Type 1 Diabetes: Almost Half Of Patients Produce Insulin
Type 1 diabetes is often described as a condition in which the body fails to produce the hormone insulin. New research, however, provides further evidence that not all insulin production is lost with the condition, and this may be down to an anti-inflammatory protein. Researchers from Uppsala University in Sweden found that nearly half of patients who had been living with diabetes for more than 10 years produced some insulin. What is more, these insulin-producing patients also had higher blood levels of immune cells that produce a protein called interleukin-35 (IL-35), which is believed to suppress the immune system and reduce inflammation. Study co-author Dr. Daniel Espes, of the Department of Medical Cell Biology at Uppsala University, and colleagues recently reported their findings in the journal Diabetes Care. Type 1 diabetes is estimated to affect around 1.25 million children and adults in the United States. The condition arises when the immune system mistakingly attacks the insulin-producing cells, or beta cells, of the pancreas. It was once thought that patients with type 1 diabetes experienced a complete loss of insulin production, but increasingly, studies have indicated that some patients still possess functioning beta cells. For this latest study, Dr. Espes and colleagues set out to determine whether there are any immunological mechanisms that might explain why some patients with type 1 diabetes still produce some insulin. Many patients produced insulin The research included 113 patients with type 1 diabetes who were aged 18 and older. All patients had been living with the condition for at least 10 years. Using the ultra-sensitive ELISA test, the researchers measured the levels of C-peptide in the patients' blood, which is an indicator of insulin production. Continue reading >>
Patients With Type 1 Diabetes Can Still Produce Insulin 40 Years Later
According to a new study, about 1/3 of people with type 1 diabetes produce insulin, as measured by C-peptide, even upward of 40 years from initial diagnosis… The findings shed new light on the long-accepted belief that patients with type 1 diabetes lose all ability to produce any insulin. The study confirmed that C-peptide is present in patients across a wide age spectrum, with greater frequency and higher values in those diagnosed as adults, compared with those diagnosed as children. They used samples from the T1D Exchange Biobank, a repository of type 1 diabetes biological samples. This information may prevent misdiagnosing patients as type 2 diabetes when their c-peptide test comes back positive. This will also provide improved treatments to control glucose levels. Asa K. Davis, PhD, T1D Exchange, Benaroya Research Institute, Seattle, Washington, which houses the TID Exchange Biobank added that, the data suggests important differences in the biological process of type 1 diabetes between those diagnosed as children or as adults. “These findings lend further credence to research underway on targeted therapies that could prolong insulin production, helping patients with type 1 diabetes better manage their disease and reduce complications,” he said. “For example, potential immunotherapy treatments are already being studied with this goal in mind, and our findings underscore that those diagnosed at a young age may be more likely to benefit from such new approaches.” For the study, researchers measured C-peptide levels in 919 people with type 1 diabetes ranging from 3 to 80 years from diagnosis (aged 3-88 years) at 28 of T1D Exchange’s 70 Clinic Network locations. Among the participants with 3- to 5-year disease duration, C-peptide was present in 78% of patient Continue reading >>
Most People With Type 1 Still Producing Insulin
With new diagnostic tools, doctors can track the insulin production of people with diabetes who are long past the honeymoon period. If you have Type 1 diabetes and are out of the “honeymoon period,” you’ve probably been told that your pancreas has stopped producing insulin. But it turns out that information may be wrong. Many people with Type 1 still produce at least some insulin, even years after diagnosis. Traditionally, doctors and researchers believed that the pancreas “crashed and burned,” rapidly declining in its ability to secrete insulin as early as a year after the onset of Type 1. What new research now shows is that many people with Type 1 produce at least some level of insulin for decades after diagnosis.1,2 Your pancreas could be functioning for decades, not just one or two years after your diagnosis. In our study of nearly 200 patients who had been living with Type 1 for nearly two decades, we saw that C-peptide secretion (a sign of insulin production) decayed gradually over 20 years, and we were able to detect C-peptide in nearly two-thirds of the blood samples we analyzed. So, why did we think for so long that people with Type 1 don’t produce any insulin? And what changed? One major reason is that, until recently, we couldn’t detect the insulin being produced by people who long have had Type 1 diabetes, since they are producing C-peptide at lower levels than most current tests can measure. However, new ultra-sensitive blood tests for C-peptide are able to pick up very low levels of secretion, and they are now what we use in our laboratory for all of our Type 1 diabetes studies. Right now, the greatest impact of our ability to detect C-peptide will be on Type 1 diabetes research. Most Type 1 diabetes clinical trials have been directed at pati Continue reading >>
1 In 3 People With Type 1 Diabetes Still Produce Insulin, Study Says
