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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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Treating Type 1 Diabetes

Gene Therapy Targets Pancreatic Cells in Treating Type 1 Diabetes

A major challenge in treating type 1 diabetes is figuring out how to overcome the destruction of insulin-producing beta cells. The body mistakenly targets and destroys these cells leaving the body unable to manage blood sugar levels on its own. Individuals with this disease must be vigilant about checking their blood sugar and administering insulin as needed, which can be an exhausting task.

Current treatment options include injection of insulin, use of continuous glucose monitors and insulin pumps, stem cell therapies and implants, partial transplants, and other strategies. These treatments vary in effectiveness from person to person as well as how long they last. In addition, some require patients to continue taking anti-rejection drugs which can be hard on the body.

However, a new treatment may offer longer lasting, more effective results in the battle against type 1 diabetes. A recent study found that by using gene therapy targeting two specific genes, insulin-producing cells may be able to be recreated in the body using existing alpha cells. A healthy pancreas contains both alpha and beta cells. In those with type 1 diabetes, insulin-producing beta cells are destroyed. But when mice were injected with gene therapy to reprogram some alpha cells to take over the function of these beta cells, they were once again able to produce insulin and manage blood sugar.

The genetic changes were administered using a bioengineered virus. The virus had been altered so that it would not make the recipient ill, but could still penetrate cells to modify their DNA. The alpha cells then assumed insulin-producing functions without triggering the immune system to attack because the cells are already normally present in the body. Furthermore, researchers found that by delivering the gene therapy endoscopically into the pancreas, it stayed there and did not negatively impact other areas of the body.

While the treatment only lasted approximately four months in mice, scientists believe that it could be effective for several years in humans before retreatment would be necessary. The researchers are seeking FDA approval to begin clinical trials on humans using this gene therapy to evaluate its effectiveness and safety in treating type 1 and type 2 diabetes. There are approximately 30.3 million people in the United States and 422 million people worldwide affected by diabetes.

The Diabetes Research Connection (DRC) is excited to see how gene therapy may advance treatment options for type 1 diabetes and improve quality of life for millions of people. The DRC supports novel research studies for type 1 diabetes and provides essential funding early career scientists to carry out these studies. To learn more about current projects and donate to this research, visit Our Projects.

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Breaking Down the Prevalence of Type 1 Diabetes

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

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

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

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

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Exploring Beta Cell Regeneration in Treating Type 1 Diabetes

In individuals with type 1 diabetes (T1D), the body’s immune system mistakenly destroys insulin-producing beta cells necessary for managing blood sugar. Instead, patients must constantly monitor their own blood glucose levels and administer the proper dosage of insulin as necessary. In individuals without T1D, the pancreas does this automatically.

Some of the challenges that researchers have faced in trying to treat or cure T1D through cellular means is that the body may still reject these cells, there may be a shortage of donor cells, or the process of creating necessary beta cells can be complex. However, researchers at the Diabetes Research Institute at the University of Miami Miller School of Medicine may have found an effective way of using the body’s existing cell supply to generate insulin-producing beta cells.

The researchers identified the exact location in the body of progenitor cells with the ability to develop into beta cells. When stimulated by bone morphogenetic protein 7 (BMP-7), a naturally occurring growth factor, the pancreatic cells differentiated into the necessary beta cells. This discovery could lead to a significant supply of new beta cells within patients’ own bodies, eliminating the need for donor cells and curbing other immune-related challenges of treatment.

This process still requires more in-depth study, but it could lead the way to new regenerative medicine strategies that stimulate insulin production more naturally. The researchers are currently exploring options to reduce the need for lifelong anti-rejection drugs by enhancing immune tolerance of the newly created cells.

This study is another step toward advancing the treatment of T1D and providing patients with more options for care. The more scientists learn about the causes and effects of T1D, the more they can target approaches to treatment.

The Diabetes Research Connection (DRC) stays abreast of the latest developments in the field and encourages novel research projects by early-career scientists focused on T1D. The DRC raises funds through contributions by individuals, organizations, and foundations to support the advancement of these studies. Find out how you can get involved 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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Single Strand of Islet Cells Could Change Diabetes Management

For patients with type 1 diabetes, daily insulin injections become a way of life. Since the pancreas either does not produce enough or any insulin, and the body’s immune system destroys insulin-producing beta cells, the body is unable to regulate blood sugar on its own. There are many studies underway examining potential treatments that would eliminate the need for regular insulin injections.

One such study is being conducted by researchers at Cornell University in collaboration with Novo Nordisk and the University of Michigan Medical School. The researchers have developed an implant that would enable the production of insulin while warding off an attack from the immune system. The device is a single thread covered with “hundreds of thousands of islet cells” that is then fully encased in hydrogel. The hydrogel not only keeps the islets in place, it also protects them from being damaged.

The thread does not adhere to tissue within the body, so it can be easily removed and replaced once the islet cells reach the end of their lifespan. Current research shows they could potentially last anywhere from several months up to two years. This device has shown promising results when tested in both mice and dogs. No testing on humans has taken place yet, which would need to be done before the technology is potentially approved for use.

Technology continues to advance when it comes to treating and managing type 1 diabetes, and this is very encouraging. The Diabetes Research Connection strives to support early career scientists in conducting novel research studies focused on type 1 diabetes in order to improve the quality of life for individuals living with the disease and enhance diagnosis, prevention, and treatment efforts. To learn more, visit http://diabetesresearchconnection.org.

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Patents Approved for Small Molecule Therapies for Type 1 Diabetes

There are numerous approaches to managing, treating, and potentially curing type 1 diabetes (T1D). Some focus on replenishing or protecting insulin-producing beta cells, some involve the development of devices that simulate similar functions, and still, others seek to zero in on issues related to the development of T1D.

ImmunoMolecular Therapeutics recently received patents for two of its small molecule therapies that can be used in the treatment of T1D. These patents provide exclusive rights to the use of methyldopa and D-methyldopa (D-MDOPA) as part of immunotherapy treatment. According to the company, “The lead candidate drug [D-MDOPA] is an oral small molecule that starves the autoimmune process in type 1 diabetes by blocking DQ8 on specific immune cells. Our goal is to preserve pancreatic beta cell function and maintain normal insulin production in at-risk and early-stage patients with type 1 diabetes.” By blocking DQ8, the immune system will not attack insulin-producing beta cells, therefore, preserving their function.

Immunotherapy is one option when it comes to treating T1D. The Diabetes Research Connection supports early career scientists in moving forward with novel research for a variety of methods used in the treatment and prevention of the disease. To learn more about current projects and support their advancement, visit http://diabetesresearchconnection.org.

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Stem-Cell Derived Therapy for Type 1 Diabetes Funded to Move Forward

Scientists have been exploring many options for treating and potentially curing type 1 diabetes (T1D) in recent years. From examining the role of gut cells to creating an artificial pancreas, the studies have been diverse. Some challenges that they have faced are undesirable side effects, short-term effects, the need for immune suppression, and continued destruction of insulin-producing cells.

However, Semma Therapeutics recently secured $114 million in Series B financing to move forward with a program using encapsulated stem cell-derived islets to treat and potentially cure T1D. This financing was made possible through investments from multiple partners and investors. It will be used to advance the stem-cell derived therapy through clinical proof-of-concept in patients.

The technology and processes used by Semma have the ability to create billions of insulin-producing beta cells that perform in the same way these cells do when naturally produced by the body. However, these cells are combined with an innovative cell delivery technology that protects them from being destroyed by the body’s immune system. Ideally, this would enable them to continue regulating blood sugar while reducing the risk of complications and the need for constant blood sugar monitoring and insulin injections.

According to Semma Therapeutics Founder and Board Observer Douglas Melton, “Semma’s scientists have very effectively dedicated themselves to systems that reliably generate cells indistinguishable from human pancreatic beta cells and to the invention of novel devices that are immunologically protective and surgically practical. We’re very encouraged and excited about the potential this program has for diabetic patients and their families.”

