Insulin Producing Cell Pouch Approaching Clinical Trials in Humans

January 7th, 2011

A Canadian health sciences company focusing on innovative medical technology has successfully tested an organ-like device containing insulin producing islet cells in animals, and is pursuing FDA approval to conduct clinical trials in humans in 2011. There were no adverse side effects associated with the device during the study, during which the diabetic pigs receiving the insulin delivery system achieved long-term blood sugar control.

Sernova Corporation's patented Cell Pouch System is implanted under the skin, where it develops into what the company refers to as "a tissue engineered pancreas" when infused with islet cells. The islet cells deliver insulin to the body, much as the islet cells of the pancreas do in people and animals without insulin dependent diabetes.

Current islet cell transplantation involves removing insulin-producing cells from a donor pancreas and transferring them through a needle directly into the liver of a person with diabetes. The technology is still considered experimental, and is hampered by the body's immune system, which sees the insulin producing cells as foreign invaders and attempts to reject them. The Cell Pouch protects the cells from the immune system, eliminating the need for powerful anti-rejection drugs, which often have serious side effects. The Cell Pouch would be less costly, and requires only about 10% of the insulin producing islets used in the existing islet cell transplant technique.

According to the American Diabetes Association, diabetes is the sixth leading cause of death in the US. The number of American adults diagnosed with diabetes has more than doubled over the past decade, rising from 9 million to 19 million, largely because of soaring obesity rates. While they are more effective, the newer diabetes medications can cost as much as ten times more than the older generic diabetes drugs. Given the option to both save money and avoid daily insulin injections, most diabetics would welcome the option of the new Cell Pouch.

Sernova Corporation says its Cell Pouch System has the potential to treat a wide range of conditions besides insulin dependent diabetes, including Parkinson's disease, spinal cord injury, and hemophilia.

Diabetes Sniffing Dogs Alert Diabetes Patients to Low Blood Sugar

January 25th, 2011

Diabetes alert dogs, also known as hypoglycemia alert dogs, are trained to detect slight changes in breath and body odors associated with high or low blood sugar, and to alert someone when they detect them. Depending on the odor, a dog's sense of smell is said to be 1000 to 100,000 times greater than a human's.

According to researchers and trainers, a sweet, fruity smell is associated with high blood sugar, while an acidic, almost rusty smell is a sign of low blood sugar. "We found that dogs are incredibly accurate," says Claire Guest from Britain's Cancer and Bio-detection Dogs, "They can warn someone immediately when their blood sugar is dropping to a dangerously low level."

It was anecdotal reports from dog owners that first led to research on man's best friend's ability to warn their diabetic owners of an impending dangerous drop in blood sugar. Sixty-five percent of 212 dog owners with type 1 diabetes who took part in one study in Belfast, Ireland reported that their pets would attempt to get their attention just before a hypoglycemic episode. Some would bark or whine, others would lick and nuzzle them repeatedly, some would jump up on them, and others would stare fixedly and intently at their faces. Almost a third of the animals in the study had reacted to at least 11 events before entering the research project, while another third had reacted more than 11 times.

There are potentially severe consequences for diabetics whose blood sugar levels fall sharply, especially during the night. They can suffer a seizure, slip into a coma or even die without waking up. This is particularly worrisome for parents of diabetic children, many of whom are chronically sleep-deprived from getting up to check on their kids throughout the night. Diabetic alert dogs are trained to sleep with the diabetes patients, periodically sniffing their breath. If they notice a fruity odor, they will attempt to wake the patient and/or alert other family members. Some dogs are even trained to bring the diabetic his or her glucose monitoring kit.

Still, trainers warn that the dogs are not always 100 percent effective, and may miss a scent on occasion, or give a false alarm. They are best considered as another tool in the diabetes patient's blood glucose control tool kit. Type 1 diabetes, previously called juvenile diabetes or insulin dependent diabetes, is a form of the disease where the body makes little or no insulin. Without insulin, the body is unable to break down glucose for energy, causing blood sugar (glucose) levels to rise.

Lifelong diabetes medication is necessary for type 1 diabetics, and proper nutrition and exercise are important to maintain good health. Insulin injection has been made easier in recent years with the introduction of the more discreet and convenient insulin pen. Insulin pens are the predominant insulin injection system in most of the world, but for some reason the insulin pen is used less commonly in the United States, although their use is increasing

Texas Researchers Hopeful They Can Eliminate the Need For Insulin Therapy

February 4th, 2011

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Research conducted at the University of Texas Southwestern Medical Center raises the exciting prospect of eliminating the need for insulin in type 1 diabetics by "turning off" the hormone glucagon, which plays a major role in blood sugar regulation.

Like insulin, glucagon is a hormone secreted by the pancreas. Glucagon has the opposite effect of insulin, increasing blood glucose levels rather than lowering them. The pancreas releases glucagon when blood sugar is low, causing the liver to release glucose into the blood stream, and stimulating the release of insulin.

