Diabetes Research: Advancing Toward A Cure
George L. King, M.D. Research Director and Head of the Section on Vascular Cell Biology, Joslin Diabetes Center; Professor of Medicine, Harvard Medical School This is an incredibly exciting time in diabetes research. In the past, we only have had one promising approach to finding a cure for patients with type 1 diabetes. Now we have several possibilities related to a cure, and even prevention, both for type 1 and type 2 diabetes. Previously, research toward a cure was focused on transplantation of the cells in the pancreas that produce insulin, the islet cells or parts of the pancreas. In type 1 diabetes, the body’s immune system turns on itself and destroys these islet cells. As a result, the body can’t produce the insulin required to escort glucose from the food we eat to where it is needed—into the cells of the body’s muscles and other organs. We are now focusing on ways to understand this immune attack to find safe ways to block it. There are several ongoing studies using our knowledge of immunology to try to intervene and prevent type 1 diabetes. Another important effort is directed to regenerating islet cells—to produce insulin again—either through the use of stem cells, embryonic or adult, or other ways of engineering these cells. We are now hopeful that a large number of people with type 1 diabetes still have surviving islet cells left to regrow. This optimism has been raised by the findings that many type 1 diabetes patients may still have residual islets that have retained some function to make insulin. A recent Joslin study of people who have lived more than 50 years with type 1 diabetes indicated that even some of these patients can still make insulin. Much attention is also aimed at the causes of type 2 diabetes. The main theory involves inflamm Continue reading >>
7 Innovations That Are Changing The Way We Manage Diabetes, A Disease That Affects 371 Million People Worldwide
It's been almost a century since researchers discovered a way to treat diabetes. Since then, there have been a number of medical and technological advances that aim to make the lives of people living with diabetes — both type 1 and type 2 — more manageable. Around the globe, the group of conditions affects 371 million people worldwide, a number that's expected to increase to 552 million by 2030. From monitoring blood sugar levels — a taxing experience that people with diabetes must grow used to doing every day — to ways that make insulin easier to deliver, here are some of the innovations that are changing the way we manage diabetes. Medtronic created the world's first 'artificial pancreas.' In September, the FDA approved a device that's often referred to as an "artificial pancreas" for use in people with type 1 diabetes over age 14. The device, made by Medtronic, is called the MiniMed 670G, and it works by automatically monitoring a person's blood sugar levels and administering insulin as needed — no constant checking and injecting required. That way, it can act like a pancreas, the organ in our bodies that in healthy people is able to moderate our blood sugar levels by pumping out insulin that can process the sugars found in food. Livongo is making a glucose monitor that can get software updates just like your phone. "No one cares about the technology," Glen Tullman, the CEO of California-based startup Livongo and whose son has Type 1 diabetes, told Business Insider. "They simply want to live their life." On Wednesday, the company added the capability for the monitor to receive software updates, eliminating the need for people to constantly upgrade to new glucose meters when the technology advances. Livongo also offers the testing strips the machine uses for Continue reading >>
Which New Diabetes Devices And Apps Are Best For You?
Admittedly, it is difficult,even frustrating, to try and keep up with what's new and which technology innovation may benefit which people, soEndocrineWebasked two experts to weigh in on what they see as the most promising new health-based devices offering advances that don't just impress a tech expert but might just inspire and motivate people with diabetes who are looking for solutions to make self-managing their health easier and may even simplify their lives. Ask your healthcare provider about whether or not new devices may be help you manage your diabetes. This list has been compiled with guidance from our two experts, with the understanding new products and solutions are being introduced daily so this list may need updating regularly. David T. Ahn, MD, is an associate clinical professor of medicine at the UCLA David Geffen School of Medicine, who is an endocrinologist and diabetes technology expert. Amy Hess-Fischl, MS,RD, LDN, BC-ADM, CDE, is a diabetes educator at the transitional program coordinator at Kovler Diabetes Center in Chicago, Illinois. Continuous Glucose Monitoring Minus Calibration Abbott's continuous glucose monitoring system (CGM), FreeStyle Libre, requires no patient calibrationneither by fingerstick or manual data entry.1This newest approach to continuous glucose monitoring can replace the traditional blood glucose finger prick check. Instead, blood glucose levels are read through a sensor worn on the back of the upper arm. The sensor can be left in place for up to 10 days, according to the manufacturer. Among the perks of the FreeStyle Libre versus other CGMs is that it has just two components, the sensor and the reader. Other systems typically also have a transmitter. The FreeStyle Libre user captures glucose readings by passing the hand-held Continue reading >>