The Diabetes Research Connection is eager to see how this program could impact the lives of those living with T1D, as well as the progress and direction of treatment options moving forward. The Diabetes Research Connection is not connected to this project, but raises funds to support early career scientists in conducting novel research in preventing, treating, and curing T1D, as well as improving quality of life for individuals with the disease. To learn more, visit http://diabetesresearchconnection.org.

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How Technology is Changing Diabetes Care and Treatment

Despite years of research and clinical trials, no cure for type 1 diabetes exists yet. However, how the disease is managed and treated has changed, leading to vast improvements in quality of life. Many individuals are better able to track their blood sugar and administer insulin more effectively to reduce instances of hypoglycemia and other complications. A recent article explores how technology has impacted current research for type 1 diabetes.

For years, researchers were focused on developing immunotherapies to try to treat T1D at its source. With this type of diabetes, the immune system attacks and destroys insulin-producing beta cells from the pancreas. The goal was to either reverse the disease or stop it from developing in the first place. Today, researchers have shifted their focus. Instead of trying to figure out how to prevent diabetes, some scientists are working to improve how patients live with the disease. This has involved major leaps in medicine including attempts at developing an artificial pancreas system that would function similar to the body’s own pancreas to regulate blood sugar.

Over the years, researchers have experimented with a variety of immune therapies trying to find an approach that could treat diabetes without a host of unpleasant side effects. This has been a difficult process and not yet produced a significantly effective treatment. However, there have continued to be technological advances that have improved how patients manage diabetes. It is easier than ever to quickly test blood sugar, and some patients even have continuous glucose monitors that send information to their smartphone and alert to low blood sugar. There have also been many improvements in more accurate dosing and administering insulin.

In 2016, scientists made progress toward creating an “artificial pancreas” system. It combined a continuous glucose monitor and insulin pump to modulate insulin delivery based on data over time. It is not yet fully automated, however, because patients still must calculate their insulin dosage during meal times. But it did have benefits for reducing hypoglycemia overnight. This technology has opened doors for others to begin testing different approaches for creating a fully automated insulin delivery artificial pancreas system. While not a “cure” for type 1 diabetes, it could help improve management of the disease while decreasing the burden on patients.

There is still a great deal of research and work to be done before this type of treatment comes to fruition. And once it exists, there is no guarantee that every patient would choose to use it, just like not all patients choose to have continuous glucose monitors. But it would be another option that exists and could potentially have a significant impact on people’s lives.

The Diabetes Research Connection recognizes the life-changing impact that a T1D diagnosis has, and supports early career scientists in moving forward with novel research projects focused on preventing, curing, or managing type 1 diabetes. Through donations from individuals, corporations, and foundations, research funding is made possible. To learn more about current projects or make a donation, visit http://diabetesresearchconnection.org.

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Could There be More than two Types of Diabetes?

and affects their body. Typically type 1 diabetes is diagnosed in childhood and type 2 diabetes develops later in life. However, a team of researchers in Europe and Asia may have identified another form of diabetes: maturity-onset diabetes of the young or MODY.

According to the researchers, MODY is believed to be “caused by a gene mutation and fueled by a lack of the insulin-stimulating hormone GIP.” Individuals with this condition have a mutation of the gene RFX6. Subjects of the study had typically developed MODY by the time they were 25, were not obese, were not insulin-dependent, and had an autosomal dominant inheritance of diabetes.

The researchers believe that the gene mutation results in the pancreas decreasing its insulin secretion, which is common in individuals with diabetes. However, subjects also had lower levels of the GIP hormone which stimulates and regulates insulin secretion. Researchers are hopeful that the creation of GIP analogs may help to treat MODY.

One challenge they have faced is distinguishing between individuals with type 1 or early-onset type 2 diabetes versus those who may have MODY. Improvements in gene testing and sequencing have allowed them to better identify RFX6 mutations.

As scientists and researchers develop a better understanding of diabetes, its forms, and how it impacts the body, it allows for more personalized treatment options. Individuals can find what works best for their specific type of diabetes and their body’s needs. The Diabetes Research Connection encourages and supports novel studies on type 1 diabetes to expand understanding and treatment approaches. Early career scientists receive up to $50,000 in funding for research projects. Learn more about current projects and how to support these efforts by visiting http://diabetesresearchconnection.org.

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Could Blood Stem Cells Be Used to Reverse Type 1 Diabetes?

Researchers know that in individuals with type 1 diabetes, the body mistakenly attacks and destroys insulin-producing beta cells that are used to regulate blood sugar levels. One of the challenges in treating T1D is finding a way to stop this process, or safely introducing new cells to take their place but protecting them from the body’s autoimmune response. This has proven difficult.

Researchers at Boston Children’s Hospital may have found a way to overcome these challenges by combining the patient’s own blood cells with a healthy PD-L1 gene or a targeted molecule “cocktail” of interferon beta, interferon gamma, and polyinosinic-polycytidylic acid. Both of these approaches had the same effect.

Scientists found that the problem with current treatments involving immunotherapy or injecting patients with their own blood stem cells is that these cells are still defective in producing PD-L1, a protein that helps protect against T1D. By introducing a healthy PD-L1 gene (or the “cocktail”) in mice with diabetes, the disease was reversed. In nearly all of the mice, the diabetes was cured in the short term, and in one-third of the mice, these results were long-term. In addition, there were no adverse effects of the treatment.

The researchers are working on gaining approval for human trials to test this therapy, and partnering with Fate Therapeutics to create a pill that would introduce these healthier blood stem cells. More extensive testing is necessary to determine how long the treatment is effective and how frequently it would need to be re-administered. However, it is encouraging to see the initial reversal of T1D in mice and what that may mean in the future for humans with the disease.

The Diabetes Research Connection strives to help early career scientists continue advancing research and treatment options for type 1 diabetes. With the support of individuals, corporations, and foundations, novel research projects can receive up to $50,000 in funding. Learn more about current projects and how to support these efforts by visiting http://diabetesresearchconnection.org.

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Potential Benefits of Incorporating Metformin in Type 1 Diabetes Treatment

Traditionally metformin is a drug used to help control blood sugar in individuals with type 2 diabetes. However, a recent study examined its effects in patients with type 1 diabetes. More specifically, the study looked at the impact on vascular health because individuals with T1D tend to be at higher risk of developing cardiovascular disease.

The researchers conducted a double-blind, randomized, placebo-controlled trial on 90 children in South Australia between the ages of 8 and 18 who had been diagnosed with T1D for at least six months. Half the of participants received metformin, and the other half received a placebo. A baseline vascular function was determined at the start of the trial and then tested at three, six, and 12 months. In addition, HbA1C, insulin dose, and BMI were also recorded at each visit. Throughout the trial, participants were asked about any side effects they may be experiencing so that therapy could be adjusted accordingly. Treatment compliance was also tracked.

The results showed that over the course of one year, vascular function improved in the metformin group compared to the control group. The difference was most noticeable at the three-month interval, and this is also when there was the greatest improvement in HbA1C levels for those in the metformin group. The difference was lower at the 12-month mark, but still significant. In addition, children in the metformin group also showed a decrease in the amount of insulin required over 12 months. Children with above-average BMIs who were taking metformin also showed improvement in vascular smooth muscle function. Overall, there were positive results for children with T1D taking metformin as compared to those receiving a placebo. However, the study was not continued long enough to determine potential changes in vascular structure, only vascular function.

With further testing, this could lead to more diverse treatment options for individuals with type 1 diabetes to help better control blood sugar and maintain a higher quality of life. It is these types of changes, as well as advancements in the treatment and prevention of T1D, that the Diabetes Research Connection aims to support. By funding novel research projects, the Diabetes Research Connection helps early career scientists to keep their work moving forward. Visit http://diabetesresearchconnection.org to learn more.

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Treating Type 1 Diabetes with Synthetic Cells

Treating type 1 diabetes (T1D) takes careful planning and calculation. Individuals must test their blood to determine their blood glucose level, then calculate exactly how much insulin they need to inject. They must pay careful attention to what they eat and how their body responds. This is because, with type 1 diabetes, the body’s immune system mistakenly attacks and destroys insulin-producing beta cells. In individuals without T1D, these beta cells automatically secrete insulin to keep blood glucose levels in check.