MONDAY, Dec. 29, 2014 (HealthDay News) -- Although it's widely accepted that people with type 1 diabetes produce no insulin, a new study suggests otherwise: Roughly one-third produce the hormone long after they are diagnosed. Residual insulin production can last for more than four decades, researchers reported recently in the journal Diabetes Care. Their findings could help avoid the misdiagnosis of type 1 diabetes as the more common type 2 diabetes and improve treatments for blood sugar control, they suggested. "Other studies have shown that some type 1 diabetes patients who have lived with the disease for many years continue to secrete insulin, and the assumption has been that these patients are exceptional," said study senior author Dr. Carla Greenbaum, director of T1D Exchange Biobank Operations Center, a repository of type 1 diabetes biological samples, in Seattle. "For the first time, we can definitively say that these patients are a true subset of the type 1 diabetes population, which has major clinical and health policy implications," she said in a journal news release. Worldwide, about 35 million people have type 1 diabetes, the researchers said. The autoimmune disease causes the destruction of insulin-producing cells in the pancreas, which means patients must take insulin injections or use an insulin pump. The researchers examined type 1 diabetes samples from more than 900 people ranging in age from 5 to 88, and found that C-peptide, a byproduct of insulin production, was present in patients of all ages. But C-peptide was found more often and in higher concentrations in those diagnosed as adults. Among those who had type 1 diabetes for three to five years, C-peptide was present in 78 percent of those diagnosed after 18 years of age, and in less than half of t Continue reading >>
Many People With Type 1 Diabetes Still Produce Insulin
Many People With Type 1 Diabetes Still Produce Insulin Many people with type 1 diabetes continue to secrete small amounts of insulin long after diagnosis, particularly those who develop the condition in adolescence or adulthood. That was the finding of two studies published online December 17, 2014 in Diabetes Care. One study , led by Dr Asa K Davis (Benaroya Research Institute, Seattle, Washington) and colleagues, found that residual insulin secretion was present in one of three people diagnosed with type 1 diabetes 3 years or more earlier. In the other study , by Dr Richard A Oram (National Institute for Health Research, University of Exeter Medical School, UK), 80% of patients aged less than 30 years when diagnosed with type1diabetes and a disease duration of 5 years or longer still had detectable C-peptide levels. "The old dictum is that if you have type 1 diabetes long enough you don't have any C-peptide, yet if you have a sensitive enough assay, many people do," Dr Anne L Peters (Keck School of Medicine, University of Southern California, Los Angeles, California) told Medscape Medical News. The finding, which has been previously reported but not in large studies each of these new studies involved more than 900patients suggests that one day it may be possible to recover and reharness beta-cell production. But the finding also has immediate clinical relevance, particularly with regard to diagnosing type1diabetes, according to Dr Peters, a coauthor of the first study. "People with type 1 diabetes still have beta cells and still make some insulin because the autoimmune process may not cause complete beta-cell destruction. It's interesting and confuses the diagnosis, but doesn't take away that this is an autoimmune disease," she told Medscape Medical News. Importantly Continue reading >>
Woman With Type 1 Diabetes Still Off Insulin One Year After Cell Transplant
Scientists report a step forward in the plan to create a truly artificial pancreas, offering new hope to people with type 1 diabetes. A 43-year-old single mother with dangerously difficult-to-control diabetes had insulin-producing islet cells transplanted into her omentum -- a fatty membrane in the belly. The cells began producing insulin faster than expected, and after one year she is doing well and doesn't need insulin injections, the University of Miami researchers said. "We're exploring a way to optimize islet cell therapy to a larger population. This study gives us hope for a different transplant approach," said the study's lead author, Dr. David Baidal. He's an assistant professor in the university's Diabetes Research Institute. Others voiced optimism as well. "This study was a good start at evaluating a novel site for transplant," said Julia Greenstein, vice president of discovery research for JDRF (formerly the Juvenile Diabetes Research Foundation). Type 1 diabetes is an autoimmune disease. That means the body's immune system mistakenly damages healthy cells -- in this case, the islet cells found in the pancreas. This leaves people with type 1 diabetes without enough insulin to convert sugars from foods into energy for the body. As a result, they must take multiple daily insulin injections, or use a pump that delivers insulin via a tube inserted under the skin that must be changed every few days. Currently, islet cells from deceased donors are transplanted into the liver, but that's not an ideal option. This new research was a proof-of-concept study expected to be the first step on a path toward developing a mini-organ called the BioHub. In its final stages, the BioHub would mimic a pancreas and act as a home for transplanted islet cells, providing them with ox Continue reading >>
People With Type 1 Diabetes May Still Have Insulin-producing Cells