10 Advances Transforming The Lives Of Diabetics Worldwide
10 advances transforming the lives of diabetics worldwide From an oral insulin capsule to a noninvasive glucose monitor, Israeli entrepreneurs and researchers are making life easier for diabetics. November 14 is World Diabetes Day and the month of November is National Diabetes Month in the United States. While there is not yet a cure for diabetes, many Israeli researchers and companies offer improved approaches for avoiding, managing and treating the condition. Diabetes is a chronic disease that occurs when the pancreas cannot make insulin the hormone that regulates blood sugar or when the body cannot make good use of the insulin it makes. As of 2015, approximately 415 million adults in the world have diabetes and that number is expected to rise to 642 million by 2040. At least 90 percent of cases are type 2 diabetes, characterized by insulin resistance and/or deficiency. In addition, more than 542,000 children in the world live with type 1 diabetes, an autoimmune condition where the body attacks its own insulin-making cells. Diabetes is the leading cause of heart disease, stroke, kidney failure, non-traumatic lower-limb amputations and new cases of blindness among adults. Those with diabetes have twice the normal risk of death; in 2014, diabetes was listed as the seventh leading cause of death in the United States. Here are some significant diabetes developments reported in Israel in recent years. Oramed Pharmaceuticals hopes to revolutionize the treatment of type 1 and type 2 diabetes through its proprietary oral insulin capsule developed through research at Jerusalems Hadassah Medical Center. Currently, insulin must be injected. The company has completed multiple Phase II clinical trials under an Investigational New Drug application with the US Food and Drug Adminis Continue reading >>
Diabetes Research: Groundbreaking Diabetes News Of 2017 | Reader's Digest
Kelsey Mcardle/Rd.com, shutterstockHow's this for a scary statistic: Nearly 800,000 new cases of cancer are attributed to type 2 diabetes and having a high BMI, per research this year in The Lancet Diabetes & Endocrinology . (The study looked at cancers from 2012.) While there are other common causes of cancer , the researchers say that diabetes was to blame for one-quarter of liver cancers and nearly four out of 10 cases of endometrial cancers. High insulin and blood sugar levels, as well as chronic inflammation may be one common underpinning of these conditions. Kelsey Mcardle/Rd.com, shutterstock Imagine fewer finger pricks to take your blood sugar. That day is here, thanks to Dexcom's Continuous Glucose Monitoring (CGM). Their G5 mobile app for Android was FDA-approved in July 2017, which allows you to stay on top of your blood sugar continuously. CGM takes a reading every five minutes to gain insight on how your glucose levels are trending. "You only need to check your blood sugar twice a day to calibrate the machine. It substantially decreased the number of finger sticks for patients with diabetes, which takes so much of the burden away," says Billings. "In a trial that we were involved in (DIAMOND), we found that CGM can help improve blood sugar control. After adding this CGM to the patients' treatment regimen, both patients with type 1 and type 2 diabetes saw significant lowering of their hemoglobin A1c (a measure of someone's average blood glucose over three months)," she adds. Your diet plays an even bigger role than you thought Kelsey Mcardle/Rd.com, shutterstockYou knew that watching your intake of refined carbohydrates and simple sugars was key in managing diabetes. You should also know that the impact of your diet goes beyond carbohydrates. New research f Continue reading >>
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Recent Advances In Diabetic Nephropathy
The classical definition of diabetic nephropathy is of a progressive rise in urine albumin excretion, coupled with increasing blood pressure, leading to declining glomerular filtration and eventually end stage renal failure. Patients generally have diabetic retinopathy. Recently, greater appreciation of the close links between nephropathy and cardiovascular disease have lead to the inclusion of premature cardiovascular disease, cardiovascular risk increasing in parallel with albuminuria (box 1). Diabetic nephropathy is now the single commonest cause of end stage renal failure worldwide and is acknowledged as an independent risk factor for cardiovascular disease. In many countries, the majority of diabetic patients starting renal replacement therapy now have type 2 rather than type 1 diabetes. This review will therefore encompass nephropathy in both type 1 and type 2 diabetes. Box 1: Clinical definition of diabetic nephropathy Progressive rise in urine albumin excretion. Progressive rise in blood pressure. Eventual decline in glomerular filtration rate and end stage renal failure. In the presence of diabetic retinopathy. Accompanied by progressive rise in cardiovascular risk. NATURAL HISTORY OF NEPHROPATHY Type 1 diabetes The initial rise in protein excretion is small and highly selective, albumin being the main protein excreted in excess. At this stage, specific immunologically based assays detect small increases in urine albumin which are below the detection limit of conventional dipstick tests (table 1). This so-called microalbuminuria generally appears within 5–15 years’ duration of diabetes. Without specific intervention, over approximately a further 10 years, albumin excretion slowly increases through the microalbuminuric range, until dipstick positive or conve Continue reading >>