However, researchers from the University of North Carolina and North Carolina State are testing synthetic cells that could replace those cells that have been destroyed and automatically release insulin in response to the body’s needs. They have created “artificial beta cells” or AβCs that are packed with insulin-stuffed vesicles. When blood sugar rises, the coating of the artificial cells changes and insulin is released. The cells would need to be injected every few days, or can be delivered by a skin patch that is replaced regularly.

These AβCs are an advancement in potential treatments for T1D. There are some studies regarding transplanting cells – whether donor cells, modified cells, or harvested cells – but the challenge is that they often require some immune suppression, can be very expensive, and the body generally ends up destroying these cells as well. The synthetic cells would be regularly replaced with new AβCs as they distributed their insulin. Studies conducted in mice have found that blood glucose levels returned to normal levels within one hour and were maintained for up to five days.

According to John Buse, MD, PhD, the Verne S. Caviness Distinguished Professor at UNC, chief of the division of endocrinology, and director of the UNC Diabetes Care Center who is a co-author of the study, “There is still much work needed to optimize this artificial-cell approach before human studies are attempted, but these results so far are a remarkable, creative first step to a new way to solve the diabetes problem using chemical engineering as opposed to mechanical pumps or living transplants.”

While this approach is still in development and requires more extensive testing, it is a step in the right direction for improving quality of life for individuals with T1D and improving management of the disease.

The Diabetes Research Connection supports innovative research to prevent or cure type 1 diabetes, reduce complications of the disease, and improve quality of life. Early career scientists can receive up to $50,000 in funding for their research through donations by individuals, corporations, and foundations. To learn more about current projects and support these efforts, visit http://diabetesresearchconnection.org.

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Comparing Insulin Pumps and Injections for Managing Type 1 Diabetes

Learning how to effectively manage type 1 diabetes can take time. It takes practice and trial-and-error to understand how each person’s body responds to different foods, activities, and insulin doses. A recent study found that children with type 1 diabetes may be able to control blood sugar levels more effectively and reduce risk of complications by using insulin pumps as opposed to manually injecting insulin.

The study was conducted by the University of Metabolic Research Laboratories and analyzed data for 14,460 patients with insulin pumps and 16,460 who injected insulin. All participants had been diagnosed with type 1 diabetes for at least one year and were younger than 20 years old. The results for children and adolescents using pumps outperformed those who did not.

According the findings, only 9.55 children per 100 experienced severe hypoglycemia each year when using insulin pumps compared to 14 children per 100 for those who relied on injections. Along the same lines, 3.64 children per 100 were treated each year for diabetic ketoacidosis (DKA) while on an insulin pump compared to 4.26 children per 100 for those treated with injections. Furthermore, HbA1c levels and daily insulin doses were slightly lower for those with insulin pumps as well.

The results highlight the importance of considering insulin pumps for children living with type 1 diabetes and ensuring that they are educated on their condition and how to properly use the pump for blood sugar control. However, this is only one option available and may not be the best choice for all children. Dr. Simon Heller from the University of Sheffield was not involved in the study but notes, “For adolescents, particularly those who find it difficult to do all the complicated things in managing diabetes, pumps may not be the best option, particularly if insulin is missed.” Parents, children, and medical provider should work together to determine the best option for each individual.

The Diabetes Research Connection supports early career scientists in novel studies regarding type 1 diabetes in an effort to develop more effective treatment options, potential cures, and options for improving quality of life. For more information about current projects and opportunities for funding, visit http://diabetesresearchconnection.org.

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A Multitude of Potential Treatment Options for Type 1 Diabetes

Type 1 diabetes is a condition that does not discriminate. It affects males and females of all races and ethnicities around the world. Researchers in many countries are striving to develop effective treatment options that help the body to regulate blood glucose on its own and reduce the need for constant monitoring and insulin injections. At the Kyoto Diabetes Mini-Symposium in June 2017, researchers presented various studies and their potential impacts. Here is an overview of some of the treatment options being explored:

Islet Transplantation: Islet transplantation is one option that scientists have been working on for many years. Patients receive infusions of human islet cells to replace the cells their bodies have mistakenly destroyed. Studies have shown that this approach has resulted in improved glycemic control and hypoglycemia awareness, as well as protection from severe hypoglycemic events in some patients. However, there are still challenges regarding the lifespan of the graphs and their prolonged effectiveness.

Cell Sourcing from Large Animals: One challenge that researchers have faced in islet transplantation is generating a sustainable amount of islet cells. Scientists have turned to large animals such as pigs to try to cultivate a new source. Studies have found that porcine islet cells function very similarly to human islet cells. However, there is concern over the potential transmission of porcine endogenous retroviruses, so scientists have been experimenting with gene editing to inactivate contributing sections of various genes and reduce risk.

Scientists are also exploring the possibility of generating a human pancreas inside a pig so that it will produce human islet cells. Similar studies have been done with rats and mice where each has developed a pancreas for the other. There are many ethical concerns and regulations to be considered with this approach, however.

Human Stem Cell-Derived Beta Cells: Scientists are exploring the potential of targeting human stem cells and guiding them into developing into pancreatic progenitor cells and eventually mature insulin-producing beta cells. Ideally, this would allow the body to better regulate its own blood glucose levels. Researchers are working on improving differentiation protocols and determining the best host conditions for the cells.

Cell Encapsulation: Current treatment involving transplantation requires patients to take medication that suppresses the immune system to keep it from attacking the transplanted cells or organs. While it protects the transplant, it puts patients at risk for a variety of complications. Scientists are working on a process to encapsulate islet cells in a device that protects them from an immune system attack. They are experimenting with different materials, locations, and processes to determine what may potentially work best.

These are just a few of the strategies scientists are investigating to help treat and potentially cure type 1 diabetes. There is still a lot more research and testing necessary to fully explore these options and their safety and efficacy. It is these types of innovative approaches that continue to advance knowledge and treatment regarding type 1 diabetes. The Diabetes Research Connection supports early career scientists in developing their research by providing essential funding. To learn more about current projects and contribute to these efforts, visit http://diabetesresearchconnection.org.

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Researchers Explore Link Between Gut Bacteria and Type 1 Diabetes

The number of people diagnosed with type 1 diabetes (T1D) continues to increase. Researchers estimate that by 2050, this number may reach 5 million. Ongoing efforts to prevent, treat, and cure type 1 diabetes aim to reduce the impact. One area that researchers are delving into is the study of gut bacteria.

When an individual has T1D, their white blood cells destroy insulin-producing beta cells that regulate blood sugar. Scientists have discovered that gut bacteria share similar molecular markers with these beta cells. These similarities may stimulate more attacks on insulin-producing beta cells thereby increasing risk of T1D.

Ningwen Tai, Ph.D., associate research scientist at Yale Diabetes Center, has teamed up with other scientists to study this occurrence more closely. The researchers are particularly interested in Fusobacteria, which they believe appear in greater quantities in individuals prone to developing T1D. Their study began by examining the presence of Fusobacteria in mice and monitoring levels as diabetes risk increased.

Now they want to roll out this study to humans and explore whether tracking the level of Fusobacteria can predict the onset of diabetes. The study will analyze oral and fecal samples from individuals with T1D, as well as those at high risk and healthy individuals. These samples will be collected and studied over the course of a year or more.

If the Fusobacteria does accurately predict development of T1D, this could lead to targeted approaches for treatment and prevention. This would impact not only those with T1D, but also individuals who are at risk for developing the disease. Doctors would be able to monitor the progression and take steps to counteract the impact of the gut bacteria.

The Diabetes Research Foundation is proud to support this research initiative by helping Dr. Tai and his team to raise necessary funds. It is through ongoing research that scientists advance their understanding of T1D and can be more aggressive regarding diagnosis, treatment, and prevention efforts. Click here to support Dr. Tai’s study on gut bacteria.

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pasta e fagioli

Winter Comfort Food Recipes for Those with Type 1 Diabetes

Now that the holidays are over and we’re deep into winter, you’re probably finding yourself craving warm, rich, delicious comfort food. Hearty soups, chili with cornbread, macaroni and cheese, chicken pot pie, pasta, baked potatoes – we all have our favorite foods and meals for when it’s chilly outside.

