The Top Ten Diabetes Research Stories of 2010

April 14th, 2011

neon news sign

According to Gary Gilles, About.com's Diabetes Guide and a health writer, educator and counselor, 2010 was an auspicious year in diabetes research and treatment, with many exciting developments.

Gilles has compiled what he considers to be the Top Ten Diabetes Research Stories of 2010. They include the first generation artificial pancreas, an implantable blood glucose sensor, the world's smallest insulin pen needle, a potential diabetes vaccine, and an organ-like insulin-producing cell pouch implant.

To read more about Gilles top picks in his article on About.com, click >HERE<.

Promising New Drug to Treat Diabetic Kidney Disease

April 25th, 2011

There's a promising new drug to treat a common complication of diabetes, diabetic nephropathy. Diabetic nephropathy is kidney disease or damage resulting from high blood sugar levels damaging kidney cells. Diabetic kidney disease is the most common type of kidney disease.

The experimental anti-fibrotic and anti-inflammatory drug, pirfenidone, not only stopped kidney deterioration, it actually improved kidney function in study participants. A randomized, double-blind of 77 diabetes patients showed dramatic results in the group receiving the lowest dose of pirfenidone.

Pirfenidone works differently than the diabetes drugs currently in use, which treat high blood pressure and lower blood sugar levels. Pirfenidone seems to work by shutting down the growth factors that cause fibrosis, or scarring in blood vessels.

The next step is to perform larger clinical trials. To read more about this exciting potential advance in treating kidney disease online at Science Daily, >CLICK HERE<.

Scientists Discover Why Oral Diabetes Medication Causes Weight Gain

May 3rd, 2011

Thiazolidinediones, also known as glitazones, are a widely prescribed class of oral diabetes medications. The most commonly used thiazolidinedione is prescription Actos, also known as generic pioglitazone. Thiazolidinediones act by binding to a group of receptor molecules called PPAR-y which regulate the production of fat cells, improving their receptivity to insulin and therefore reducing insulin resistance.

Although effective, pioglitazone has a down side - one of Actos side effects is considerable weight gain. This is of particular concern to diabetics, many of whom have been instructed to lose weight to help control their condition.

Before this study, it was believed that weight gain in patients taking oral diabetes medication was due to PPAR-y's effect on fat cells. Researchers at the University of Cincinnati (UC) have now discovered that the diabetes medication delivers a double-whammy. It not only stimulates the production of fat cells, it also causes changes in the part of the brain which effects appetite, increasing hunger.

The researchers also conducted experiments to see if the PPAR-y molecular system is activated by a high fat diet. Experiments with animals showed that to be the case. This suggests that Americans' fondness for high-fat foods that activate PPAR-y might be contributing to our rising rates of obesity, and the associated increase in diabetes.

According to lead researcher Randy Seeley, PhD, PPAR-y is a system designed to promote eating more and gaining weight. "It tells your brain to eat more, and it tells your fat tissue to add new fat cells to serve as repositories to store those extra calories," explains Seeley, a UC professor.

It's hoped that these discoveries may lead to modified diabetes medications that still lower blood sugar, but without impacting the part of the brain effecting appetite. "If you artificially turn on PPAR-y, you can increase food intake in rats," explained Seeley, "[But] if you block these receptors in animals on high fat diets that make animals obese, they gain less weight."

Seeley stresses the importance of understanding how what we eat affects our bodies. "We know that one way to activate PPAR-y is by exposing cells to fatty acids," he points out, "If we know which ones activate PPAR-y, we could find ways to alter diets so as to limit their ability to turn on this system that drives increased food intake, making it easier for people to avoid weight gain."

Pancreatic Cell Breakthrough May End Need for Insulin Therapy

May 6th, 2011

In a potential breakthrough that could lead to a cure for type 1 diabetes, scientists at the University of California, Los Angeles (UCLA) have found a way to alter the DNA of pancreas cells to turn them into insulin producing beta cells.