Jdrf’s Top Advances On Type 1 Diabetes Cure & Treatment Research
“JDRF made exciting progress this year in our mission of accelerating life-changing breakthroughs to cure, prevent and treat type 1 diabetes (T1D) and its complications,” explains Emily Howell from JDRF. This video with Aaron Kowalski, Ph.D. features some of JDRF’s most promising and exciting advances in type 1 diabetes cure and treatment research and technology. (Kowalski also takes questions from people in the diabetes community!) Here are a few of the notable advances mentioned in the video with details provided by Emily Howell. ViaCyte: Implantable Insulin Capsule JDRF is paving a pathway to a cure by pursuing research priorities that can improve treatment of T1D in the short term and mature over time into curative therapies. For example, ViaCyte’s VC-01 device that features pancreatic precursor cells enclosed in a device to protect them from immune attack. In January 2016 ViaCyte reported that VC-01’s precursor cells showed signs of developing into insulin-producing beta cells in one participant of the phase 1 safety trial. According to ViaCyte, although the observations are preliminary, they suggest the VC-01 device is working as designed. Read more about past ViaCyte research updates. Early Screening for Type 1 Diabetes in Children JDRF is funding the Fr1da project, in which 3-and 4-year-olds in Bavaria, Germany, are screened for early-stage markers of T1D at well-child visits. Those who test positive for the markers can enroll in a study monitoring disease progression or a trial testing whether oral insulin can stop progression of T1D. This trial raises the exciting prospect of stopping T1D in its tracks and changing the future for those at risk of developing T1D. New T1D Classification System Leading diabetes organizations along with JDRF’s leadersh Continue reading >>
Advances In Diabetes, Part I: Injectable Medications
Advances in Diabetes, Part I: Injectable Medications By Kim Maryniak, PhDc, MSN, RNC-NIC, contributor There have been many advances in the treatment of diabetes over the last several decades. With these rapid changes, it is important for healthcare professionals, particularly nurses, to be aware of medications that may be used to treat the diabetic patient. Insulin is required for patients with type I diabetes mellitus (also known as juvenile diabetes, or new onset diabetes). In this form of diabetes, the pancreas does not make any insulin at all (American Diabetes Association [ADA], 2016b). Conversely, for patients with type II diabetes, the body does not use insulin effectively, known as insulin resistance. Patients with type II diabetes may also benefit from insulin if other regimens have not worked (ADA, 2016c). In addition to insulin, there are injectable medications for both type I and type II diabetics. [CHECK OUT the nursing CE classes on diabetes from RN.com.] The number of available insulins on the market continues to grow. Rapid-acting insulins include: The insulin aspart (Novolog) is a clear liquid, used in syringes, pumps, or pens, and may be given subcutaneously (subq) or intravenous (IV). The onset is 10 to 20 minutes, with a peak of 30 to 90 minutes. The duration of aspart is 3 to 5 hours (Curry, 2015). Lispro (Humalog, available in U-100 and U-200) Another rapid acting insulin, lispro (Humalog), is also a clear liquid, used in syringes, pumps, or pens, and may be given subq or IV. The onset is 10 to 20 minutes, with a peak of 30 to 90 minutes. The duration of lispro is 3 to 5 hours (Curry, 2015). The insulin glulisine (Apidra) is also in clear form, used in syringes, pumps, or pens, and can also be given subq or IV. The onset is 10 to 20 minutes, with Continue reading >>
Progress In Research
Since Banting and Bests discovery of insulin in Toronto in 1921, the scope of diabetes research in Canada has been vast and the numerous studies both varied and unique. There have been huge strides and key advances in mapping and understanding the physiology, biochemistry, and genetics of diabetes. Diabetes Canada understands funding of diabetes research is a crucial step in providing these advances. This is why we choose, each year, to fund Canadas most renowned scientists and clinicians in their quest for new and innovative developments in the prevention, treatment, and management of diabetes. And although the research is diverse in its scope, covering a broad range of specialties, the key aspects of every study and researcher remain the same to improve the quality of life of people living with diabetes and to find a cure. Since Banting and Bests discovery of insulin in Toronto in 1921, the scope of diabetes research in Canada has been vast. The innovative research funded by Diabetes Canada has contributed to key advances in mapping and understanding the physiology, biochemistry, and genetics of the disease. Although the topics of Canadian researchers are varied and unique, the objective of every study remains the same to find a cure and improve the quality of life of people living with diabetes. The known history of diabetes through the ages began in 1552 BCE, when an Egyptian physician first described diabetes and listed remedies to combat the passing of too much urine. The history of Diabetes Canadas relationship with diabetes research is much more recent: Since 1975 and the establishment of the Charles H. Best Research Fund named for insulin co-discoverer and Diabetes Canada co-founder Dr. Charles H. Best Diabetes Canada has awarded more than $120 million in rese Continue reading >>