However, for those of us with type 1 diabetes, indulging in our favorite comfort food can be a bit more complicated, especially when so much of these foods are carb-heavy.

Below we’ve compiled some of our favorite T1D-friendly comfort foods for the colder winter months.

Pasta e Fagioli

Taken from Diabetic Living.

Pasta e Fagioli is a traditional pasta and bean soup that is perfect for warming up on a cold night.

[su_spoiler title=”View recipe”]

Makes: 8 servings

Ingredients

1 tablespoon olive oil
2 ounces prosciutto or turkey bacon, chopped
2 cups chopped onions (2 large)
1/2 cup chopped celery (1 stalk)
1/2 cup chopped carrot (1 medium)
2 tablespoons bottled minced garlic
1 tablespoon dried oregano, crushed
1 teaspoon anchovy paste (optional)
1 teaspoon crushed red pepper
2 14 – ounce can reduced-sodium chicken broth
1 28 – ounce can no-salt-added diced tomatoes, undrained
1 cup whole grain medium pasta shells
2 15 – ounce can no-salt-added cannellini beans (white kidney beans), rinsed and drained
1/2 cup snipped fresh parsley
2 tablespoons lemon juice
1/4 cup finely shredded Parmesan cheese (1 ounce)

  1. In a Dutch oven, heat oil over medium-high heat. Add prosciutto; cook for 2 to 3 minutes or until crisp. Using a slotted spoon, transfer prosciutto to paper towels; let drain. Set aside.
  2. Add onions, celery, carrot, and garlic to the Dutch oven; cook over medium heat for 3 to 4 minutes or until softened, stirring frequently. Stir in oregano, anchovy paste (if desired), and crushed red pepper. Cook and stir for 1 minute. Add broth, tomatoes and pasta shells. Bring to boiling; reduce heat. Simmer, uncovered, about 15 minutes or until pasta is tender.
  3. Meanwhile, use a fork to mash one can of the beans. Stir the whole and mashed beans into pasta mixture. Simmer about 5 minutes or until heated through.
  4. Stir in parsley and lemon juice. Immediately ladle into serving bowls. Sprinkle with Parmesan and the prosciutto.

Nutrition (per serving): 235 calories, 5 g fat, 3 g saturated fat, 2 mg cholesterol, 490 mg sodium, 35 g carbohydrates, 9 g fiber, 7 g sugars, 13 g protein

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Classic Beef Stroganoff

Taken from Diabetic Living.

Beef Stroganoff is a hearty, creamy beef dish, and this slow-cooker recipe makes it perfect for enjoying on a busy weeknight!

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Makes: 6 servings

Ingredients

1 1/4 pounds beef stew meat
2 teaspoons vegetable oil
2 1/2 cups sliced fresh mushrooms
1/2 cup sliced green onions (4) or chopped onion (1 medium)
1 bay leaf
2 cloves garlic, minced
1/2 teaspoon dried oregano, crushed
1/4 teaspoon salt
1/4 teaspoon dried thyme, crushed
1/4 teaspoon black pepper
1 1/2 cups 50% less sodium beef broth
1/4 cup dry sherry
1 8 – ounce carton light sour cream
1/3 cup all-purpose flour
1/4 cup water
Sauteed zucchini “noodles” or hot cooked whole wheat pasta
Snipped fresh parsley or basil (optional)

  1. Cut up any large pieces of meat. In a large nonstick skillet, cook half of the meat in hot oil over medium-high heat until brown. Using a slotted spoon, remove meat from skillet. Repeat with the remaining meat. Drain off fat. Set meat aside.
  2. In a 3-1/2- or 4-quart slow cooker combine mushrooms, green onions, bay leaf, garlic, oregano, salt, thyme, and pepper. Add meat. Pour broth and sherry over mixture in cooker.
  3. Cover and cook on low-heat setting for 8 to 10 hours or on high-heat setting for 4 to 5 hours. Remove and discard bay leaf.
  4. If using low-heat setting, turn to high-heat setting. In a medium bowl stir together sour cream, flour, and the water until smooth. Gradually stir about 1 cup of the hot broth into sour cream mixture. Return sour cream mixture to cooker; stir to combine. Cover and cook about 30 minutes more or until thickened and bubbly. Serve over sauteed zucchini and, if desired, sprinkle with parsley.

Nutrition (per serving): 257 calories, 10 g total fat, 5 g saturated fat, 74 mg cholesterol, 312 mg sodium, 14 g carbohydrates, 2 g fiber, 4 g sugars, 26 g protein

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Diabetes Research Connection 2016 Year in Review

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

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

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

Dr. Sangeeta Dhawan

 

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

Dr.Lancman in Lab

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

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

Peter Thompson - Regrowth of beta cells with small molecule therapy

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

Agata-Headshot

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

jeremy_racine_lab

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

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

doubledollarsplaceholder

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

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

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ETH Researchers T1D

New Weapon Against Diabetes

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

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

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

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

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

Voltage switch causes insulin production

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

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

Helpful modelling

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

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

Market-readiness is a long way off

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

Diabetes is becoming the modern-day scourge of humanity. The International Diabetes Federation estimates that more than 640 million people worldwide will suffer from diabetes by 2040. Half a million people are affected in Switzerland today, with 40,000 of them suffering from type 1 diabetes, the form in which the body’s immune system completely destroys the insulin-producing beta cells.
[su_button url=”https://www.ethz.ch/en/news-and-events/eth-news/news/2016/12/artificial-beta-cells.html?elqTrackId=3118751de0d340b8bf7c42cba3a3a7d2&elq=3ba510d3772545b28e0cfdf8c559795e&elqaid=17762&elqat=1&elqCampaignId=10602″ target=”blank” style=”flat” background=”#64b243″ size=”6″ center=”yes” radius=”5″ icon=”icon: angle-right”]Continue Reading[/su_button]

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alberto hayek

Meet the DRC Board: Alberto Hayek, M.D.

At the Diabetes Research Connection, our passion is working together with the scientific community to find a way to treat, cure and prevent type 1 diabetes, and our board is dedicated to helping achieve our vision.

2016 has been a monumental year for us, as we’ve raised more money than ever before for early-career scientists’ T1D research. One of our core values is to build a strong connection between the board and our supporters. Thus, we’ve interviewed members of our board to find out more about the impact T1D has had on their lives, why they choose to work with DRC and much more.

First up, get to know one of DRC’s founders, Dr. Alberto Hayek.

Alberto Hayek, M.D., President of DRC

Dr. Hayek is the Scientific Director at San Diego’s Scripps Whittier Institute for Diabetes and Professor Emeritus of Pediatrics at UCSD. He is a world-renowned diabetes expert in pancreatic islet research and experimental cell replacement therapies for T1D.

We asked Dr. Hayek a few questions to help our donors get to know him better.

How have you been affected by T1D?

Taking care of children with T1D gave me a first-hand glimpse of the struggles this disease causes for patients and their families.

What is the most rewarding part of serving on the DRC board for you personally?

The opportunity to provide funding for junior investigators in T1D as they take their first steps for independent thinking in research and care has been tremendously rewarding.

What is your favorite holiday tradition, related to T1D or not?

I spend a day during Christmas with my grandchildren, ages 3 and 6, making sandwiches for homeless people in San Diego.

Once again, we want to extend a heartfelt thank you to all our donors for helping to make 2016 such a successful year for DRC, and helping to fund innovative T1D research. We’re looking forward to all that 2017 will bring, and we’re hopeful that a year from now we’ll be even closer to eradicating T1D.