THURSDAY, Oct. 10 (HealthDay News) -- Most people with type 1 diabetes still have active insulin-producing cells in their pancreas, a new study shows. The finding suggests it may be possible one day to preserve or replenish these cells. Type 1 diabetes occurs when the body's immune system destroys insulin-producing beta cells, and it was believed that all these cells were lost within a few years of developing the disease. But British researchers used new technology that enabled them to detect far lower levels of insulin than was previously possible. They tested 74 people with type 1 diabetes, and found that 73 percent of them had working beta cells that produced low levels of insulin, regardless of how long they'd had the disease. The study was published in the journal Diabetologia. "It's extremely interesting that low levels of insulin are produced in most people with type 1 diabetes, even if they've had it for 50 years," study leader Dr. Richard Oram, of the University of Exeter Medical School in the United Kingdom, said in a university news release. "The fact that insulin levels go up after a meal indicates these remaining beta cells can respond to a meal in the normal way -- it seems they are either immune to attack or they are regenerating." Dr. Matthew Hobbs, head of research for Diabetes UK, added: "We know that preserving or restoring even relatively small levels of insulin secretion in type 1 diabetes can prevent hypoglycemia [low glucose levels] and reduce complications, and therefore much research has focused on ways to make new cells that can be transplanted into the body." "This research shows that some of a person's own beta cells remain, and therefore it may be possible to regenerate these cells in the future," Hobbs said. "It is also possible that unders Continue reading >>
This Is Why Some Type 1 Diabetics Still Produce Insulin
This is why some type 1 diabetics still produce insulin Swedish researchers have launched a study to see if they can boost insulin production in people with type 1 diabetes who are still making some insulin. Some type 1 diabetics still produce a bit of insulin. (iStock) ~ In type 1 diabetes, the immune system attacks the cells in the pancreas that produce insulin, the hormone that helps usher sugar to cells to be used as fuel. A recent Swedish study found that almost half of people with type 1 diabetes are still producing some insulin more than a decade after being diagnosed with the disease. This challenges previous assumptions that people with type 1 diabetes lose their ability to produce any insulin over time. Researchers at Sweden's Uppsala University, led by post-doctoral researcher Daniel Espes, reached their conclusions after studying more than 100 patients with type 1 diabetes. The study appears in the June issue of Diabetes Care. The investigators found that people who still produced insulin despite their long-standing type 1 diabetes had higher levels of a protein called interleukin-35. This protein appears to play an important role in the immune system. Past research had shown that both newly diagnosed people with type 1 diabetes and those who've had the disease for some time had lower average levels of interleukin-35 compared to healthy people. Type 1 diabetes is an autoimmune disease that causes the body's immune system to mistakenly attack healthy cells in the pancreas that make insulin, causing insufficient insulin production and uncontrolled blood glucose levels in the cardiovascular system leading to various health complications. According to Health24 , three-and-a-half million South Africans – about 6% of the population – suffer from diabete Continue reading >>
Type 1 Diabetes
Type 1 diabetes can occur at any age. It is most often diagnosed in children, adolescents, or young adults. Insulin is a hormone produced in the pancreas by special cells, called beta cells. The pancreas is below and behind the stomach. Insulin is needed to move blood sugar (glucose) into cells. Inside the cells, glucose is stored and later used for energy. With type 1 diabetes, beta cells produce little or no insulin. Without enough insulin, glucose builds up in the bloodstream instead of going into the cells. This buildup of glucose in the blood is called hyperglycemia. The body is unable to use the glucose for energy. This leads to the symptoms of type 1 diabetes. The exact cause of type 1 diabetes is unknown. Most likely, it is an autoimmune disorder. This is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue. With type 1 diabetes, an infection or another trigger causes the body to mistakenly attack the cells in the pancreas that make insulin. The tendency to develop autoimmune diseases, including type 1 diabetes, can be passed down through families. Continue reading >>
Diabetic Patients That Still Produce Insulin Might Be The Key To A New Therapy
A study from Uppsala University has identified higher levels of interleukin-35 in type 1 diabetics that still produce insulin years after their diagnosis. Researchers at Uppsala University have published the first study in humans that shows the potential of interleukin-35 (IL-35) as a promising new target to treat type 1 diabetes. The results, published in Diabetes Care, showed that 41% of the 113 patients tested, all living with the disease for 10 years or more, still presented residual insulin production. Until now, it was thought that the diagnosis of type 1 diabetes led to the full loss of insulin production. The researchers set out to study what made those patients different and analyzed the levels of circulating cytokines, which are signaling molecules involved, among other functions, in the regulation of the immune system. What they found was that the patients that could still produce some insulin had much higher blood levels of IL-35, as well as more IL-35-producing B- and T-cells. IL-35 has been previously studied as a candidate to treat type 1 diabetes given its known role in suppressing autoimmune responses. Studies in mice models have shown that the molecule has the potential to stop the immune attack against insulin-producing beta cells. The new study not only proves that IL-35 could have a similar effect in humans, but it shows it could be a natural process that could be enhanced to reduce or stop the progression of the disease. The researchers still not know whether the patients presented high IL-35 levels at the onset of the disease, though a previous study by the same group determined that the levels of IL-35 in type 1 diabetics, both newly diagnosed and long-term sufferers, show in average lower levels of the cytokine as compared to healthy people. The Continue reading >>
Do People With Type 1 Diabetes Make Any Insulin?
