Clinical Trials And The Type 1 Diabetes Cure

Clinical Trials and the Type 1 Diabetes Cure

WRITTEN BY: Stephen Gitelman, MD
I am often asked the question, “Where is the cure for Type 1 diabetes (T1D)?” For those with long-standing diabetes, we are very close to replicating insulin producing beta cell functionality or the actual replacement of those cells — either with closed loop systems with continuous glucose sensor driving an insulin pump, or use of replacement beta cells derived from stem cells.
However, as a Pediatrician, I think the ultimate cure for T1D will be prevention. Why can’t we screen and predict who is at risk, and then prevent someone from getting Type 1 diabetes in the first place?
It turns out that T1D occurs in about 1 in 300 people in the general population, but if you already have someone in your family with diabetes, like a brother or sister, then the risk jumps to a 1 in 20 chance of developing Type 1 diabetes. This is why researchers in an NIH sponsored international research effort called TrialNet have been focusing prevention efforts on families with at least one T1D.
T1D results from both underlying genetic risk and environmental exposures, but researchers are still working to determine these specific factors. Thanks to some of this work, we now have the ability to predict who will get T1D, in some cases as long as 10-20 years before it happens (see figure). Researchers use three different pieces of information for prediction. First, we look at the immune system. This is done with a simple blood test, measuring up to five different autoantibodies that the immune system might produce against beta cells. If no abnormality is foun Continue reading

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Type 2 diabetes can be cured through weight loss, Newcastle University finds

Millions of people suffering from Type 2 diabetes could be cured of the disease if they just lost weight, a new study suggests.
Scientists at Newcastle University have shown the disease is caused by fat accumulating in the pancreas and losing less than one gram from the organ can reverse the life-limiting illness and restore insulin production.
Type 2 diabetes affects 3.3 million people in England and Wales and, until now, was thought to be chronic. It can lead to blindness, stroke, kidney failure and limb amputation.
“For people with Type 2 diabetes, losing weight allows them to drain excess fat out of the pancreas and allows function to return to normal”
Professor Roy Taylor, Newcastle University
But now researchers at Newcastle have shown that the disease can be reversed, even in obese people who have had the condition for a long time.
18 obese people with Type 2 diabetes who were given gastric band surgery and put on a restricted diet for eight weeks were cured of their condition. During the trial the patients, aged between 25 and 65, lost an average of 2.2 stone, which was around 13 per cent of their body weight. Crucially they also lost 0.6 grams of fat from their pancreas, allowing the organ to secrete normal levels of insulin.
The team is now planning a larger two year study involving 200 people with Glasgow University to check that the findings can be replicated and weight loss can be sustained for two years.
“For people with Type 2 diabetes, losing weight allows them to drain excess fat out of the pancreas and allows function to return to normal,” said Pro Continue reading

Diabetes is on a rapid rise through sub Saharan Africa

In the 1990s diabetes was seen as a condition that mainly affected rich people in high income countries. Nowadays, it’s one of the leading contributors to death in all countries in the world, driven by increases in national and personal wealth resulting in people having more disposable income. In addition, urbanization has led to more and more people living sedentary lifestyles. A commission of experts, which was set up in 2014 to tackle the challenge in Africa, have recently released their findings. The Conversation’s health and medicine editor Candice Bailey spoke to professor Justine Davies about the importance of the commission and what good it can do.
What do we know about diabetes in Africa? Why is there a concern?
About 95% of cases around the world are type 2 diabetes, which is associated with obesity. The impact of diabetes is becoming much greater in poorer countries and regions. Sub-Saharan Africa is home to 34 of the world’s 48 least developed countries. In lower-income countries, even though national and personal wealth is increasing, health systems are not developed enough to cope with the increasing numbers, or the long-term consequences of diabetes such as heart attacks, strokes, blindness, and kidney failure.
The health fraternity has a good idea diabetes rates in Africa are increasing but they don’t know enough about the number of people with the disease. The health fraternity has a good idea that diabetes rates on the continent are increasing but they don’t know enough about the number of people with the disease. For example, a recent study foun Continue reading

Diabetes Insipidus

On this page:
What is diabetes insipidus?
Diabetes insipidus is a rare disorder that occurs when a person's kidneys pass an abnormally large volume of urine that is insipid—dilute and odorless. In most people, the kidneys pass about 1 to 2 quarts of urine a day. In people with diabetes insipidus, the kidneys can pass 3 to 20 quarts of urine a day. As a result, a person with diabetes insipidus may feel the need to drink large amounts of liquids.
Diabetes insipidus and diabetes mellitus—which includes both type 1 and type 2 diabetes—are unrelated, although both conditions cause frequent urination and constant thirst. Diabetes mellitus causes high blood glucose, or blood sugar, resulting from the body's inability to use blood glucose for energy. People with diabetes insipidus have normal blood glucose levels; however, their kidneys cannot balance fluid in the body.
What are the kidneys and what do they do?
The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the kidneys normally filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder.
How is fluid regulated in the body?
A person's body regulates fluid by balancing liquid intake and removing extra fluid. Thirst usually controls a person Continue reading

Fruits for Diabetes: All You Need to Know

Eating fruit is a delicious way to satisfy hunger and meet daily nutritional needs. However, most fruits contain sugar, which raises questions about whether they are healthy for people who have diabetes.
Is fruit unhealthy for people with diabetes? This article will look at what you need to know about fruit and diabetes.
Contents of this article:
What is fruit?
Most people can probably name several fruits such as oranges and apples, but not know why they are fruits. Fruits contain seeds and come from plants or trees. People eat fruits that are stored in many ways - fresh, frozen, canned, dried, and processed.
But aren't tomatoes and cucumbers also fruits because they have seeds? There are many foods that are classed as fruits that may surprise some people. Tomatoes, cucumbers, avocados, peas, corn, and nuts are all fruits.
It's fine to think of tomatoes and cucumbers as vegetables rather than fruits, however. What's important is how much energy (calories) and nutrients each food has.
The bottom line: it's not important to know the difference between fruits and vegetables but to know that both are good for health.
Does eating fruit play a role in managing diabetes?
Eating enough fiber plays an important role in managing diabetes. A diet high in soluble fiber can slow the absorption of sugar and control blood sugar levels. Many fruits are high in fiber, especially if the skin or pulp is eaten.
Many fruits are filling because they contain fiber and a lot of water.
Diets containing enough fruits and vegetables can reduce the risk of obesity, heart attack, and stroke. Obesity ha Continue reading