Beta cells are a type of cell in areas of the pancreas called islets of Langerhans. These beta cells produce insulin, a hormone that regulates blood sugar. Beta cells react quickly to spikes in blood glucose by releasing insulin into the bloodstream, and producing more. They also produce C-peptide and amylin, which contribute to blood sugar control and prevent nerve disorders associated with diabetes.

In type 1 diabetes, the body's immune system attacks and destroys the pancreas' beta cells, leading to a lack of insulin. Type I diabetes is fatal unless treated with insulin injections (insulin is destroyed in the stomach, and can't be taken orally).

The UCLA scientists report they may have discovered an underlying mechanism that could convert other types of cells into insulin producing pancreatic beta cells. It's been assumed that cells were immutable and could not be altered, but recent studies indicate that some cells can be "coaxed" into changing into other cells.

But it's now known that chemical tags called methyl groups that bind to DNA can activate or deactivate the actions and identities of certain genes. "Our work shows that beta cells and related endocrine cells can easily be converted into each other," reports study co-author Dr. Anil Bhushan form the UCLA Department of Molecular, Cell and Developmental Biology.

The UCLA findings suggest that a defect in beta cells' DNA methylation keeps a gene that triggers the ability to produce insulin "silent". The researchers are hopeful that knowledge can lead to discovery of a mechanism to produce functioning beta cells.

Converting other pancreatic cells to insulin producing beta cells would also benefit those with the much more common type 2 diabetes. In type 2 diabetes, beta cells decline over time. Type 2 diabetics either can't produce enough insulin, or develop insulin resistance, a condition where insulin becomes less effective at lowering blood sugar.

Almost 26 million American adults and children have diabetes, and that number is rising so rapidly that the International Diabetes Association has called the disease "the epidemic of the 21st century". Although the techniques to manipulate non-beta pancreatic cells into insulin producing beta cells are still emerging, the prospect of an eventual end to the need for diabetes medication brings new hope to all those impacted by the disease.

High Tech Tools for Diabetes Control

May 11th, 2011

insulin pump
It's hard to believe that insulin has only been around as a diabetes treatment since 1922. A pair of Canadians, Dr. Frederick Banting and Charles Best, discovered how to extract insulin from animal pancreases, and then used the insulin to treat diabetes in humans. Stories are told of how they went to hospitals and, with a single insulin injection, resuscitated diabetes patients who were already in a coma.

Originally, all insulin was extracted from animals. In the 1970's, researchers started using recombinant DNA technology to produce pure analogues of human insulin. In the last century, diabetes medication and management has progressed by leaps and bounds, including the introduction of long acting insulin in 2003.

The first FDA approved insulin pump hit the market in 1983, and dibetes management technology has greatly advanced in the last couple of decades. WebMD has researched four noteworthy high tech tools for insulin control, including continuous glucose monitors, insulin pumps, a combination of a continuous glucose monitor and an insulin pump, and diabetes information management software that allows the monitor and pump to operate much like an artificial pancreas.

To read the entire article on WebMD, >CLICK HERE<.

Enzyme Discovery May Lead to New Diabetes Medication

May 13th, 2011

Researchers at the Salk Institute for Biological Studies have discovered a mechanism that stimulates glucose production in the liver in response to a drop in blood sugar. Histone deacetylasses (HDACs) are a group of enzymes that respond to what researchers call "fasting signals".

Fasting signals kick in after long periods without food, such as overnight. HDACs are situated in liver cells, usually outside of the nucleus. The Salk researchers discovered that they move rapidly into the cell in response to fasting signals, and turn on the genes that produce glucose.

After a meal, the hormone insulin normally prompts cells to store glucose for future fuel, and turns off the liver's sugar production to avoid blood glucose from getting too high. Many people with type 2 diabetes have insulin resistance, a condition in which the body no longer responds properly to insulin, allowing the liver to continue manufacturing glucose, resulting in high blood sugar.

Currently, most type 2 diabetics are prescribed an oral diabetes medication called metformin (marketed as Glucophage XR) to help control their blood sugar levels. "Metformin is originally derived from a plant found in Western Europe called 'French lilac' or 'Goat's Rue because goats don't like to eat it, explains scientist Reuben Shaw, Ph.D., "They steered clear of the plant because it contains a compound that acts naturally to lower blood glucose in animals that eat it to prevent them from eating it again."