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diabetes research

Economic 3D-Printing Approach for Transplantation of Human Stem Cell-Derived β-Like Cells

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

Abstract

Transplantation of human pluripotent stem cells (hPSC) differentiated into insulin-producing βcells is a regenerative medicine approach being investigated for diabetes cell replacement therapy. This report presents a multifaceted transplantation strategy that combines differentiation into stem cell-derived β (SC-β) cells with 3D printing. By modulating the parameters of a low-cost 3D printer, we created a macroporous device composed of polylactic acid (PLA) that houses SC-β cell clusters within a degradable fibrin gel. Using finite element modeling of cellular oxygen diffusion-consumption and an in vitro culture system that allows for culture of devices at physiological oxygen levels, we identified cluster sizes that avoid severe hypoxia within 3D-printed devices and developed a microwell-based technique for resizing clusters within this range. Upon transplantation into mice, SC-β cell-embedded 3D-printed devices function for 12 weeks, are retrievable, and maintain structural integrity. Here, we demonstrate a novel 3D-printing approach that advances the use of differentiated hPSC for regenerative medicine applications and serves as a platform for future transplantation strategies.

[su_button url=”http://iopscience.iop.org/article/10.1088/1758-5090/9/1/015002/meta?elqTrackId=96062d779f46499eb7cc18d9ab30d665&elq=3d599e01edda49df92afa531a8a717ae&elqaid=17717&elqat=1&elqCampaignId=10609″ target=”blank” style=”flat” background=”#64b243″ size=”6″ center=”yes” radius=”5″ icon=”icon: angle-right”]Continue Reading[/su_button]

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holiday travel

Holiday Travel Tips for Those With T1D

The holiday season is in full swing, and many of us will be traveling this month to visit friends, family and loved ones. For those with type 1 diabetes (T1D), though, holiday travels may require a bit more planning. Below we’ve outlined a few things to keep in mind when planning a trip if you or a loved one you are traveling with has T1D. Following these tips will help your travels go smoothly, ensuring a joyous time for all.

Packing Your Medication and Supplies

Whether you’re traveling across the state for a long weekend or across the country for a full week, you’ll need to be strategic when packing your medication and other supplies. Make sure you bring enough of your medication so you’re prepared for any situation that may arise; many find that packing twice as much as they think they’ll need is a safe option. If you’ll be checking any luggage, keep your medicine and anything else you will need in your carry-on, so that you have it if your bags get lost.

In your carry-on bag, make sure you have:

  • Insulin and syringes
  • Blood-testing supplies and extra batteries
  • Any other medications you may need
  • An ID, including something that identifies you as having T1D
  • A small snack and candy or some form of sugar to treat hypoglycemia

As you’re packing, be thinking of where you’ll store your supplies upon arrival. In particular, don’t store your insulin somewhere very hot or very cold, such as the trunk of a car.

Preparing for an Emergency if You’re Abroad

Anyone traveling to another country should have a plan in place in case of a medical emergency, but this is especially important for those with T1D.

If you would like to get a list of English-speaking doctors at your destination before you leave, we suggest contacting the International Association for Medical Assistance to Travelers. If something happens while you’re abroad and you’re unsure of where to go, contact your local embassy for assistance.

Of course, preventing an emergency is better than preparing for one. This goes without saying, but check your blood glucose levels frequently, and be mindful of crossing time zones when you’re planning the timing of your injections.

Keep Your Medical ID With You

It’s always a good idea to be wearing a medical ID identifying you as someone with T1D, but this can become even more important when traveling. In the event of an emergency, your ID will let first responders, doctors and nurses know that you have T1D and provide information about how you manage it, as well as information about allergies and other pieces of your medical history.

Traditionally, these medical IDs are worn as a bracelet or necklace, and usually consist of a piece of metal with information etched into it. However, modern technology has to lead to more detailed medical IDs with QR codes, URLs and more that can help emergency responders and medical personnel access all your necessary health records.

For more tips and insights for living with type 1 diabetes, subscribe to our newsletter.

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insulin

“Artificial Pancreas” Is Approved

Original article published by The JAMA Network on October 4, 2016. Click here to read the original article.

A new device that automatically monitors blood glucose levels and adjusts insulin levels has received FDA approval. The device, manufactured by Dublin-based Medtronic PLC, is the first such system to gain the agency’s blessing.

The new MiniMed 670G hybrid closed-loop system is intended for people aged 14 years or older who have type 1 diabetes. Because it operates with a smart algorithm that learns an individual’s insulin needs and delivers appropriate basal doses 24 hours a day, little user input is required. Patients who use the system will only have to enter their mealtime carbohydrates, accept bolus correction recommendations, and periodically calibrate the sensor.

[su_button url=”http://jamanetwork.com/journals/jama/article-abstract/2584035″ target=”blank” style=”flat” background=”#64b243″ size=”6″ center=”yes” radius=”5″ icon=”icon: angle-right”]Continue Reading[/su_button]

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Diabetes Supplies - Bottles

Imbalance of Bacteriome Profiles Within the Finnish Diabetes Prediction and Prevention Study

Original article published by Wiley Online Library on August 22, 2016. Click here to read the original article.

Abstract

Background

We set out to explore associations between the stool bacteriome profiles and early-onset islet autoimmunity, taking into account the interactions with the virus component of the microbiome.

Methods

Serial stool samples were longitudinally collected from 18 infants and toddlers with early-onset islet autoimmunity (median age 17.4 months) followed by type 1 diabetes, and 18 tightly matched controls from the Finnish Diabetes Prediction and Prevention (DIPP) cohort. Three stool samples were analyzed, taken 3, 6, and 9 months before the first detection of serum autoantibodies in the case child. The risk of islet autoimmunity was evaluated in relation to the composition of the bacteriome 16S rDNA profiles assessed by mass sequencing, and to the composition of DNA and RNA viromes.

Results

Four operational taxonomic units were significantly less abundant in children who later on developed islet autoimmunity as compared to controls—most markedly the species of Bacteroides vulgatus and Bifidobacterium bifidum. The alpha or beta diversity, or the taxonomic levels of bacterial phyla, classes or genera, showed no differences between cases and controls. A correlation analysis suggested a possible relation between CrAssphage signals and quantities of Bacteroides dorei. No apparent associations were seen between development of islet autoimmunity and sequences of yet unknown origin.

Conclusions

The results confirm previous findings that an imbalance within the prevalent Bacteroidesgenus is associated with islet autoimmunity. The detected quantitative relation of the novel “orphan” bacteriophage CrAssphage with a prevalent species of the Bacteroides genus may exemplify possible modifiers of the bacteriome.

[su_button url=”http://onlinelibrary.wiley.com/doi/10.1111/pedi.12468/full” target=”blank” style=”flat” background=”#64b243″ size=”6″ center=”yes” radius=”5″ icon=”icon: angle-right”]Continue Reading[/su_button]

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pumpkin mashed potatoes

A Diabetes-Friendly Thanksgiving

Food-heavy holidays, such as Thanksgiving, can be particularly hard for those with type 1 diabetes. Between carb-heavy foods, meals served at odd times to accommodate everyone’s schedules and perhaps even multiple meals with different sides of the family or groups of friends, keeping your blood sugar in check on Thanksgiving day is no easy task.

However, with careful planning and some support from your family and friends, enjoying Thanksgiving doesn’t have to be difficult!

As you’re celebrating, keep the following in mind:

  • Keep fat content of the foods you are eating in mind. For example, make your mashed potatoes with low-fat milk and margarine instead of butter.
  • Choose white meat turkey over dark meat, and skip the skin.
  • Opt for steamed vegetables over casseroles. For example, serve seasoned steamed green beans with salt, pepper and garlic powder instead of green bean casserole.

Thanksgiving Recipes for Diabetes

If you’re responsible for preparing a dish for a potluck or an entire Thanksgiving meal, consider these T1D-friendly takes on traditional Thanksgiving favorites.

Pumpkin Mashed Potatoes

Recipe from Diabetic Living Online.

The addition of pumpkin makes for a flavorful, low-calorie twist on traditional mashed potatoes.

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Makes 4 servings.

1 pound medium baking potatoes, peeled and quartered

2 cloves garlic, peeled

1 cup canned pumpkin

2 tablespoons reduced-fat cream cheese (Neufchatel)

1 tablespoon butter or tub-style vegetable oil spread

1/8 teaspoon ground sage

1/4 cup fat-free milk

1.In a covered large saucepan, cook potatoes and garlic in enough boiling water to cover for 20 to 25 minutes or until potatoes are tender; drain.

