Diabetes news, discovery and discussion thread

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An oral medication shows benefits treating Type 1 diabetes for at least two years after diagnosis
https://medicalxpress.com/news/2022-03- ... years.html
by University of Alabama at Birmingham

Use of the drug verapamil to treat Type 1 diabetes continues to show benefits lasting at least two years, researchers report in the journal Nature Communications. Patients taking the oral blood pressure medication not only required less daily insulin two years after first diagnosis of the disease, but also showed evidence of surprising immunomodulatory benefits.

Continuing medication was necessary. In the two-year study, subjects who stopped daily doses of verapamil at one year saw their disease at two years worsen at rates similar to those of the control group of diabetes patients who did not use verapamil at all.

Type 1 diabetes is an autoimmune disease that causes loss of pancreatic beta cells, which produce endogenous insulin. To replace that, patients must take exogenous insulin by shots or pump and are at risk of dangerous low blood sugar events. There is no current oral treatment for this disease.

The suggestion that verapamil might serve as a potential Type 1 diabetes drug was the serendipitous discovery of study leader Anath Shalev, M.D., director of the Comprehensive Diabetes Center at the University of Alabama at Birmingham. This finding stemmed from more than two decades of her basic research into a gene in pancreatic islets called TXNIP. In 2014, Shalev's UAB research lab reported that verapamil completely reversed diabetes in animal models, and she announced plans to test the effects of the drug in a human clinical trial. The United States Food and Drug Administration approved verapamil for the treatment of high blood pressure in 1981.
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New method of pancreatic islet cryopreservation marks breakthrough for diabetes cure research
https://medicalxpress.com/news/2022-03- ... rough.html
by University of Minnesota
Engineering and medical researchers at the University of Minnesota Twin Cities and Mayo Clinic have developed a new process for successfully storing specialized pancreatic islet cells at very low temperatures and rewarming them, enabling the potential for on-demand islet transplantation. The breakthrough discovery in cryopreservation is a major step forward in a cure for diabetes.

According to the Centers for Disease Control and Prevention, diabetes is the seventh leading cause of death in the United States, accounting for nearly 90,000 deaths each year. While diabetes management has improved greatly over the 100 years since the discovery of insulin, even the most modern methods remain a treatment for the condition rather than a cure.
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New strategy to preserve insulin-producing cells in diabetes
https://medicalxpress.com/news/2022-03- ... betes.html
by Karolinska Institutet
High blood glucose is responsible for several complications in type 1 and type 2 diabetes. Researchers at Karolinska Institutet in Sweden have identified a new antidiabetic substance that preserves the activity of insulin-producing beta cells and prevents high blood glucose in mice. The study is published in the journal Science Translational Medicine.

Although several families of glucose-lowering agents are currently used in diabetes therapy, none of them can stop or reverse the progression of the disease. Maintenance of adequate beta cell activity is essential to prevent the progression of type 1 and type 2 diabetes.

"In diabetes, beta cells are challenged to produce high amounts of insulin," says the study's first author Erwin Ilegems, senior researcher at the Department of Molecular Medicine and Surgery, Karolinska Institutet. "Our study shows that this leads to a hypoxic state that increases the levels of HIF-1alpha protein, which in turn reduces beta cell activity. By treating diabetic mice with the HIF-1alpha inhibitor PX-478, we successfully decreased their blood glucose levels."
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House votes to cap cost of insulin at $35
Source: ABC News
Congress could soon send to the president's desk a bill that would cap the cost of the lifesaving drug insulin at $35 per month -- a move that could significantly reduce and rein in out-of-pocket drug costs for millions of Americans with diabetes.

The House approved the bill Thursday by a vote of 232-193, with 12 Republicans joining all Democrats in support.

The bill now heads to the Senate, and it could be taken up in the upper chamber in a matter of weeks if there is bipartisan agreement.

Experts say it costs less than $10 a vial to manufacture, yet there are still American families with insurance paying hundreds of dollars per vial of insulin.
Read more: https://www.msn.com/en-us/news/politics ... ar-AAVJuLE
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Treating diabetes without drugs? Novel non-pharmacologic treatments are on the horizon
https://medicalxpress.com/news/2022-04- ... rizon.html
by Jane E. Dee, Yale University
A multi-institutional team including Yale School of Medicine (YSM) has demonstrated the ability to use ultrasound to stimulate specific neurometabolic pathways in the body to prevent or reverse the onset of type 2 diabetes in three different preclinical models. The team, which includes the lab of Raimund Herzog, MD, MHS, at YSM, reported its findings in Nature Biomedical Engineering.

The team of investigators is now conducting human feasibility trials with type 2 diabetic subjects, moving medicine closer to the day when diabetes is no longer monitored and managed with blood sugar tests, insulin injections, and drug treatments. The goal of the studies is to provide a long-lasting treatment for people with type 2 diabetes to alleviate and potentially reverse the disease.

Type 2 diabetes affects millions of people worldwide. The long-term condition results in too much sugar circulating in the bloodstream. Diabetes is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.
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Scientists uncover key cellular mechanism that shows saturated fat can worsen diabetes
https://medicalxpress.com/news/2022-04- ... anism.html
by Nanyang Technological University

Scientists at Nanyang Technological University, Singapore's (NTU Singapore) Lee Kong Chian School of Medicine (LKCMedicine) have mapped a novel cellular pathway that shows that saturated fat contributes to the development of diabetes and can worsen the disease, underscoring its role in metabolic diseases.

Through experiments on laboratory-cultured mouse cells and on mice fed with a diet rich in saturated fat, the NTU Singapore scientists found that saturated fatty acids can degrade a protein called FIT2, triggering a chain of molecular events that cause insulin-producing cells to lose their function and die.