Advances In Medical Technology
Improving Diabetes Care Treatment of diabetes, like most areas of medicine, has changed considerably over the years as a result of technological advances. From the discovery, purification, and mass production of insulin to the development of less painful ways to deliver it, the lives of people with diabetes have been improved — and sometimes greatly extended — by both diabetes-focused research and broader improvements in medical care. Although it can be difficult to predict the impact of an emerging technology, there are several exciting developments on the horizon that may soon significantly change how people with diabetes receive medical care or manage the condition on their own. At least one relatively new innovation, the continuous glucose monitor, is already changing the daily routine for some. This article examines several innovations that are likely to change — or are already changing — the way medical care is delivered and the way medical information is communicated. Not all assessments of medical technology are completely upbeat, however. Especially when it comes to electronic health records, many experts are either frustrated at the pace of progress or skeptical of how the technology will be used. Electronic health records Dr. Richard Hellman, who is past-president of the American Association of Clinical Endocrinologists and has an endocrinology practice in North Kansas City, Missouri, laments that although someone can get money from an ATM or use a credit card anywhere in the world, medical information often cannot be easily accessed when it is needed. “The tragedy is that information doesn’t move around to the benefit of the patient,” he says. “There is much too much information that can’t be transmitted.” The problem is not a technologic Continue reading >>
New Diabetes Treatment Could Eliminate Need For Insulin Injections
A cell-based diabetes treatment has been developed by scientists who say it could eliminate the need for those with the condition to inject insulin. The therapy involves a capsule of genetically engineered cells implanted under the skin that automatically release insulin as required. Diabetic mice that were treated with the cells were found to have normal blood sugar levels for several weeks. Scientists said they hope to obtain a clinical trial licence to test the technology in patients within two years. If successful, the treatment would be relevant for all type 1 diabetes patients, as well as those cases of type 2 diabetes that require insulin injections. Martin Fussenegger, who led the research at the ETH university in Basel, said: “By 2040, every tenth human on the planet will suffer from some kind of diabetes, that’s dramatic. We should be able to do a lot better than people measuring their glucose.” Fussenegger said that, if confirmed as safe and effective in humans, diabetes patients could be given an implant that would need to be replaced three times a year rather than injections, which do not perfectly control blood sugar levels, leading to long-term complications including eye, nerve and heart damage. In Britain, about 400,000 people have type 1 diabetes and three million have type 2 diabetes, about 10% of whom need to inject insulin to control the condition. Type 1 diabetes normally begins in childhood and is an autoimmune disease in which the body kills off all its pancreatic beta cells. The cells respond to the body’s fluctuating glucose levels by releasing insulin, which regulates blood sugar. Without beta cells, patients need to monitor glucose and inject insulin as required – typically several times each day. Previously, scientists have attempt Continue reading >>
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What's New In Endocrinology And Diabetes Mellitus
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2017 UpToDate, Inc. All topics are updated as new evidence becomes available and our peer review process is complete. The following represent additions to UpToDate from the past six months that were considered by the editors and authors to be of particular interest. The most recent What's New entries are at the top of each subsection. DIABETES MELLITUS ACE inhibitors and statins do not prevent moderately increased albuminuria or progression of retinopathy in type 1 diabetes (November 2017) Angiotensin inhibition and statin therapy have been proposed as treatments to prevent microvascular complications in patients with type 1 diabetes mellitus, although evidence has not supported this hypothesis. In a 2x2 placebo-controlled trial of quinapril and atorvastatin in 443 normoalbuminuric and normotensive adolescents with type 1 diabetes, neither drug reduced the incidence of moderately increased albuminuria (primary outcome), and neither drug significantly reduced the progression of retinopathy (an exploratory outcome) [1]. Thus, UpToDate continues to recommend that angiotensin inhibition and statin therapy not be used for primary prevention of microvascular complications in type 1 diabetes. (See "Moderately increased albuminuria (microalbuminuria) in type 1 diabetes mellitus", section on 'ACE inhibitors or ARBs' and "Diabetic retinopathy: Prevention and treatment", section on 'Prevention'.) Continuous glucose monitoring in patients with type 2 diabe Continue reading >>