2. Mash with a potato masher or beat with an electric mixer on low speed until nearly smooth.

3. Beat in canned pumpkin, cream cheese, butter, ground sage, 1/4 teaspoon salt, and 1/4 teaspoon ground black pepper.

4. Gradually add milk, beating until light and fluffy.

5. Return to saucepan; heat through.

Nutrition (per serving): 159 calories, 5 g fat, 3 g saturated fat, 13 mg cholesterol, 206 mg sodium, 26 g carbohydrates, 4 g fiber, 4 g sugars, 4 g protein

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Sweet Raisin-Apple Strudel

Recipe from Prevention

Whole-wheat phyllo dough makes this dessert a slightly healthier replacement for apple pie.

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Makes 12 servings.

2 granny smith or golden delicious apples, peeled, cored, and thinly sliced (about 3 c)

1/4 cup packed light brown sugar

2 tablespoons golden raisins

1/2 teaspoon ground cinnamon

1/4 teaspoon ground nutmeg

1/3 cup plain dry bread crumbs

1/4 cup granulated sugar

12 sheets (17″ x 11″ each) frozen whole wheat phyllo dough, thawed

1/2 cup apricot all-fruit preserves, warmed

1 tablespoon confectioners’ sugar

1. Preheat the oven to 400°F. Line a large baking sheet with parchment paper.

2. Mix the apples, brown sugar, raisins, cinnamon, and nutmeg in a large bowl.

3. Mix the breadcrumbs and granulated sugar in a small bowl.

4. Place the phyllo on a dry kitchen counter and cover with plastic wrap and a damp towel to keep it from drying out. Remove 1 sheet, spread it flat, and mist with butter-flavored cooking spray. Sprinkle with 1 scant tablespoon of the crumb mixture. Repeat layering to use 4 more of the remaining phyllo sheets and about half of the crumb mixture. Top with 1 phyllo sheet and mist with the cooking spray.

5. Spread with 1/4 cup of the preserves to within 1″ of the edges. Spoon half of the apple mixture over the preserves. Fold 1″ of each long edge over the apple mixture. Starting with the short edge, roll up as tightly as possible. Gently place the strudel, seam side down, on the prepared baking sheet. Mist the top with cooking spray.

6. Repeat to make a second strudel.

7. Using a sharp knife, make several slashes in the top of each strudel.

8. Bake for 15 minutes, or until crisp and golden brown. Sprinkle with the confectioners’ sugar. Serve warm.

Nutrition (per serving) 153 calories, 1 g fat, 0 g saturated fat, 2 g protein, 34 g carbohydrates, 18 g sugar, 1 g fiber, 121 mg sodium

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How to Honor National Diabetes Month

Diabetes affects more than 29 million Americans and is the 7th leading cause of death in the US today. While Diabetes Research Connection fights to find a cure for type 1 diabetes every month, we give an extra push during the month of November for National Diabetes Month. There are many ways you can contribute during National Diabetes Month, including our Double Your Dollars campaign, shopping with AmazonSmile, volunteering at a hospital or research center or participating in a walk/run benefiting diabetes. Read below for more details on how you can get involved.

Make Your Donation Count Twice As Much With Double Your Dollars

In honor of National Diabetes Month, DRC is matching every dollar donated to the General Fund (up to $50,000) between now and November 30 through our Double Your Dollars campaign. It is the perfect time to make a difference in the T1D community by donating to our campaign and making your charitable act go twice as far.

Every donation helps early-career scientists launch their ideas and allows 100% of funds directed for T1D research to go directly to the researcher’s laboratory. Donations are critical for us to operate our innovative platform, even though DRC’s operating costs are kept less than 10% of gross revenue.

Make a Difference While Shopping on Amazon

November is the month where most of us start our holiday shopping- the excitement of the good deals of Black Friday and Cyber Monday are almost too much to bear. If the crowds and late hours of Black Friday intimidate and overwhelm you and Cyber Monday is more your speed, try using AmazonSmile to accommodate all your holiday shopping needs. AmazonSmile is Amazon’s nonprofit charitable support arm and allows the shopper to choose from a variety of charities who will benefit monetarily from their purchases, without any additional cost to the shopper.

To honor National Diabetes Month, you can do your holiday shopping through AmazonSmile and select Diabetes Research Connection as your charity of choice so that a portion of your purchase goes to finding a cure for those with T1D. Visit smile.amazon.com to get started.

Participate in a Walk or Run

A great way to get involved with the fight to find a cure for T1D and honor National Diabetes Month is to participate in a walk/run benefiting diabetes. Not only would it be benefitting a great cause, but doing a walk/run is a great way to be active with a big group of people. There are many options available depending on what area you live, so it helps to do some research to find one that suits your fitness level needs.

Volunteer at a Hospital or Research Center

It’s very easy to find places that need volunteers, such as hospitals or research centers. Not only is it a good time of year to donate your time because of the holiday giving season, but also because of National Diabetes Month- you can opt for a research center or a hospital that specializes in T1D. This is the perfect way to give back for those who can’t donate money.

For more information on how you can get involved in the fight to find a cure for T1D, and to receive frequent updates about DRC, sign up for our newsletter!

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Measuring blood sugar

Presidential Proclamation — National Diabetes Month, 2016

Original article published by The President of the United States of America on October 28, 2016. Click here to read the original article.

More than 29 million Americans have diabetes — a disease in which the glucose levels in one’s blood are higher than normal. Although the rate of new cases is falling, the numbers are still alarming. Diabetes is one of the leading causes of death in the United States and results in staggering health and financial costs for Americans. With a concentrated effort to reduce the number of new diagnoses and improve treatment and care for those living with this disease, we must continue making progress in the battle against this epidemic. Each year during National Diabetes Month, we resolve to support everyone battling this chronic disease, and we recommit to fighting it so that more Americans can lead a healthy life.

 

[su_button url=”https://www.whitehouse.gov/the-press-office/2016/10/28/presidential-proclamation-national-diabetes-month-2016″ target=”blank” style=”flat” background=”#64b243″ size=”6″ center=”yes” radius=”5″ icon=”icon: angle-right”]Continue Reading[/su_button]

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t1d research

Antibiotic-Mediated Gut Microbiome Perturbation Accelerates Development of Type 1 Diabetes in Mice

Original article published by PubMed on August 22, 2016. Click here to read the original article.

The early life microbiome plays important roles in host immunological and metabolic development. Because the incidence of type 1 diabetes (T1D) has been increasing substantially in recent decades, we hypothesized that early-life antibiotic use alters gut microbiota, which predisposes to disease. Using non-obese diabetic mice that are genetically susceptible to T1D, we examined the effects of exposure to either continuous low-dose antibiotics or pulsed therapeutic antibiotics (PAT) early in life, mimicking childhood exposures. We found that in mice receiving PAT, T1D incidence was significantly higher, and microbial community composition and structure differed compared with controls. In pre-diabetic male PAT mice, the intestinal lamina propria had lower Th17 and Treg proportions and intestinal SAA expression than in controls, suggesting key roles in transducing the altered microbiota signals. PAT affected microbial lipid metabolism and host cholesterol biosynthetic gene expression. These findings show that early-life antibiotic treatments alter the gut microbiota and its metabolic capacities, intestinal gene expression and T-cell populations, accelerating T1D onset in non-obese diabetic mice.

[su_button url=”https://www.ncbi.nlm.nih.gov/pubmed/27782139?dopt=Abstract&utm_source=twitterfeed&utm_medium=twitter#” target=”blank” style=”flat” background=”#64b243″ size=”6″ center=”yes” radius=”5″ icon=”icon: angle-right”]Continue Reading[/su_button]

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insulin pen

In-Depth: Five innovators who see the future of connected insulin delivery in pens, not pumps

Original article published by Mobi Health News on October 21, 2016. Click here to read the original article.

Medtronic. Dexcom. Abbott. Sanofi. Google. A lot of very large, well-known companies are investing heavily into innovating the diabetes space, and that innovation is exciting. But a disproportionate amount of the innovation around insulin delivery focuses on the insulin pump, a delivery device that’s only used by a small percentage of insulin users. Most insulin users — between 70 and 93 percent, depending on whose figures you use and what part of the world you’re looking at — use an insulin pen, a device developed by Novo Nordisk in the eighties and relatively unchanged since then.

