but medical providers should carefully monitor those they believe may have T1D and conduct related tests to determine whether they should be treated initially using insulin as opposed to an oral medication.

The study was presented at the European Association for the Study of Diabetes (EASD) 2018 Annual Meeting by Nicholas J. Thomas, MD, from the University of Exeter, United Kingdom. Dr. Thomas’ team is working on developing algorithms to improve the accuracy of diabetes diagnoses in order to provide the best care for patients.

Accurate diagnosis of type 1 or type 2 diabetes is essential for effective care and patient education. The Diabetes Research Connection supports research related to T1D and advancing understanding related to the diagnosis, treatment, and prevention of this disease. Early career scientists are provided with up to $70,000 in funding to conduct peer-reviewed, novel research studies. Learn more and find a project to support by visiting http://diabetesresearchconnection.org.

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Building a Pipeline of Young Researchers

New and innovative research is essential to continuing to expand scientific knowledge and improve the future of healthcare. Yet over the years, the biomedical community has seen a troubling downward trend in funding, support, and opportunities for young researchers. A study published in the Proceedings of the National Academy of Sciences of the United States of America investigated some potential factors for why investigators are struggling early on in their careers and not receiving as much funding to stimulate independent research.

For years, attaining an R01 from the National Institutes of Health (NIH) has been a prerequisite for young biomedical researchers to become independent investigators and start their own laboratories. Yet the average age that they receive their first R01 has steadily increased from less than 38 years old in 1980 to more than 45 years old in 2013. In 1980, 5.6% of grant funding went to investigators who were younger than 36, but by 2012, this had dropped to just 1.3%. Principal investigators over age 65 are awarded more than twice as many R01s as those under age 36.

It has become increasingly challenging for young scientists to secure necessary funds to advance their careers in research. In turn, this puts future generations of biomedical researchers in jeopardy because more scientists are becoming disheartened and exploring other career paths. It also disrupts the emergence of scientific breakthroughs from bright young minds with untapped potential.

There are many reasons why young investigators may be losing out on the fight for NIH funding. For one, some are spending more time in post-doctoral programs training and it is taking longer for them to secure faculty positions. There may also be unintentional bias from review committees to select more established investigators who have a proven track record of success rather than taking a risk on unknown scientists. Funding has been reduced over the years making the competition fiercer and the awarding of grants increasingly selective. This also means that universities must shoulder a larger portion of the costs associated with supporting research endeavors.

The Diabetes Research Connection (DRC) is reversing this trend by funding early-career scientists who then leverage funding from DRC to seek additional funding from larger foundations and NIH.

 

DRC is supporting the next generation by directing its fundraising toward early-career scientists. It recognizes that mainstream funding is highly competitive, and, as the above research has shown, is less frequently awarded to young researchers. Through DRC, scientists receive up to $70,000 from donors for their research projects, which can be enough to give them a strong foundation to conduct novel research related to type 1 diabetes. To learn more about current projects and support these efforts, visit http://diabetesresearchconnection.org.

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Increasing Polyclonal IgMs May Help Prevent or Reverse T1D

A common strategy used by researchers in treating type 1 diabetes (T1D) is to destroy or deactivate immune cells that mistakenly attack insulin-producing beta cells. There have been many variations on this approach over the years, but effectiveness has been limited. Typically, these autoreactive cells reemerge. However, tackled this issue from a different angle instead of looking at how to increase certain protective cells.

Researchers, including Daniel Moore who works with the Diabetes Research Connection, found that IgMs have immunoregulatory properties that help to limit inflammatory responses and decrease autoreactive B lymphocytes. Islet-reactive B lymphocytes have been found to produce anti-islet antibodies linked to the development of stage 1 T1D. IgM may also help to stimulate the production of regulatory T cells.

When administered in non-obese diabetic (NOD) mice, purified IgM was able to prevent the development of diabetes and increase regulatory T cells. However, IgM that was taken from pre-diabetic mice was not as effective. IgM obtained from Swiss Webster donor mice (recognized as healthy, not pre-diabetic, mice) was highly effective in reversing hyperglycemia and preventing the onset of diabetes. The researchers also used human IgM from healthy donors and found similar results.

The study shows the potential effectiveness of healthy donor IgMs in promoting normal immune homeostasis, preventing diabetes occurrence, and reversing new-onset diabetes. While immunoglobulin therapy is not a new concept, it usually contains low levels of IgM, whereas this study focused on higher levels of purified IgM. More research is necessary to further explore the potential of donor polyclonal IgM for the prevention and treatment of type 1 diabetes.