The essential definition of type 1 diabetes is that people make little or no insulin, but the answer isn't as simple as that. Type 1 diabetes most often results from an autoimmune process that leads to the loss of beta cells, the cells in the pancreas that manufacture and release insulin. Someone with fully developed type 1 diabetes will often make little or no insulin. However, the autoimmune process does not lead to a loss of insulin in one step or overnight, and some people lose their insulin production very gradually. These are usually people who are diagnosed with type 1 diabetes relatively late--in their 30s, 40s or later. When they are first diagnosed, they often still make a fair amount of insulin. They are often thought to have type 2 diabetes, and because they still make a good deal of insulin they usually respond to oral medications, reinforcing the idea that they have type 2 diabetes. However, as they continue to lose beta cells, their insulin production declines, and eventually they need insulin treatment to maintain blood sugar control. It may take several years from the time of their initial diagnosis to progress to this point. The other thing to note is that even people with fully-established type 1 diabetes differ in terms of how much insulin they make. Some people still make enough insulin to help smooth out the fluctuations in blood sugar that you typically have with insulin injections or an insulin pump. These are people who are easily controlled and have good hemoglobin A1c levels and very few episodes of hypoglycemia without very much effort. These people often have low but detectable levels of C-peptide, a marker of insulin production by the body. Other people make virtually no insulin. They typically have a much harder time achieving good blood s Continue reading >>
Type 1 Diabetes
Type 1 diabetes is much less common than type 2 diabetes and typically affects younger individuals. Type 1 diabetes usually begins before age 40, although there have been people diagnosed at an older age. In the United States, the peak age at diagnosis is around 14. Type 1 diabetes is associated with deficiency (or lack) of insulin. It is not known why, but the pancreatic islet cells quit producing insulin in the quantities needed to maintain a normal blood glucose level. Without sufficient insulin, the blood glucose rises to levels which can cause some of the common symptoms of hyperglycemia. These individuals seek medical help when these symptoms arise, but they often will experience weight loss developing over several days associated with the onset of their diabetes. The onset of these first symptoms may be fairly abrupt or more gradual. To learn more about type 1 diabetes basics, see our type 1 diabetes slideshow. It has been estimated that the yearly incidence of type 1 diabetes developing is 3.7 to 20 per 100,000. More than 700,000 Americans have this type of diabetes. This is about 10% of all Americans diagnosed with diabetes; the other 90% have type 2 diabetes. What You Need to Know about Type 1 Diabetes Type 1 Diabetes Causes Type 1 diabetes usually develops due to an autoimmune disorder. This is when the body's immune system behaves inappropriately and starts seeing one of its own tissues as foreign. In the case of type 1 diabetes, the islet cells of the pancreas that produce insulin are seen as the "enemy" by mistake. The body then creates antibodies to fight the "foreign" tissue and destroys the islet cells' ability to produce insulin. The lack of sufficient insulin thereby results in diabetes. It is unknown why this autoimmune diabetes develops. Most often Continue reading >>
One In Every Three People With Type 1 Diabetes Produces Insulin Years Post-diagnosis
One in Every Three People with Type 1 Diabetes Produces Insulin Years Post-Diagnosis Largest Study to Date of Residual Insulin Production Proves Such Patients Are Not ‘Exceptional’ Major Clinical and Health Policy Implications About one-third of people with type 1 diabetes (T1D) produce insulin, as measured by C-peptide, a byproduct of insulin production, even upward of forty years from initial diagnosis, according to a first-of-its-kind, large-scale study conducted by researchers from T1D Exchange. This sheds new light on the long-accepted belief that these patients lose all ability to produce any insulin; this could have significant policy implications, said researchers from T1D Exchange, whose Clinic Network involves a national consortium of diabetes centers. The findings were published online this week in Diabetes Care. Using samples from the T1D Exchange