DRC & Research News

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

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FDA Approval of Insulin Pump with Basal-IQ™ Technology Increases Options for T1D Patients

There is a plethora of options when it comes to managing type 1 diabetes. Some people don’t mind the finger sticks and calculation of insulin dosages, while others prefer to have everything automated for better monitoring and control. As technology changes and research improves, so do the devices used to treat T1D, which can make the process easier and less stressful.

The FDA recently approved the t:slim X2™ Insulin Pump with Basal-IQ™ technology by Tandem Diabetes Care®, Inc., and it is expected to be available in August 2018. This device is an automated insulin delivery system, but it has the ability to work with integrated continuous glucose monitoring (iCGM) systems and can automatically suspend insulin delivery when low glucose levels are predicted. The Basal-IQ technology can predict glucose levels up to 30 minutes in advance and respond accordingly. Once glucose rises, it once again begins administering insulin.

Patients who have the Dexcom G6® CGM will be able to use this device in conjunction with it. During the study, participants had a 31 percent reduction in the amount of time their blood sugar levels were at 70 mg/dL or lower. In addition, they experienced no rebound hyperglycemia thanks to the Basal-IQ technology.

Patients are in control of how they use the system and can turn the Basal-IQ feature on or off depending on their preference. They can also use the touchscreen system to display a CGM chart or simply the Bolus and Option buttons. Plus, they can customize the alerts received for highs and lows or insulin delivery being turned on or off. Furthermore, when integrated with the Dexcom G6 CGM, there are no finger sticks required to calibrate the system or determine dosing at mealtimes thanks to the Basal-IQ technology.

The Diabetes Research Connection (DRC) is excited to see new technology being developed and approved in order to improve quality of life and diabetes management for individuals with T1D. The organization strives to support continued advancement in the field through funding early career scientists conducting peer-reviewed studies. To learn more about current projects and find out how you can help, visit https://diabetesresearchconnection.org.

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What You Need to Know About Hypoglycemia Unawareness

Many people are aware of warning signs that their blood sugar is too low. They experience sweating, shakiness, hunger, or dizziness. They may also feel confused, sleepy, or weak. As a result, they eat or drink something to bring their blood sugar back up. However, some people with diabetes are unaware of the signs of hypoglycemia or low blood sugar – not that they don’t know what the symptoms are, they just don’t experience or perceive them. This can be dangerous to their health and well-being.

There are numerous risk factors for hypoglycemia including:

  • Sleeping: Blood sugar may drop while sleeping and occur frequently enough that it alters their ability to detect symptoms while awake.
  • Time: The longer someone lives with diabetes, the less sensitive they may become to low blood sugar. People who have used insulin for 20 years or more tend to be at greater risk.
  • Age: Older adults may experience cognitive changes that affect their ability to recognize hypoglycemia.
  • Exercise: Rigorous exercise can affect blood sugar levels up to 15 hours later.
  • Alcohol: When the liver is occupied with processing alcohol, it may not be able to release glucose as effectively resulting in hypoglycemia.
  • Prescription Drugs: Certain medications may affect a person’s ability to recognize symptoms of low blood sugar.

However, there are several ways to manage hypoglycemia unawareness and be proactive in keeping blood sugar in check.

  • Testing blood sugar more frequently throughout the day can help individuals to recognize when their blood sugar is getting low so they can treat it early.
  • Using a continuous glucose monitoring system (CGM) or automatic insulin delivery (AID) device can help with tracking blood sugar trends and administering or suspending insulin as necessary. This can help to achieve more stable blood glucose levels and reduce incidences of hypoglycemia.
  • Using long-acting or fast-acting insulin analogs may help as well, especially at night and during meal times.
  • Targeted training on improved insulin usage and how to be proactive in managing blood sugar can reduce risk. Working with a certified diabetes educator can be very beneficial in managing hypoglycemia unawareness.

Effectively managing blood sugar is an essential part of living with type 1 diabetes, but that can be difficult, especially with so many contributing factors and the fact that every person is different. That is what makes the work of the Diabetes Research Connection (DRC) even more important. The DRC provides vital funding for early career scientists to pursue novel research projects geared toward diagnosing, treating, and curing type 1 diabetes, as well as improving quality of life for individuals living with the disease. Their studies have the potential to make a difference in the future of type 1 diabetes care. Find out more about current projects and how to support these efforts by visiting http://diabetesresearchconnection.org.

