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A Quest: Insulin-Releasing Implant For Type-1 Diabetes

A Quest: Insulin-Releasing Implant For Type-1 Diabetes

A Quest: Insulin-Releasing Implant For Type-1 Diabetes

Scientists in California think they may have found a way to transplant insulin-producing cells into diabetic patients who lack those cells — and protect the little insulin-producers from immune rejection. Their system, one of several promising approaches under development, hasn't yet been tested in people. But if it works, it could make living with diabetes much less of a burden.
For now, patients with Type-1 diabetes have to regularly test their blood sugar levels, and inject themselves with insulin when it's needed.
Some researchers are developing machines to automate that process.
But Crystal Nyitray, founder and CEO of the biotechnology startup Encellin, in San Francisco, didn't want to use a machine to treat diabetes. As a graduate student in bioengineering at the University of California, San Francisco a few years ago, Nyitray wanted to try something different: living cells.
"Cells are the ultimate smart machine," she says. Clinical trials that transplant insulin-making pancreatic cells into people with diabetes have been underway for several years, with some success. But the recipient's immune system is hard on these transplanted cells, and most patients still need insulin injections eventually.
Nyitray and colleagues designed a system that would encase live islet cells from the pancreas in a flexible membrane that could be implanted under the skin. Insulin and blood sugar could pass through the membrane, but cells from the recipient's immune system would be kept out, preventing immune rejection.
"I think of it like if you're sitting in a house and you have the win Continue reading

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How Diabetes Got To Be The No. 1 Killer In Mexico

How Diabetes Got To Be The No. 1 Killer In Mexico

Mario Alberto Maciel Tinajero looks like a fairly healthy 68-year-old. He has a few extra pounds on his chest but he's relatively fit. Yet he's suffered for the last 20 years from what he calls a "terrible" condition: diabetes.
"I've never gotten used to this disease," he says. Maciel runs a stall in the Lagunilla market in downtown Mexico City. This market is famous for its custom-made quinceañera dresses and hand-tailored suits.
Diabetes has come to dominate Maciel's life. It claimed the life of his mother. He has to take pills and injections every day to keep it under control.
And because of the disease he's supposed to eat a diet heavy in vegetables that he views as inconvenient and bland. "Imagine not being able to eat a carnitas taco!" he says with indignation. His doctors have told him to stop eating the steaming hot street food that's for sale all around the market — tacos, tamales, quesadillas, fat sandwiches called tortas. His eyes light up when talks about the roast pork taquitos and simmering beef barbacoa that he's supposed to stay away from.
"A person who has to work 8 or 10 hours has to eat what's at hand, what's available," he says. "It's difficult to follow a diabetic diet. The truth is it's very difficult."
Diabetes is the leading cause of death in Mexico, according to the World Health Organization. The disease claims nearly 80,000 lives each year, and forecasters say the health problem is expected to get worse in the decades to come. By contrast, in the U.S. it's the sixth leading cause of death, with heart disease and cancer claiming 10 times more Ame Continue reading

Diabetes has become one of America’s most expensive diseases

Diabetes has become one of America’s most expensive diseases

With an estimated 30 million Americans struggling with diabetes, the disease is one of the nation’s most entrenched chronic conditions. It’s also one of the most expensive.
Consider these facts:
▪ In California, roughly 55 percent of adults either have diagnosed diabetes or blood-sugar levels that put them at high risk of developing the disease. That includes roughly 1 in every 3 adults ages 18 to 39 – a finding researchers call alarming.
▪ In terms of personal health care spending, diabetes tops the nation’s list of 155 chronic conditions, hitting $101.4 billion in 2013. According to the American Diabetes Association, average medical expenditures for people with diabetes are an estimated 2.3 times higher than for those without it.
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▪ The cost of insulin alone has spiked by triple-digit percentages in the past 20 years.
“It’s horrible for patients,” said N. Chesney Hoagland-Fuchs, a registered nurse and chairwoman of the Diabetes Coalition of California. She said prices for insulin medications began a slow climb after the recession and started “shooting up” around 2013.
Over the past 20 years, the price of human insulin produced by two major manufacturers – Eli Lilly and Novo Nordisk – rose 450 percent, after accounting for inflation, according to a 2016 Washington Post analysis of data from Michigan-based Truven Health Analytics. A single 10-milliliter vial of Eli Lilly’s Humalog insulin – less than a month’s supply for many adult Continue reading

The Best and Worst Diabetes Food Advice I've Seen

The Best and Worst Diabetes Food Advice I've Seen

The lame food advice at my diagnosis, why it didn’t work, and my #1 Bright Spot solution
I’ll never forget the diabetes food advice I received from my doctor at diagnosis:
“You can eat whatever you want, as long as you take insulin for it.”
In my view, this advice is misleading, overly simplistic, and damaging. In fact, I’d nominate it for the “worst” diabetes food advice out there. Unfortunately, those who are newly diagnosed tell me it is still common. Ugh.
Eating “whatever I wanted” and taking insulin for it was the worst kind of blank check – it set me up for years of out-of-control high blood sugars, deep and prolonged lows, huge guesstimated insulin doses (and therefore big mistakes), mood and energy swings, and lots of diabetes frustration. My blood sugar rarely stayed in my target range (70-140 mg/dl), since the effort required was so high.
It wasn’t until I took some nutrition classes in college, shared a dorm with a bodybuilder, started writing at diaTribe, and began using a continuous glucose monitor (CGM) that I landed on the food advice below: eating fewer carbs and more fat had a game-changing impact on my diabetes, insulin dosing burden, overall health (including cholesterol), and quality of life. In Bright Spots & Landmines, this advice appears first in the book for a reason – it’s been the most important tool for improving my life with diabetes. I’ll follow up next month with an updated list of foods I currently eat, recipes, and interesting new food tricks I’ve been testing.
Eat less than 30 grams of carbohydrates at one time. Continue reading

New diabetes treatment teaches rogue immune cells to behave

New diabetes treatment teaches rogue immune cells to behave

(Getty Images)
A treatment targeting wayward immune cells in people with Type 1 or Type 2 diabetes may help even years later, a new study finds.
For the treatment, researchers take blood from a person with diabetes and separate out the immune system cells (lymphocytes). They briefly expose those cells to stem cells from umbilical cord blood from an unrelated infant. Then they return the lymphocytes to the patient's body.
The researchers have dubbed this treatment "stem cell educator therapy," because when exposed to the stem cells, the errant lymphocytes seem to re-learn how they should behave.
"Stem cell educator therapy is a safe approach" with long-term effectiveness, said the study's lead author, Dr. Yong Zhao, an associate scientist at Hackensack University Medical Center in New Jersey.
Type 1 diabetes, an autoimmune disease, occurs when the body's immune system cells mistakenly attack the insulin-producing (beta) cells in the pancreas. This leaves people with Type 1 diabetes with little to no insulin. They need insulin injections to survive.
Researchers have long thought that any cure for Type 1 diabetes would have to stop the autoimmune attack, while regenerating or transplanting beta cells.
But Zhao and his team developed a new approach to the problem — educating the immune cells that had been destroying beta cells so they stop attacking.
In Type 2 diabetes, Zhao said immune cell dysfunction is responsible for chronic inflammation that causes insulin resistance. When someone is insulin-resistant, their body's cells can't properly use insulin to usher sugar from fo Continue reading

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