Shaw researched metformin to find out how it helped insulin to control blood sugar. He discovered it binds to AMPK, a metabolic regulating enzyme which blocks glucose production in the liver. A graduate student in his laboratory, Maria Mihhaylova, then delved into targets of AMPKs relevant to diabetes, eventually focusing on a family of HDACs called class II HDACs.

In collaboration with two other labs, Mihhaylova discovered that HDACs only controlled glucose synthesizing enzymes in response to the fasting hormone glucagon. "In response to the glucagon, chemical modifications on class II HDACs are removed, and they can translocate into the [liver cell] nucleus", she explains.

The team went on to perform tests on mice with dramatic results - suppression of HDACs restored blood glucose levels to near normal in four different models of type 2 diabetes. "These exciting results show that drugs that inhibit the activity of class II HDACs may be worthwhile to be pursued as potential diabetes drugs," says Shaw.

The search for a new and improved diabetes medication may get a boost from current cancer research - prescription drug companies have been developing HDAC inhibitors as anti-cancer drugs. Shaw hopes that some of the compounds they have developed could have therapeutic potential for the treatment of insulin resistance and diabetes, whether or not they are effective against cancer.

To view Shaw's explanation of his team's discovery on YouTube, >CLICK HERE<.

Dietary Supplement Could Replace Diabetes Medication

May 24th, 2011

grapefruit

Could the common grapefruit hold the key to avoiding or treating both type 2 diabetes and high cholesterol? A pre-meal supplement currently in clinical trials in the US could change the way your body reacts to both fats and sugars.

A nano-dietary supplement which substantially reduces the amount of fat and sugar the body absorbs from a meal has been developed in a collaboration between Boston's Harvard University and the Hebrew University of Jerusalem.

The supplement contains naringenin, the flavonoid that gives grapefruit its bitter taste. In studies with rats, a single dose of naringenin taken just before a high fat and high sugar meal increased insulin sensitivity by an impressive 64%, and reduced the generation of bad cholesterol by a substantial 42%.

The researchers had previously established that the bitter molecule had the potential to treat diabetes, arteriosclerosis (hardened fat in the arteries) and hypermetabolism (increased metabolism, accompanied by insulin resistance), but had to contend with the fact that absorption of naringenin in its natural from is very low.

They were able to increase naringenin's absorption rate by 11 times by creating a nano-complex of naringenin within a ring of sugar called cyclodextrin. As an added bonus, the sugar makes the bitter naringenin more palatable.

"The complex is special in that it is taken just before a meal as a preventative measure," explains Yaakov Nahmias from the Hebrew University, "In comparison, existing medications are given only after the chronic development of abnormal lipid [and sugar] levels in the blood."

Naringenin activates a family of small proteins called nuclear receptors, which cause the liver to break down fatty acids. It appears to mimic the action of both lipid lowering drugs such as Tricor (generic fenofibrate), and diabetes medication such as Avandia (generic rosiglitazone), without any undesired side effects. Naringenin not only combats high levels of cholesterol and other fats in the blood; it also improves the body's sensitivity to insulin, reducing insulin resistance.

The researchers have applied for patents, and the supplement is undergoing clinical trials in the US. They are hopeful that the complex may be an effective future preventative and treatment for diabetes, arteriosclerosis and hypermetabolism.

Lipid Profiling Can Predict Diabetes Risk Better than Current Methods

June 2nd, 2011

Studying the genetic make-up of lipids, or fatty molecules, in the blood (lipidomic profiling) can lead to improved and earlier prediction of the risk of developing diabetes, atherosclerosis and heart disease.

A ten-year study of about 1100 Mexican Americans - a group at high risk of diabetes - discovered that a single predictor, a lipid component called dihydroceramide (dhCer), was substantially increased in people with diabetes.

Dihydroceramide is genetic, and appears to be an independent risk factor with no connection to blood sugar and insulin levels. In the future, measurement of dhCer levels may become part of routine screenings for diabetes, allowing health care providers to identify those at risk long before existing screening procedures.