Glucagon prevents low blood sugar in healthy people, but causes high blood sugar in people with type 1 diabetes, whose pancreas can't produce enough insulin to counteract its effect. A synthetic version of glucagon is used to treat severe low blood sugar, or hypoglycemia, in diabetics in emergency situations.

The UT Southwestern researchers genetically altered laboratory mice so that they lacked working glucagon receptors and couldn't react to glucagon. They then gave the mice the glucose tolerance test used to diagnose diabetes. Mice with normal insulin levels but non-working glucagon receptors responded normally to the test.

When their insulin-producing islet cells were destroyed and they lacked both insulin and the ability to use glucagon, they were still able to stabilize their blood sugar, again testing normally. Blocking the action of glucagon essentially made insulin unnecessary for the mice - despite the lack of both glucagon and insulin, the mice did not develop diabetes.

"We've all been brought up to think insulin is the all-powerful hormone without which life is impossible," says researcher and professor of internal medicine Dr. Roger Unger, "But that isn't the case. This doesn't mean that insulin is unimportant - it's essential for normal growth and development. But in adulthood, at least with respect to glucose metabolism, the role of insulin is to control glucagon. If you don't have glucagon, then you don't need insulin."

Insulin injections have been the treatment of choice for type 1 diabetes since its introduction in 1922. But insulin is a treatment, not a cure, and can't restore normal glucose tolerance as blocking the glucagon receptors did in the laboratory mice. It now appears that insulin's benefit results from its suppression of glucagon, and that the blocking of glucagon action restores glucose tolerance to normal.

In the next all-important step, the researchers will be studying the mechanism behind the results to determine how to turn off the glucagon receptors in humans. "If these latest findings were to work in humans, injected insulin would no longer be necessary for people with type 1 diabetes," states Dr. Unger, "If diabetes is defined as restoration of glucose homeostasis to normal, then this treatment can perhaps be considered very close to a cure."

Antibodies Associated with Insulin Resistance Raise Hope of a Diabetes Vaccine

April 28th, 2011

Doctors and researchers have known for a while that excess weight, diet and lack of exercise can all be contributing factors in the development of type 2 diabetes and insulin resistance. Unlike type 1 diabetes, which is known as an immune disease, type 2 diabetes is generally considered a metabolic disorder, and is attributed to poor lifestyle choices. A new study shifts some of the responsibility for the development of their condition away from the patients by shedding light on other possible influences.

For this study, the results of which were published in Nature Medicine, researchers tested blood samples of 32 obese people, and found that the half who had insulin resistance had antibodies that were not present in the half who were obese but not insulin resistant. This suggests that type 2 diabetes may be an immune disorder, and that there is a possibility of developing a vaccine for the condition.

When fat developing in the abdomen runs out of space and becomes constricted the fat cells eventually die, and the immune system sends in cells to clean up the dead fat cells. Among the immune system response cells are T-cells and B-cells, which are responsible for remembering threats to the body and creating antibodies. The antibodies then attack the fat cells, which makes them insulin resistant. This immune response against fat cells is also connected to fatty liver disease, high cholesterol and high blood pressure.

The study also tested the effects on mice of an immune-modifying drug called anti-CD20. Mice were fed a diet that was 60% fat, and after six and seven weeks some of the mice received the drug. The mice who were given the drug had normal blood sugar levels, and did not develop insulin resistance, whereas the control mice did become insulin resistant. However, anti-CD20 can have serious side effects and can negatively affect the immune system, so it is likely that it will not be used any time soon as a diabetes medication.

While the findings of this study are promising, more research needs to be done. The mice and human subjects were all male, so it is not known whether the results apply to females. Currently, type 2 diabetes is treated first with lifestyle changes such as diet and exercise, sometimes combined with oral diabetes medication. Over time, many type 2 diabetics require insulin injections to control their blood sugar.

Online Diabetes Community Invited to Contribute to Video Project

June 17th, 2011

Kim Vlasnik, an insulin dependent type 1 diabetic since the age of six, found welcome support through the online diabetes community. She has been writing the cheeky diabetes blog Texting My Pancreas (a name inspired by her insulin pump) since 2010. "Living with diabetes feels much more bearable when I think of it as a team sport," she writes on her About Me page.

Now the ambitious Vlasnik has launched a companion video project to strengthen the online community and to lessen the isolation, depression, anxiety and frustration often caused by diabetes. The project, called You Can Do This, invites diabetics to create and share videos of their personal challenges to show others they can get through the tough times.

Vlasnik believes that everyone with diabetes struggles at one time or another, and that validation and community can lighten the emotional load. "Tell us your stories," she invites her readers, "Show others what living with diabetes is really like - no sugar-coating. Talk about the tough stuff. Show us how you've dealt with it. Let others see their own struggles and feeling through your words."

Launched June 15th, 2010, the site had almost fifty videos uploaded in its first two days, and numerous positive comments posted by grateful fans. Texting My Pancreas and the You Can Do This Project can be found at www.textingmypancreas.com.