Daniel Moore, a senior author on the study, is a scientist associated with the Diabetes Research Connection (DRC). The DRC is committed to funding novel, peer-reviewed research focused on preventing and curing T1D as well as improving quality of life for those with the disease. It has played a role in supporting dozens of projects. To learn more about current studies, visit http://diabetesresearchconnection.org.

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Factors Identified for More Effective Type 1 Diabetes Care

Managing type 1 diabetes is a complex process. Every person is different and must figure out what strategies and devices work best for their care, and that involves working together with their healthcare provider. Results of a recent audit have identified some key factors that contribute to better diabetes management from a provider perspective.

Participants in the study included top clinics that care for more than 500 individuals with type 1 diabetes. Results found that at up to 40 percent of patients achieved HbA1c levels of 58mmol/mol or lower at some centers, while in other centers only 20 percent of patients hit this target. The data was analyzed in an effort to identify factors that may have contributed to these differences.

Some of the strategies that have been found effective include providing structured education and dedicated pump clinics for patients to support them in diabetes care. More than half of the centers that participated in the audit reported having nurses and staff that were specially trained in type 1 diabetes care. Several of the centers also offered support services via phone and online to patients and focused on improving access to continuous glucose monitors (CGMs).

It may also be beneficial for treatment centers to partner with other services including psychological care and community organizations to improve outcomes for patients. Taking a collaborative approach could support patients in managing health across multiple areas thereby enhancing overall type 1 diabetes care.

The Diabetes Research Connection (DRC), though not involved in this study, is committed to advancing knowledge and treatment when it comes to type 1 diabetes. The DRC provides critical funding to support early-career scientists in conducting peer-reviewed, novel research studies. To learn more and contribute to these efforts, visit http://diabetesresearchconnection.org.

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Next Stop Cure? A Quick History of Diabetes Research

From an insulin pump that’s the size of a backpack to stem cells hitching rides on what’s the size of a band-aid, diabetes research has come a long way. It is not without tireless efforts from the scientific community, keen investors, visionaries and donors, alike, who have moved the needle.

With research funding, people managing this challenging disease have received tools that help them to live better lives. Every advancement or milestone has elevated our understanding of Type 1, achieved improved management and has gotten us one step closer to an actual cure. That’s why donating to diabetes research is so important — it’s the only way we’ll eliminate this disease.

Diabetes research milestones

The timeline of advancements

1889: Pancreatic diabetes discovered

Oskar Minkowski and Joseph Von Mering met accidentally in a library in 1889. Striking up a conversation, they began to debate whether the pancreas helped digest and absorb fats. Performing a pancreatectomy on a dog that same night, they found the dog developed glycosuria, a condition associated with diabetes that causes the production of a lot of urine. Minkowski found the urine was 12% sugar. They then depancreatized another dog and found that prevented hyperglycemia.

1921: Discovery of insulin

In 1921, Frederick Banting and Charles Best closed off the pancreatic ducts of a dog then removed the pancreas. They crushed, froze, and salted it. Then they gave this substance to a diabetic dog and found the dog’s blood sugar dropped significantly.

1922: Purification of insulin

James Collip refined Banting and Best’s insulin extraction and purification method. The new substance was tested in the first human in 1922. 14-year old Leonard Thompson was in a critical condition. He was given an insulin injection in his buttocks. This had a negative effect on him and he grew sicker. Collip worked to improve the insulin’s quality and Thompson received another injection soon after. This time, it lowered his blood sugar and saved his life.

1959: Type 1 and Type 2

Solomon Berson and Rosalyn Yalow measured how much insulin was in a diabetic’s blood. This led to the discovery that some diabetics could still make insulin, which split the diabetic world into two sections—Type 1 and Type 2.

1961: Glucagon introduced

Eli Lilly and Company succeeded in creating a pure form of glucagon, a hormone that elevates blood glucose levels. The introduction of glucagon as an injectable treatment became life-saving in emergency situations of severe hypoglycemia.

1963: The first pump

Designed by Dr. Arnold the pump that looks like a backpack delivers both glucagon and insulin.

1966: First pancreas transplant

The University of Minnesota Hospital was the first to successfully transplant a pancreas into a human. The success rate of these transplants has increased since then as better surgical techniques and immune suppressant drugs improved.

1967: Laser treatment for diabetic blinding

William Beetham and Lloyd Aiello created a laser treatment that, over the next five years, radically changed diabetic retinopathy care.  

1976: A1C Test developed

Researchers at the Joslin Diabetes Center in Boston perfected the A1C test, which can provide information about a diabetic’s average blood glucose control over the previous 2-3 months.