Those identified as being at risk could then make lifestyle changes such as losing weight, becoming more physically active and improving their diet to avoid becoming diabetic.

Currently, the most commonly used predictors are measurements of blood glucose and insulin levels, which do not provide useful information until the patient is close to developing or has already developed insulin resistance or diabetes.

The discovery of the link between dhCer and diabetes could also lead to new and more effective means of diabetes control. To read more about lipid genetics on ScienceDaily, >CLICK HERE.<

Type 1 Diabetics Respond Well to New Type 2 Diabetes Medication

June 8th, 2011

Type 1 diabetics given a recently approved type 2 diabetes medication in addition to their insulin therapy experienced a "dramatic change" in their health. They had more stable blood sugar levels, needed less insulin, and even lost an average ten pounds over six months.

The FDA approved Victoza as a once-daily injection to treat type 2 non insulin dependent diabetes in adults in early 2010. Although it is injected, Victoza is not a type of insulin. Victoza (generic name liraglutide) belongs to a new class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists.

GLP-1 receptor agonists mimic the action of a natural peptide which helps the pancreas to make more insulin after a meal. They also slow the absorption of sugar in the stomach, act as an appetite suppressant, and lower levels of glucagon, a hormone which counteracts the effect of insulin.

Researchers at the State University of New York conducted a clinical study with 14 type 1 diabetics whose blood sugar was well controlled using an insulin pump. Although their insulin therapy was effective, all the study participants showed unpredictable peaks and dips in their blood sugar levels.

When Victoza was added to their insulin therapy, all 14 saw their blood sugar quickly stabilize. Within a week, their fasting and blood sugar levels fell an average 15 percent. The longer they took Victoza, the less insulin they required. Both their mealtime and all-day insulin dosing lowered about 30 percent. Those that continued in the study for six months experienced even less need for insulin.

Lowering the levels of insulin suppressing glucagon appears to be of much more benefit to type 1 diabetics than had been anticipated. "Over a protracted period of time, as their diabetes continues to be well controlled, there is delightful improvement in patients' well being," says study leader Dr. Paresh Dandona.

Prescription Byetta (generic name exenatide) is a similar GLP-1 receptor agonist also recently approved by the FDA. Exenatide mimics the action of incretin hormones to lower blood sugar. Byetta is injected twice daily. Byetta has not yet been tested in type 1 diabetes, but the researchers believe both type 2 diabetes drugs would have the same effects.

Both liraglutide and exenatide are normally prescribed in combination with diet, exercise, and other diabetes medication. Neither Victoza or Byetta are FDA approved for use in type 1 diabetes, and Dandona advises that they should only be prescribed off-label by an endocrinologist specializing in diabetes treatment. Dandona is pursuing funding for a larger study.

Insulin has Direct Effects On the Brain

June 9th, 2011

Researchers from the Max Planck Institute for Neurological Research (MPINR) claim to have proven that insulin has direct effects on the reward centers of the brain. In a recent article in Cell Metabolism outlining their work the MPINR team explained that they set out to better understand the "reward" aspects of food and how insulin influences brain function.

Unlike earlier studies that had focused on insulin's effect on the feeding behavior related hypothalamus, the team focused on neurons in the brain that release dopamine, a brain chemical that plays a role in reward and motivation. They found that insulin causes the dopamine-releasing neurons to fire more frequently.

Mice whose insulin receptors were inactivated to no longer respond to insulin overate and became obese. They also showed an altered response to sugar and cocaine when their food supply was limited, further suggesting that the brain's reward centers require insulin to function normally.

The findings suggest that insulin resistance may help to explain why many obese individuals find it so difficult to resist food and lose weight. "Insulin resistance may drive a vicious cycle," explains MPINR's Jens Bruning, "There is no evidence that this is the beginning of the road to obesity, but it may be an important contributor to obesity and to the difficulty we have in dealing with it.

The next step is to conduct functional magnetic resonance imaging (MRI) scans in human subjects who have had insulin artificially delivered to the brain to observe its effects on their reward centers.