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DRC-Funded Scientist Creates New Insulin-Producing Cells to Fight Type 1 Diabetes

Thanks in part to funding from the Diabetes Research Connection (DRC), Dr. Kristin Mussar was able to conduct an in-depth study regarding how to stimulate the body’s own cells to create new insulin-producing cells that may help treat type 1 diabetes (T1D). In individuals with T1D, the immune system attacks insulin-producing cells, destroying them and leaving the body unable to effectively regulate blood sugar.

The human body is filled with myeloid cells that all differentiate to help grow, maintain, and repair various organs. When these cells are depleted, it impacts organ health. For instance, lack of insulin-producing cells results in diabetes. However, Dr. Mussar and her team discovered that there is a population of macrophages – white blood cells that recirculate throughout the body constantly monitoring the health status of all tissues – that instruct insulin-producing cells to grow in the perinatal stage of pancreas development. During this period of prolific growth, enough insulin-producing cells are created to support glucose homeostasis throughout one’s life.

Dr. Mussar found that there is a special population of these cells that act as cargos of potent growth factors for the insulin-producing cells in the pancreas. If these cells are prevented from entering the pancreas, the growth of insulin-producing cells is arrested and diabetes ensues. This lack of cell growth, as well as cell destruction, are issues that researchers have been trying to remedy through various strategies for treating T1D.

One avenue of treatment that is being explored is finding ways to use the body’s own cells and processes to support insulin production. Current challenges in treatment include the constant monitoring and accurate dosing of insulin, as well as the use of immunosuppressants or other medications to prevent the body from destroying modified cells or specialized therapies. Using the body’s own cells can help reduce risk of immune attack or rejection.

To this effect, Dr. Mussar’s research revealed that there are precursors to these special macrophages that exist within the bone marrow of adults. When these precursors are injected into the blood stream, they are able to signal growth of insulin-producing cells. This discovery raises hopes that, by dispatching these pro-regenerative cells from the bone marrow to injured pancreatic islets, it may be possible to enhance regeneration of insulin-producing cells in individuals with type 1 diabetes. This may in turn help to stabilize blood sugar naturally using the body’s own cells.

The Diabetes Research Connection is proud to have played a role in making Dr. Mussar’s research possible by providing funding that enabled her to continue moving forward with her project and eventually get the results published in the Journal of Clinical Investigation.

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Simpler Measuring Technique May Help Identify Partial Clinical Remission in Type 1 Diabetes

One of the major challenges of type 1 diabetes is effectively managing blood glucose levels. It is a careful balancing act and differs for every patient. With type 1 diabetes, the body’s immune system mistakenly attacks and destroys insulin-producing cells. This means that patients require regular insulin injections to compensate. However, this is not a perfect solution and patients may still experience complications or side effects and need to be carefully monitored.

Researchers found that after children are initially diagnosed with type 1 diabetes and begin treatment, some experience partial clinical remission (PCR), also known as a “honeymoon period.” During this period, the pancreas is still producing some insulin on its own, and this can temporarily restore blood glucose levels to near normal. This means that patients require fewer or lower doses of insulin. The honeymoon period may last from three months to one year.

But not all children experience this effect. Those who do not are at a higher risk of developing diabetes-related complications. This makes it even more important for physicians to determine whether or not children go into partial clinical remission so they can develop a more effective treatment plan moving forward.

Traditionally partial clinical remission is determined by calculating daily insulin doses and average blood glucose levels and then analyzing the correlation (known as IDAA1C). This can take some time, and when faced with tight time schedules, physicians may not use this method as often as recommended.

In light of this, UMass Medical School physician-scientist Benjamin Nwosu, MD, began studying the accuracy of a simpler method. This approach involves evaluating the total daily dose of insulin the child receives compared to their body weight. If they receive less than 0.3 units per kilogram of body weight per day, it indicates they are in partial clinical remission. There were no major differences in results between using this method and the more complex IDAA1C technique. It is a faster way for clinicians to determine the same results and is just as reliable.

According to Dr. Nwosu, “Encouraging clinicians to use the total daily dose of insulin guideline will improve monitoring of PCR and, therefore, ensure the prevention of early hyperglycemia in patients who exceed it for better long-term outcomes.”

It is encouraging to see an emphasis on early detection and more effective treatment for type 1 diabetes. The Diabetes Research Connection raises funds for early career scientists who are pursuing novel research projects related to the prevention and cure of type 1 diabetes as well as improving quality of life for those living with the disease. One hundred percent of research funds go directly to scientists. To learn more and support innovative studies, visit https://diabetesresearchconnection.org.

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