Advances In Treating And Detecting Diabetic Retinopathy
Advances in Treating and Detecting Diabetic Retinopathy By Ava Runge, Lynn Kennedy, and Abigail Dove FDA approves Lucentis for all types of diabetic retinopathy and IBM announces a new technology that helps doctors better diagnose retinopathy Biotech giant Genentech recently announced FDA approval of Lucentis for diabetic retinopathy , a long-term diabetes complication where blood vessels in the back of the eye (the retina) become damaged from high blood sugars. The approval establishes Lucentis, a once-monthly eye injection administered by a healthcare provider, as the first and only medicine approved to treat all forms (!) of diabetic retinopathy . This news marks noteworthy progress in treatment options for diabetes complications. Previously it was only approved for the treatment of diabetic retinopathy in people with diabetic macular edema (DME) leakage and swelling of a part of the eye responsible for sharp and detailed vision, which is called the macula (see past diaTribe coverage here ). On a similarly exciting note, IBM Research announced only days later that its very smart Watson technology is well on the way to learning how to better diagnose diabetic retinopathy . In a very impressive study, Watson was extremely accurate at classifying eye images into five stages of retinopathy (no retinopathy, mild, moderate, severe, and proliferative), getting it right a whopping 86% of the time. In comparison, while doctors are able to make a yes or no determination about whether or not retinopathy is present 90% of the time, it is often very hard for them to make more specific stage classifications. The approval of Lucentis and development of tools to help healthcare providers detect and classify diabetic retinopathy (like Watson) are welcome news for people with diabete Continue reading >>
Advances In Management Of Type 1 Diabetes Mellitus
Advances in management of type 1 diabetes mellitus Ravindranath Aathira, Vandana Jain, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India Author contributions: Aathira R did the literature search and reviewed the relevant articles to contruct the body of the document; Jain V guided through the whole process and edited the final document. Correspondence to: Vandana Jain, Additional Professor, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India. [email protected] Telephone: +91-981-0167265 Fax: +91-011-26588663 Received 2014 May 13; Revised 2014 Jun 18; Accepted 2014 Jul 17. Copyright 2014 Baishideng Publishing Group Inc. All rights reserved. This article has been cited by other articles in PMC. Treatment of type 1 diabetes mellitus has always posed a challenge to balance hyperglycemia control with hypoglycemia episodes. The quest for newer therapies is continuing and this review attempts to outline the recent developments. The insulin molecule itself has got moulded into different analogues by minor changes in its structure to ensure well controlled delivery, stable half-lives and lesser side effects. Insulin delivery systems have also consistently undergone advances from subcutaneous injections to continuous infusion to trials of inhalational delivery. Continuous glucose monitoring systems are also becoming more accurate and user friendly. Smartphones have also made their entry into therapy of diabetes by integrating blood glucose levels and food intake with calculated adequate insulin required. Artificial pancreas has enabled to a certain extent to close the loop between blood glucose level and insulin delivery with devices armed with meal and exercise anno Continue reading >>
Study Advances Efforts To Screen All Children For Type 1 Diabetes
Follow all of ScienceDaily's latest research news and top science headlines ! Study advances efforts to screen all children for Type 1 diabetes Novel way to present pancreatic proteins increases the sensitivity of Type 1 Diabetes Tests Researchers report the development of a novel antibody detection technology that holds promise for improving the accuracy of diagnostic tests for type 1 diabetes in young children and making population-wide screening practical. This is an illustration of the ZnT8 protein embedded in a fatty membrane and attached to the P-Gold Assay. This is an illustration of the ZnT8 protein embedded in a fatty membrane and attached to the P-Gold Assay. Researchers from the Johns Hopkins University School of Medicine, Stanford University and the University of Florida report the development of a novel antibody detection technology that holds promise for improving the accuracy of diagnostic tests for type 1 diabetes in young children and making populationwide screening practical. In a report on the work, published in the Proceedings of the National Academy of Sciences on Sept. 5, the scientists say the technology enables screening for more autoimmune antibodies implicated in type 1 diabetes than current tests by incorporating a full-length pancreatic protein, called the pancreatic zinc transport 8 (ZnT8), that is targeted for autoimmune attack in people with the disease. By improving the accuracy of this test, researchers hope to catch the disease earlier and extend testing to all people. Type I diabetes, once known as juvenile diabetes, is a relatively rare form of the disorder in which the pancreas produces no insulin. It accounts for about 5 percent of all cases of diabetes in the United States. "Although current tests are about 94 percent accurate in Continue reading >>