To read the article in Cell Metabolism, >CLICK HERE.<

"Super Mice" Suggest Promising New Approach to Diabetes Medication

June 14th, 2011

lab mice

Scientists at the prestigious Mayo Clinic are excited about a promising prospective treatment for type 2 diabetes. Type 2 diabetes is a result of the body losing sensitivity to insulin and no longer being able to respond to it. Current diabetes treatments concentrate on increasing insulin levels - either by administering insulin injections, or by stimulating the pancreas to produce more insulin.

A Mayo Clinic Department of Neuroscience research team, led by Malcolm Leissring, Ph.D, took a different approach - blocking the breakdown of insulin after it was released by the pancreas. Conducting studies in mice, the researchers genetically deleted an insulin-degrading enzyme, or IDE, which breaks insulin down into smaller pieces to help control insulin levels in the blood.

The IDE-less rodents were "super mice" in regards to their ability to lower their blood sugar after a meal (a problem for many diabetics). They also had higher insulin levels, weighed less, and had better overall blood sugar control.

"Insulin levels in the blood reflect the balance between how much is secreted and how fast it is broken down," explains Leissring, "Blocking the breakdown of insulin is simply an alternative method for achieving the same goals as existing diabetes therapies."

Unfortunately, IDE inhibitors will need some work before they can be used in humans. The "super mice" eventually overdosed on the trial diabetes drug, becoming insulin resistant and developing classic type 2 diabetes. "It's an example of too much of a good thing becoming bad for you, explains researcher Samer Abdul-Hay, Ph.D, "Deleting all IDE is overkill". He believes that drugs that only partially or temporarily inhibit IDE could be effective long-term diabetes medications.

The study also raises some interesting questions about how diabetes starts. Diabetes is usually believed to cause hyperinsulinemia, or excess insulin levels in the blood. But as the "super mice" with IDE-elevated insulin levels aged, it worked the other way around - the mice lost insulin receptors, became insulin resistant, and developed type 2 diabetes.

Dr. Leissring and his team are currently working on developing more IDE inhibitors, stressing that they in the "early, but exciting days" of their research, and are still unsure if the results will apply to humans. The American Diabetes Association recently awarded them a five-year development grant - a solid indication of its interest in and support for this new avenue of diabetes research.

Oil Refining Expertise Being Applied to Closed Loop Artificial Pancreas

June 15th, 2011

Engineers from the Rensselaer Polytechnic Institute are building on automation techniques used in oil refining to create a closed-loop artificial pancreas for type 1 diabetics. The Institute's Professor B. Wayne Bequette, whose sister developed diabetes early in life, has been fine tuning an increasingly advanced diabetes control system for six years.

The pancreas of a type 1 diabetic produces little or no insulin, leaving them dependent on insulin injections. Blood sugar and insulin levels rise and fall normally during the day, responding to factors like meals, the type of food eaten, stress and exercise. Diabetics must monitor their blood sugar levels frequently, and adjust their insulin dose accordingly.

Bequette's artificial pancreas marries an insulin pump with a continuous glucose monitoring system. The combination quickly and accurately identifies and responds to rapid variations in blood sugar and insulin levels, eliminating the need for frequent testing and guesswork.

To read more about Bequette and his fellow researcher's work on theEngineer >CLICK HERE.<

Caffeine Increases Insulin Resistance

June 20th, 2011

Add your daily cup of java to the list of things that can makeit more difficult to control your diabetes. A growing body of research indicates that caffeine disrupts glucose metabolism and increases insulin resistance, even in people that don't have diabetes.

The findings raise concerns that caffeine's tendency to increase insulin resistance could increase the risk of developing diabetes, or lead to poor control of the disease in those that already have it.

In people with type 2 diabetes, the expected rise in blood sugar after eating carbohydrates is exaggerated if they also drink a caffeinated beverage. This larger than anticipated rise in blood glucose could throw off diabetics' calculations of the required dosage of diabetes medication, including insulin injections.

This is further complicated by the fact that people metabolize coffee at different speeds, and that both slow and fast metabolizers are common in the general population.