A small crop of startups has decided that it’s high time connected health innovation came to the insulin pen. One of the leaders of the pack — a San Diego startup called Companion Medical — is led by a veteran of those big company efforts. CEO Sean Saint previously worked at Medtronic, Dexcom, and Tandem Diabetes.

“Here I am at Tandem asking this question ‘How do we get more people to use the insulin pump?’” he told MobiHealthNews. “And that’s the right question for Tandem. So we’re asking questions like ‘Why will you or won’t you use an insulin pump?’ and we’re getting answers like tubing, cost, complexity that sort of thing. To be frank I was getting a little frustrated with the patient, and asking ‘Why won’t you use this great technology we’re developing?’”

That’s when Saint found himself on the other side of the pump: He was diagnosed with Type 1 diabetes.

“For me it caused me to look in the mirror and say ‘Stop being frustrated with people who won’t use your great technology. They have their reasons.’ Instead, let’s ask a different question. Let’s ask ‘How do we bring the benefits of insulin pumps to the 93 percent of people who use insulin who are pen and syringe users?’”

Companion Medical, with backing from Eli Lilly and Company, announced this past summer that it had FDA clearance to do just that. And in the months that followed, three other companies came out of stealth announcing that they were working on similar offerings. A fifth, Emperra, has been quietly developing its own smart insulin pen in Germany and will soon be ready to take it to other parts of the world.

First Patients Pending, a London company that had already innovated the insulin pen space with a non-connected cap called Timesulin, announced that it was working on a smartphone-connected product. Then an Irish group called Innovation Zed, which also had a pre-existing nonconnected insulin pen accessory, announced its plans to enter the space. And finally a second US company, Cambridge, Massachusetts-based Common Sensing, announced a trial funded by Sanofi and led by the Joslin Diabetes Center.

What all these companies have in common is they recognize that, though it might be the focus of big companies, the insulin pump is not the preferred device of the masses.

“We’ve talked to a lot of people in the space and what we’ve learned is that, first of all, not everyone prefers pumps,” James White, president of Common Sensing, told MobiHealthNews. “There’s people that have access to them and a lot of them choose not to use pumps. There’s people who want access and can’t get them. But we’re pretty sure for the next five to 10 years there is not a pump both for the market and everyone’s preferences, so there won’t be that ‘coming together’ to take any kind of authority in the market. We talk with pharma companies and we hear a fair amount of their predictions. And as nice as the pump is for some people, for a lot of people it just doesn’t make sense.”

Creating a connected insulin pen is a leap of several steps at a time. Unlike, say, fingerstick glucometers, which have always collected data but didn’t always store or transmit it, the traditional insulin pen doesn’t collect data at all. If patients want a record of how much insulin they used, they have to eyeball it and write it down. A connected pen is first and foremost an adherence play, but it can go much further — by interfacing with glucometer or CGM data or self-reported food data, a connected insulin pen could allow pen users to live some variant of the artificial pancreas dream, which up until now has only been a possibility for pump users.

“I believe that the insulin data is the most important data that we have,” Patients Pending CEO and cofounder John Sjölund told MobiHealthNews. “Currently, every time you turn the dial and inject yourself, it just disappears. All of the blood sugar and especially the CGMs, they exist, they’re good enough and the apps exist and they’re getting better. But the insulin information is just missing. And that’s the piece of the pie we bring out, and what’s important is the accuracy we bring to the table.”

From insulin adherence to insulin management

One way in which the various companies in this space differ is exactly what problem they’re using connectivity to solve. For most of the startups right now, the objective is simply to collect the data of how a often a patient uses an insulin pen and how much insulin they inject, and to use that data to drive adherence.

“The [device] we announced this week is the first step, we’re tackling that 60 to 70 percent adherence rate of insulin users,” John Hughes, CEO of Innovation Zed, told MobiHealthNews. “The insulin user audience are at a very low level of compliance. You show up at the doctor and inevitably when you get there, you don’t have your records. They’re working on anecdotal data. We have focus groups [of doctors] that we work with and they tell us, they cannot trust the data that they’re getting.”

The most basic advantage of tracking pen usage doesn’t require connectivity at all. Patients Pending’s original product, Timesulin, is a cap for insulin pens that starts a timer when it’s removed and replaced, so that patients can always look at it and see when their most recent dose was. Even this is useful information that can help prevent double dosing.

Adding connectivity also allows a device to send alerts about a missed dose to the patient’s smartphone, or to alert a patient’s physician, caregiver, or coach when they miss a dose. That’s where James White, president of Common Sensing, sees the initial value of the technology.

“Right now, people go home from the doctor after being given insulin for the first time and they don’t have another touchpoint for three months with anything,” he told MobiHealthNews. “Their data is theirs, they’re looking at it, they often don’t know how to interpret it because they weren’t taught at the doctor, and more than half of those people, in those first three months, drop off. They come back and they’re not using it. They haven’t filled all their prescriptions, things like that. The reasons vary a ton. Sometimes people aren’t prescribed needles to use with their insulin pen. Some people don’t know how to use it, they’re afraid to inject something new, or they don’t remember the instructions.”

Common Sensing’s Gocap is focused on collecting the data and sending it to a smartphone app, from whence it can also be sent to a data aggregator or a caregiver. The company is looking into developing its device for different levels of tech savvy: some use cases might allow for more patient engagement while others are designed to be more passive.

“We’ve sent this home now with a fair number of people and we’ve seen a wide spectrum. Some people don’t have a smartphone, they want to keep a very cheap mobile data device plugged into the wall and never look at it and use this hardware device. They know the data’s going somewhere, to their doctor, and that’s all they care about,” he said. “And then some people are the power users, just like any product. They want to get into the data, enable that exact setting, see every new dose they’ve done, understand the accuracy and the glucose readings.”

As an adherence play, the space is very reminiscent of another medication delivery device that’s recently blossomed into a burgeoning industry in digital health: the connected, sensor-laden inhaler. After some early success by companies like Propeller Health, the connected inhaler space rapidly became a hot acquisition target for the pharmaceutical industry. The comparison isn’t lost on insulin pen innovators.

“What I like about insulin and why we made it a first target for the company is that right now, you know, inhalers can be expensive when they’re taken incorrectly, but the cost burden on the healthcare system right now of incorrect insulin use is far greater than any other medication,” White said. “Pharma right now loses on the order of a third of revenue they could be getting just because a third of prescriptions are never picked up. And not only that but among people who are using it it’s not being used very effectively. So a company that can differentiate in making their insulin more effective stands to benefit, and that’s why companies like Sanofi are interested.”

So far at least two major pharma companies have invested in this space: Sanofi has invested in Common Sensing and Lilly has invested in Companion Medical. Neither of those investments has “strings attached” according to the two companies, but the interest is certainly notable.

But Sean Saint, of Companion, sees the insulin pen space as being much deeper than the inhaler space.

“The connected inhaler market is a compliance tool,” he said. “And that’s wonderful, because we all know about compliance problems. And we have 100 percent of that benefit. Same exact thing. But one of the biggest problems in diabetes is not that I don’t remember to take my dose, but how much do I take? I know my blood sugar, I know what I have recently eaten and my recent insulin doses, so how much insulin do I take right now? That’s what a dose calculator provides and we are the only company I am aware of in the connected pen/cap space that has a dose calculator and certainly the only one cleared by FDA.”

That’s why Companion Medical has FDA 510(k) clearance while some of the other companies are holding off. (Common Sensing is registered with the FDA but White doesn’t believe it’s current adherence-focused offering requires premarket approval). By taking the next step and offering a dose calculator, and starting to offer advice on how much insulin a patient could take, the company enters a new risk category, but also potentially offers even more benefits to people with diabetes.

Saint’s company’s goal is to create a learning dose calculator, which will use the same kind of algorithms closed-loop “artificial pancreas” systems use, but with a connected pen rather than a pump as the delivery method.