1978: First human insulin synthesized

Genentech discovered how to synthesize human insulin from E. coli. The scientists had to synthesize genes then put them in the E. coli bacteria. This forced the E. coli to produce insulin chains. Two chains were then combined and a human insulin molecule was made. They turned each individual bacterium into a manufacturing plant for human insulin.

1986: Insulin Pen

Insulin pens were introduced, replacing disposable syringes. Now diabetics could vary their dose. The pen also gave them more privacy as it was less obvious what the pens were for.

1990: Insulin external pump

These pumps continuously monitor sugar levels and allow the wearer more freedom and control over their sugar levels.

1999: First continuous glucose monitor (CGM)

MiniMed received FDA approval for the first CGM device in the USA. The company was later bought by Medtronic. Initially, it was called a “retrospective CGM device” and was meant to look back at a 72 hours monitoring of blood sugars.

2006: First inhaled insulin is FDA approved

Exubera was the first inhaled insulin. It was put on the market in 2006 but taken off in 2007 due to low sales. Since then researches have created Affreza, an improved version that hit the market in 2014.

2014: Stem cell islets implant

Viacyte created a therapy called VC-01, which implants a collection of young stem cells in an immune-protective container under the skin. The young stem cells develop into insulin-producing cells that release insulin when the body needs it.

2016: Hybrid closed-loop system

Medtronic receives FDA approval for the first hyped closed-loop system which connects CGM and insulin pump. It learns what an individual’s insulin needs are and takes action to minimize both high and low glucose levels. It delivers variable insulin 24 hours a day.

 

 

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WHY SUPPORT DIABETES RESEARCH

Less than one hundred years ago, Type 1 diabetes was a mysterious, daunting disease. Parents watched their children’s health quickly deteriorate as they awaited their inevitable early demise. By the early 20th century, medical advancements, stemming from intensive research, completely transformed the fate of people living with Type 1 diabetes.

In 1889, upon removing and then replacing the pancreas of a dog, scientists found that that the pancreas played a major role in preventing high blood glucose, paving the way for future diabetes treatment advancements. One of these major advancements came over thirty years later in 1921-22, radically changing the lives of thousands: the discovery and purification of animal insulin. While this insulin greatly increased the lifespan of those with Type 1, it caused painful allergic reactions in some because of its foreign origin from pigs and cows. However, by 1978, researchers discovered how to create synthetic human insulin from E. coli bacteria, allowing increased insulin absorption without the allergic side effects.

Before the introduction of the disposable syringe in 1956, and then insulin pens in the 1980s, needles for insulin injections were commonly sharpened at home with a grinding stone. Since 1990, insulin pens can even be replaced by an external insulin pump, allowing people with T1D more freedom and control.

The first successful pancreas transplant occurred in the University of Minnesota Hospital in 1966. Pancreas transplants have provided a life-saving option for those with Type 1 diabetes with extremely poor health, and they have continued progressing in refinement, with better surgical techniques and the development of improved immunosuppressant drugs.

Unfortunately, despite the advancements, the long-term complications of Type 1 diabetes are numerous. Research, however, has been effectively diminishing their severity. In 1966, a laser treatment was developed that changed retinopathy care, a common cause of blindness with those who have diabetes. The A1C test, developed in 1976, assesses overall control of blood glucose over a span of three months, thereby showing the effectiveness of a treatment plan.

A modern-day person with diabetes can utilize resources and that wouldn’t have been possible without scientific research. Medical treatments have gone from starvation diets to compact, portable devices that control, measure and track blood glucose levels every second of the day.

Diabetes research is relatively young yet is advancing exponentially. The life of a person diagnosed with diabetes in the last decade and someone diagnosed fifty years ago is incomparable. A cure would mean liberation for people with Type 1 diabetes from constant injections, constant monitoring, and constant worry. However, it is completely unattainable without outside support. Diabetes is one of the most prevalent diseases in the United States with a multitude of costly and life-threatening complications.  Unfortunately, research for this disease still remains one of the least funded by the national government.

In order to be successful, in order to change and save lives, diabetes research requires funding. When someone supports an organization that funds research, they become a part of positive change. Support of scientific research has already transformed the world we live in: we have already cured many of the devastating diseases of the 20th century such as polio and smallpox. Be a part of the profound scientific evolution that is occurring in the 21st century. Supporting diabetes research isn’t just funding scientists and laboratories — it’s providing hope for the millions of children and adults affected by this chronic illness.

Disease prevalence versus funding

Diabetes only receives 3% of the total funding from the NIH (National Institute of Health), compared to cancer (16%) and HIV/AIDS (9%). However, there are 29 million people living with diabetes in the US, compared to 1.2 million living with HIV/AIDS and 13.4 million living with either a current or past experience with cancer. With these statistics, The NIH spends around $38 each year per person with diabetes, $417 per person with HIV/AIDS, and $2,583 per person with cancer.