Caffeine is not only found in coffee, but also in tea, soft drinks and in energy drinks. Caffeine's impact on glucose metabolism was reported on in the inaugural issue of the Journal of Caffeine Research: The International Multidisciplinary Journal of Caffeine Science.

"The links that have been revealed between diabetes and the consumption of caffeine beverages - especially coffee - are of monumental importance when it is acknowledged that more than 80 percent of the world's population consumes caffeine daily," says the new journal's editor in chief, Jack E. James.

Dramatic Increase in Life Expectancy for Type 1 Diabetics

June 27th, 2011

ScienceDaily (2011-06-25) -- The life expectancy of people diagnosed with Type 1 diabetes between 1965 and 1980 dramatically increased, compared to people diagnosed with Type 1 diabetes between 1950 and 1964, according to a new study. ... > http://www.sciencedaily.com/releases/2011/06/110624182309.htm read full article

Diabetes Discoveries Could Lead to Better Blood Glucose Control

June 30th, 2011

New discoveries in diabetes suggest novel ways to treat, delay the disease

ScienceDaily (2011-06-22) -- A new signal pathway that renders the insulin-releasing beta cell more sensitive to high levels of blood glucose has been discovered by researchers in Sweden. A second new study reveals a possible way to delay the disease by inhibiting a lipoprotein.

A new joint study published in Nature Medicine and conducted by researchers at Karolinska Institutet's Department of Molecular Medicine and Surgery and their American colleagues provides new insights into how beta cells react to raised concentrations of blood sugar, which occur, for example, after a meal.

... > read full article

Thirty Seven Strawberries a Day Keep the Doctor Away

July 5th, 2011

A flavonoid called fisetin, found in abundance in strawberries, has been found to lessen complications of diabetes in mice. Fisetin is a neuroprotective flavonoid that can target multiple organs, suggesting that a single natural remedy could be developed to address numerous diabetes complications.

But obtaining a protective patent to bring a natural product like fisetin to market is difficult, meaning further research is stalled until researchers can find someone willing to support a clinical trial. Read more about the benefits of strawberries and the recent research on fisetin and diabetic complications on Diabetic Live.

Researchers Invent New Drug Delivery Device to Treat Diabetes-Related Vision Loss

July 6th, 2011

ScienceDaily (2011-06-29) -- Engineers and scientists have developed a device that can be implanted behind the eye for controlled and on-demand release of drugs to treat retinal damage caused by diabetes. Diabetic retinopathy is the leading cause of vision loss among patients with diabetes. The disease is caused by the unwanted growth of capillary cells in the retina, which in its advanced stages can result in blindness.

The novel drug delivery mechanism is detailed in the current issue of Lab on a Chip, a multidisciplinary journal on innovative microfluidic and nanofluidic technologies.

Read the full article...

Stem Cell "Memory" Can Boost Insulin Levels

July 15th, 2011

ScienceDaily (2011-07-14) -- Scientist have now derived embryonic-like stem cells from adult stem cells that appear to retain their effectiveness in producing insulin in the human body. This research may promise a new avenue of treatment that avoids costly and dangerous pancreas transplants.

Stem cells from early embryos can be coaxed into becoming a diverse array of specialized cells to revive and repair different areas of the body. Therapies based on these stem cells have long been contemplated for the treatment of diabetes, but have been held back by medical and ethical drawbacks.

Read full article...

Swamp Gas Plays a Role in Diabetes Control

August 9th, 2011

The last decade has been an exciting time in diabetes research, with scientists approaching diabetes control from many different angles. Enter hydrogen sulfide, the foul smelling gas better known as "swamp gas". It turns out the sewer-scented compound, a substance that occurs naturally in our bodies, may play an important role in protecting blood vessels from diabetic complications.

In a finding that they say "may open the door for new therapies", researchers discovered that providing cells with high levels of hydrogen sulfide protected them against the toxic effects of sugar.

To read the full story on diabeticlive.com, a news publication focused on the latest research in diabetes drugs, diets, and medical advances, >CLICK HERE.<