“You can call it a poor man’s artificial pancreas or artificial pancreas light or whatever you want to call it, but it’s basically using the same algorithms and applying them to mobile injection therapy,” he said. “Nobody’s ever done that, so nobody knows what the ultimate clinical benefit of that will be, but we know that there will be one.”

For Patients Pending and Common Sensing, that functionality could be in the cards eventually, but they don’t see a reason to reinvent the wheel. Once the data is accurately collected and sent to a smartphone, third party apps can focus on making it actionable for the user.

“We’ve had a lot of experience developing software, but we’ve also learned how tricky healthcare and medical apps is,” Patients Pending’s Sjölund said. “And there are a lot of apps in the space already.”

Pens, caps, and wraps

Another differentiating factor between the various companies is the form factor. Only two of the five companies make a full-on insulin pen, two make smart pen caps, and one, Innovation Zed, makes a unique wraparound device that fits on the back part of the pen.

There are different facets to the decision. One is that, most companies agree, creating an entire insulin pen is a more daunting endeavor than creating an add-on.

“At first we thought, hey let’s build a digital pen,” Innovation Zed’s John Hughes told MobiHealthNews. “Not being very experienced in medical device market we were quickly put off by the regulatory implications of such a device. We thought, it will take us seven years to do that. So we came up with the concept of an add-on technology.”

Saint, at Companion, echoed these sentiments, though his company did decide to go down the full pen road (as did Emperra in Germany).

“One thing I can absolutely assure you: we did not design a full insulin pen instead of a cap because we thought it would be fun,” he said. “We considered the different solutions and we decided that the only way we could provide a solution to the patient that was going to be truly transparent to their current therapy was to control the whole experience. And that’s why we went with the pen.”

Controlling the whole device simplifies the design of the sensors and allows Companion Medical to include a larger battery — their device will last a year with no need to plug in or replace batteries, compared to Common Sensing’s cap, which will have to be plugged in once a week (though White says they’re also working on a version with a longer-term battery). It also allows for some complex features, like compensating for inaccuracies that can be caused by priming the pen (activating it without dosing to eliminate air bubbles).

On the other hand, add-on solutions have some added convenience in the market. While Companion’s device will replace a durable pen, other devices can work with disposable insulin pens, which are currently more popular.

“We diabetics are a pretty conservative lot and we don’t like changing our habits,” Innovation Zed’s Hughes said. “So when we get used to insulin pens we want to keep them. So we offer them a sleeve that wraps around the pen and a timer devices that clips on to the sleeve and is triggered only when the injection is completed.”

Saint thinks the additional value will be enough to persuade patients to change their habits. Caps are also likely cheaper to produce, but that could be a moot point if health insurers start routinely reimbursing for the devices.

The path to market and reimbursement

Although the space is just starting to emerge into public consciousness, the players have been working quietly on it for years, and now the race to market is on.

One company, Emperra, has a big lead, but it has only focused on its native Germany. It’s CE-marked Esysta pen is already on the market in Germany and reimbursable by German payers.

“We are on the market,” Emperra CEO Christian Krey told MobiHealthNews in an email. “It is working and has proved success. We are reimbursed by all health insurers in Germany. We have a unique software, that connects patients, relatives, nurses and physicians with high secured servers. We have unique contracts with health insurers that pay not only for the hardware, but also for data sharing between patient and the physician as well as for coaching the patients, depending on their needs.”

He also said the company has “proven success in a field trial together with a health insurer, that the use of the ESYSTA system leads to significant lowering of HbA1c without more usage of insulin.”

Emperra is already making inroads in the rest of the EU and in the US. The company has filed for FDA approval and hopes to enter the US market next year.

Innovation Zed also has trial data showing its product improves HbA1c, thanks to a partnership with the UK’s NHS. The Irish company also has a joint venture with Swedish injectables manufacturer SHL Group that could help them bring their new solution to market quickly once it’s fully developed. They’re targeting a 2017 European launch for the connected product and eyeing the US shortly thereafter. They are hoping for reimbursement from national systems like the NHS and from private payers in the US.

Common Sensing recently announced a clinical trial with Joslin Diabetes Center. Their product is ready to go, White says.

“The device is ready now, so what we’re looking for is the most efficient way to commercialize it with those services to insurers, self-insured employers, etc.,” he said.

Similarly, Companion Medical’s Sean Saint says his company is planning for commercialization in 2017, having been focused up until now on the FDA clearance.

“Smart pens are not a category yet,” he said. “We have the first cleared smart pen, and we’re going to be in the unenviable position of starting to figure out pricing on that. Pricing what amounts to a new category of devices can be very challenging. On the one hand, we have the negative that we look a lot like a traditional insulin pen. On the other hand we have the positive that we believe we offer a very significant clinical benefit over and above traditional insulin pens and potentially as much as a pump. So certainly the pricing will be in between traditional insulin pens and pumps. But I can’t tell you exactly where at this point.”

He says there will be some work to do for reimbursement, but he’s confident that the device will eventually be covered via the pharmacy benefit of a prescription drug plan. White agrees that reimbursement is inevitable.

“The general idea is we don’t want people to have to pay for this out of pocket,” he said. “The idea that patients are causing the problem right now is one that shouldn’t really exist in any modern society. And that means that patients shouldn’t be responsible for fixing this problem in terms of paying for their own medicine. So in our minds, the people who stand to gain the most from this are insurance companies and pharma companies. If someone switches from taking their insulin to not taking their insulin, in the next year they will probably cost on the order of $2,500 more per year and the insurer’s paying for all of that.”

Innovation in the diabetes space is coming in a lot of forms from a lot of places, from the artificial pancreas, to AI coaching, to glucose-sensing contact lenses. But when it comes to making a big difference right now in the lives of many insulin-using type 1 diabetics, smart pens might just be the next big thing. As Saint pointed out, the market is so much larger for pens that even a modest improvement in diabetes management could help a lot of people.

“The health economics of smart pens are phenomenal when you start to think about them,” he said.

[su_button url=”http://www.mobihealthnews.com/content/depth-five-innovators-who-see-future-connected-insulin-delivery-pens-not-pumps?mkt_tok=eyJpIjoiTW1Vd056UTBOR1kyTlRndyIsInQiOiJKbkRadjFnbGdXOTR1UVwvNTJsZFNGanNDaXc5Ylo0bGhycEhjSnVcL2RNWlFUWFRcL3Y3WUp6TFRwaVA5TTQ0QzFyVXU5SVNhblwvdGw5REZSYk5jWTZUeGpMcGdBVzl4NnVLS2J1bXlTbW1DdEU9In0%3D” target=”blank” style=”flat” background=”#64b243″ size=”6″ center=”yes” radius=”5″ icon=”icon: angle-right”]Continue Reading[/su_button]

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Single-Cell Mass Cytometry Analysis of the Human Endocrine Pancreas

Single-Cell Mass Cytometry Analysis of the Human Endocrine Pancreas

Original article published by Cell Press on October 11, 2016. Click here to read the original article.

Highlights

  • Mass cytometry promotes high-throughput phenotyping of islets at a single-cell level
  • Alpha cells maintain higher basal proliferation and are more responsive to mitogens
  • Beta cells exist in distinct states

Summary

The human endocrine pancreas consists of multiple cell types and plays a critical role in glucose homeostasis. Here, we apply mass cytometry technology to measure all major islet hormones, proliferative markers, and readouts of signaling pathways involved in proliferation at single-cell resolution. Using this innovative technology, we simultaneously examined baseline proliferation levels of all endocrine cell types from birth through adulthood, as well as in response to the mitogen harmine. High-dimensional analysis of our marker protein expression revealed three major clusters of beta cells within individuals. Proliferating beta cells are confined to two of the clusters.

[su_button url=”http://www.cell.com/cell-metabolism/abstract/S1550-4131(16)30486-7?elqTrackId=6789327ac64b42228e73a1532b63e754&elq=d19a63a48c4c401c9e53b0028684553c&elqaid=16965&elqat=1&elqCampaignId=9″ target=”blank” style=”flat” background=”#64b243″ size=”6″ center=”yes” radius=”5″ icon=”icon: angle-right”]Continue Reading[/su_button]

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