When these cells die, the body's ability to secrete enough insulin in response to carbohydrates is impaired, resulting in diabetes. Partially restoring FIT2 levels in insulin-producing cells, however, could mitigate the damage caused by saturated fat, the scientists found.
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Scientists make new discoveries in the origin and ID of pancreatic endocrine cells
https://medicalxpress.com/news/2022-04- ... crine.html
by University of Geneva
The pancreas is a key metabolic regulator. When pancreatic beta cells cease producing enough insulin, blood sugar levels rise dangerously—a phenomenon known as hyperglycemia—thus triggering diabetes. After discovering that other mature pancreatic cells can adapt and partly compensate for the lack of insulin, a team from the University of Geneva (UNIGE) demonstrates that the stem cells from which beta cells are derived are only present during embryonic development. This discovery puts an end to a long-standing controversy about the hypothetical existence of adult pancreatic stem cells that would give rise to newly differentiated hormone-producing cells after birth. The scientists also succeeded in precisely defining the 'identity card' of pancreatic endocrine cells, which is a promising tool for the production of replacement insulin-secreting cells. These results can be read in Cell Reports and Nature Communications.
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Poor diet associated with increased diabetes risk across all gradients of genetic risk
https://medicalxpress.com/news/2022-04- ... netic.html
by Public Library of Science

Genetic risk factors and diet quality are independently associated with type 2 diabetes; a healthy diet is linked to lower diabetes risk across all levels of genetic risk. That's the conclusion of a study of more than 35,000 US adults publishing April 26th in PLOS Medicine by Jordi Merino of Massachusetts General Hospital, US, and colleagues.

Both genetic and lifestyle factors are known to contribute to individual susceptibility to type 2 diabetes. Previous studies have shown that adherence to a healthy lifestyle is associated with reduced risk of type 2 diabetes across genetic profiles, but whether genetic profiles, in part, interact with lifestyle factors was unclear. In the new study, researchers analyzed data from three extensive cohort studies, including 35,759 U.S. health professionals followed for 902,386 person-years of follow-up.

The team found that, irrespective of genetic risk, a low diet quality, as compared to high diet quality, was associated with a 30% increased risk of type 2 diabetes (Pinteraction=0.69). The relative risk of type 2 diabetes was 1.29 (95% CI 1.25-1.32, P<0.001) per standard deviation increase in the global polygenic score—one measure of genetic risk—and was 1.13 (1.09-1.17, P<0.001) per 10-unit decrease in Alternate Healthy Eating Index, a measure of diet quality. The joint association of low diet quality and increased genetic risk was similar to the sum of the risk for each factor alone (Pinteraction =0.30), further supporting independent associations. That said, one limitation of the study was that the cohort sampling might not necessarily generalize to other populations.
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Stem cell therapy protects against the side effects of cancer drugs
https://medicalxpress.com/news/2022-05- ... fects.html
by Osaka University
Immune checkpoint inhibitors are widely used to treat a variety of cancers; however, one serious side effect is the onset of type 1 diabetes. Now, researchers from Osaka University have discovered that stem cell therapy may protect against such side effects.

One strategy by which tumor cells evade recognition by the immune system is by upregulating factors that interfere with immune cell signaling—a process known as immune checkpoint. For example, the upregulation of programmed death-ligand 1 (PD-L1) leads to increased binding to its receptor (PD-1) on T cells of the immune system, inhibiting T cell activation. The therapeutic use of immune checkpoint inhibitors can reverse these effects, restoring immune system surveillance and tumor cell killing. However, these anti-cancer drugs are accompanied by autoimmune side effects, including the onset of type 1 diabetes.

Type 1 diabetes is a serious autoimmune disease that develops when the level of insulin produced by the islets of Langerhans in the pancreas drops below the required threshold, resulting in the body's inability to control blood sugar levels. Such patients are dependent on insulin therapy. When insulin-producing cells are completely lost, the control of blood sugar levels becomes severely compromised, resulting in clinical complications, impaired quality of life, and a poor prognosis. Strategies for the prevention or cure of type 1 diabetes are currently lacking.

Mesenchymal stem cell (MSC) therapy is the most commonly used type of cell therapy. MSCs secrete factors that contribute to tissue regeneration, anti-fibrosis activity, and modulation of immune functions.
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Biomaterial improves islet transplants for treatment of type 1 diabetes
https://medicalxpress.com/news/2022-05- ... betes.html
by Georgia Institute of Technology
Islet cell transplants are a promising treatment that can cure difficult-to-treat type 1 diabetes. The cells, taken from a donor pancreas, provide patients with a sustainable and tightly controlled source of insulin. A major problem is getting the patient's immune system to accept the influx of new donor cells; the patient's protective T-cells naturally want to reject the foreign invaders.

But a team of investigators co-led by Georgia Institute of Technology researcher Andrés García overcame this hurdle in previous small animal studies. Their technique uses synthetic hydrogel particles called microgels. The microgels present a potent immunomodulatory protein called SA-FasL to modulate the body's immune response, allowing the transplanted insulin-producing cells to safely do their job, regulating blood glucose levels, and fighting diabetes.

A new study in the journal Science Advances from García and his collaborators moves this hopeful treatment strategy closer to the clinic.

"Immunosuppression is a significant problem for patients, but in our prior work we showed that this biomaterial, this microgel, is a potent immunomodulatory molecule, and can induce permanent acceptance of the new cells," said García, the Petit Chair in Bioengineering and Regents' Professor in the George W. Woodruff School of Mechanical Engineering and executive director of the Petit Institute for Bioengineering and Bioscience.
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