Short-term complications

In addition to long-term major complications, immediate dangers may occur if a person with Type 1 diabetes has low or high blood glucose levels. These include the following:

  • Severe Hypoglycemia: extremely low blood sugars can cause seizures, loss of consciousness or death. Death from unrecognized low blood sugar upon going to sleep accounts for 6% of all deaths in people with Type 1 diabetes under forty-years old.
  • Ketoacidosis: If someone with T1D does not receive insulin, the body will break down fat to produce energy, releasing ketones into the bloodstream. When ketone levels become too high, diabetic ketoacidosis (DKA) can cause vomiting and dehydration, and even cause one to fall into a coma.

Long-term complications of Type 1

People with Type 1 diabetes may have access to insulin and blood glucose monitors, but such treatment still cannot completely prevent future complications. Common complications include:

  • Eye disease: diabetic retinopathy is the leading cause of blindness in diabetics. High blood sugar damages the blood vessels in the back of the eye, eventually causing vision loss.
  • Kidney disease: High blood sugar levels overwork the kidneys filtration system. A damaged filter allows waste products to build up in the blood, and the kidneys begin to fail (end-stage renal disease).
  • Nerve damage: Symptoms of diabetic neuropathy can range from pain to complete numbness in the legs or feet, causing severe disabling.
  • Heart disease: people with Type 1 diabetes have four times the risk of suffering a heart attack.

Everyday management of Type 1

To avoid long-term and short-term health risks, Type 1 diabetes must be managed diligently. People with T1D may have a specialized treatment plan, however, there are certain consistencies for all people with Type 1. Insulin must be taken after every meal and blood glucose levels must be checked several times a day. Special attention must be paid to the foods that a person with Type 1 diabetes consumes so that their insulin dosage is appropriately calibrated. As early as infancy, such intensive daily procedures become the responsibilities of every person managing Type 1. Better care means a better quality of life with Type 1. Diabetes research is the key to improving methods of care and ultimately finding a cure.

DRC provides funding to early-career scientists pursuing novel research studies related to type 1 diabetes in an effort to prevent and cure the disease as well as improve quality of life for those living with T1D. To learn more and support current research projects, visit http://diabetesresearchconnection.org.

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Viruses May Cause T1D and Other Autoimmune Diseases

Viruses are the cause of many health conditions and affect the body in different ways. As scientists learn more about these viruses, they can develop targeted strategies for preventing and treating them. A major breakthrough was recently discovered involving a very common virus known as the Epstein-Barr Virus or EBV.

EBV is most commonly known for causing mononucleosis (mono) or the “kissing disease” since it is often transmitted via saliva. By age 20, more than 90 percent of the population in developed countries will be infected by the disease. This rate spikes in under-developed countries with more than 90 percent of the population being affected by age 2. There is no cure for the virus – it remains in the body for life, though may not have a noticeable impact.

However, researchers have found that the effect it can have at a cellular level may be more significant than previously realized. Scientists from the Cincinnati Children’s Hospital’s Center for Autoimmune Genomics and Etiology have published a study potentially linking EBV to seven diseases, including T1D. One of the Diabetes Research Connection’s own Scientific Review Committee members, Matthias Von Herrath, was an author on an article cited by the study in its research.

Typically, the body responds to viruses by increasing the production of antibodies by B cells. These antibodies then attack and destroy the virus. However, with EBV, the virus actually takes over the B cells and re-programs them using transcription factors. This alters the way that B cells respond and can change their basic function, which may increase the risk of developing other diseases. The scientists have narrowed it down to one factor in particular – the EBNA2 protein.

Transcription factors associated with this protein attach to and change sections of person’s genetic code. Depending on where they attach, it could contribute to different diseases including T1D, lupus, multiple sclerosis, rheumatoid arthritis, celiac disease, and more. Identifying what is happening on a cellular level could help researchers to develop more targeted treatment options and potential cures for these diseases. The study also opens doors for more in-depth research regarding how transcription factors may affect other gene variants and diseases.

These findings are very encouraging in better understanding some of the underlying factors that may contribute to T1D. More research is necessary to explore each disease in particular and the potential impact from EBV and the EBNA2 protein. The Diabetes Research Connection is excited to see where these discoveries may lead moving forward and how it could change the future of T1D treatment. The DRC provides funding to early-career scientists pursuing novel research studies on type 1 diabetes to improve prevention strategies, treatment options, and management techniques as well as potentially find a cure. Learn more about current projects and provide support by visiting http://diabetesresearchconnection.org.

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