Biobank, a repository of type 1 diabetes biological samples, the study confirmed that C-peptide is present in patients across a wide age spectrum, with greater frequency and higher values in those diagnosed as adults as compared with those diagnosed as children. The findings provide clinicians proof that residual insulin production can be anticipated in this population, thereby potentially decreasing the risk of misdiagnosis as the more common type 2 diabetes and increasing opportunities for improved treatments to control glucose levels. The data suggests important differences in the biological process of type 1 diabetes between those diagnosed as children or as adults, according to investigator Asa K. Davis, Ph.D., T1D Exchange program manager at Benaroya Research Institute, which houses the TID Exchange Biobank. “These findings lend further credence to research underway on targeted therapies that could prol Continue reading >>
Type 1 And Type 2 Diabetes: What’s The Difference?
If your child or someone you know has been recently diagnosed with type 1 diabetes, you may be wondering how the disease differs from type 2 diabetes — the form people tend to know more about. What causes type 1 versus type 2 diabetes? Are the symptoms the same? And how is each treated? Here to clear up the confusion with an overview of key differences — and similarities — between these two types of diabetes are experts Julie Settles, M.S.N., A.C.N.P.-B.C., C.E.N., a clinical research scientist at Lilly Diabetes, and Rosemary Briars, N.D., P.N.P.-B.C., C.D.E., C.C.D.C., clinical director and program co-director of the Chicago Children’s Diabetes Center at La Rabida Children’s Hospital. Causes Diabetes, or diabetes mellitus, as it’s formally known in medical terms, describes a group of metabolic diseases in which a person develops high blood glucose (blood sugar). The underlying health factors causing the high blood sugar will determine whether someone is diagnosed with type 1 or type 2 diabetes. Type 1 diabetes is an autoimmune disease in which “the body’s immune system starts to make antibodies that are targeted directly at the insulin-producing cells of the pancreas (islet cells),” explains Briars. Over time, the immune system “gradually destroys the islet cells, so insulin is no longer made and the person has to take insulin every day, from then on,” she says. As for why this happens, Settles notes, “The immune system normally fights off viruses and bacteria that we do not want in our body, but when it causes diabetes, it is because something has gone wrong and now the body attacks its own cells.” Triggering this autoimmune response is a complex mix of genetic and environmental factors that researchers are still trying to fully understand. O Continue reading >>
Type 1 Diabetes
Introduction Diabetes is a lifelong condition that causes a person's blood sugar (glucose) level to become too high. The hormone insulin – produced by the pancreas – is responsible for controlling the amount of glucose in the blood. There are two main types of diabetes: Type 1 – where the pancreas doesn't produce any insulin Type 2 – where the pancreas doesn't produce enough insulin or the body’s cells don't react to insulin This topic is about type 1 diabetes. Read more about type 2 diabetes Another type of diabetes, known as gestational diabetes, occurs in some pregnant women and tends to disappear following birth. It's very important for diabetes to be diagnosed as soon as possible, because it will get progressively worse if left untreated. You should therefore visit your GP if you have symptoms, which include feeling thirsty, passing urine more often than usual and feeling tired all the time (see the list below for more diabetes symptoms). Type 1 and type 2 diabetes Type 1 diabetes can develop at any age, but usually appears before the age of 40, particularly in childhood. Around 10% of all diabetes is type 1, but it's the most common type of childhood diabetes. This is why it's sometimes called juvenile diabetes or early-onset diabetes. In type 1 diabetes, the pancreas (a small gland behind the stomach) doesn't produce any insulin – the hormone that regulates blood glucose levels. This is why it's also sometimes called insulin-dependent diabetes. If the amount of glucose in the blood is too high, it can, over time, seriously damage the body's organs. In type 2 diabetes, the body either doesn't produce enough insulin to function properly, or the body's cells don't react to insulin. Around 90% of adults with diabetes have type 2, and it tends to develop l Continue reading >>
