Beyond Mice: Regeneration In The Human Pancreas
Okay, so FMD reverses type 1 diabetes in mice. But what about humans? Unfortunately, its pretty hard to measure the regeneration of a pancreas in living humans, since we cant collect human tissue like we can mouse tissue. So instead, the researchers performed ex vivo experiments on cultured human pancreatic islets from both healthy people and type 1 diabetics.
Ingeniously, they separately enrolled five human subjects in an FMD lasting five days and took blood samples at baseline and at day five of the FMD. The post-FMD blood serum samples had higher levels of growth factors and ketone bodies and lower levels of glucose, as expected. The researchers then took the cultured pancreatic islets and bathed them in the collected samples. In both healthy islets and type 1 diabetic islets exposed to the FMD-treated serum, there was a trend toward glucose-dependent induction of embryonic genes Sox2 and Ngn3.
They then tried applying commercially available fasting mimicking culture mediums that were low in glucose and serum to the cultured islets. When supplied with just this small amount of glucose, insulin secretion was stimulated in both healthy and diabetic islets. There were also major changes in cell reprogramming markers 30130-7″ rel=”nofollow”> 1).
What Is Type 1 Diabetes Symptoms Causes Diagnosis And Treatment
Type 1 diabetes is an autoimmune disease that leads the body to stop making enough insulin to keep glucose at a healthy, normal level. It is most often diagnosed in children and young adults, although it can develop at any age, according to the National Institute of Diabetes and Digestive and Kidney Diseases .
Whats The Difference Between Type 1 And Lada
Type 1 diabetes is a fast-progressing, strong autoimmune condition which results in a near complete loss of insulin production between 12-18 months on average. Patients with type 1 diabetes often test positive for multiple antibodies to beta cell proteins.
Type 1.5 diabetes is a slow-progressing, weaker autoimmune condition which results in a decline in insulin production that may take years to develop. Patients with type 1.5 diabetes often test positive for a single antibody to beta cell proteins.
As we mentioned above, identifying these conditions through the onset of their symptoms can be difficult. However, both adult-onset type 1 diabetes and LADA/type 1.5 diabetes can be effectively identified with two decisive tests: the C-peptide test, and a diabetes antibody panel.
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What Causes Type 1 Diabetes
Type 1 diabetes is thought to be caused by an autoimmune reaction that destroys the cells in the pancreas that make insulin, called beta cells. This process can go on for months or years before any symptoms appear.
Some people have certain genes that make them more likely to develop type 1 diabetes, though many wont go on to have type 1 diabetes even if they have the genes. Being exposed to a trigger in the environment, such as a virus, is also thought to play a part in developing type 1 diabetes. Diet and lifestyle habits dont cause type 1 diabetes.
How Does My Diet Affect Diabetes
A healthy diet is an important part of managing Type 1 diabetes. The right foods can help keep your blood pressure and blood glucose in check. Healthy meal planning for people without Type 1 diabetes is similar to healthy meal planning for people with Type 1 diabetes:
- Avoid foods with added sugar, sodium and trans fats.
- Eat a balance of proteins, carbohydrates and healthy fats.
- Read nutrition labels to select foods with more fiber and less sugar.
- Skip the highly processed foods found in cans or packages.
In addition, it’s important for people with Type 1 diabetes to understand how foods with carbohydrates impact their blood sugar levels and how much insulin to take for various amounts of carbs. Work with your healthcare team to figure out the best plan for you.
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Diabetes Sick Day Rules
If you need to take insulin to control your diabetes, you should have received instructions about looking after yourself when you’re ill known as your “sick day rules”.
Contact your diabetes care team or GP for advice if you haven’t received these.
The advice you’re given will be specific to you, but some general measures that your sick day rules may include could be to:
- keep taking your insulin it’s very important not to stop treatment when you’re ill your treatment plan may state whether you need to temporarily increase your dose
- test your blood glucose level more often than usual most people are advised to check the level at least four times a day
- keep yourself well hydrated make sure you drink plenty of sugar-free drinks
- keep eating eat solid food if you feel well enough to, or liquid carbohydrates such as milk, soup and yoghurt if this is easier
- check your ketone levels if your blood glucose level is high
Seek advice from your diabetes care team or GP if your blood glucose or ketone level remains high after taking insulin, if:
- you’re not sure whether to make any changes to your treatment
- you develop symptoms of diabetic ketoacidosis
- you have any other concerns
Read more about sick day rules
Duration Of Type 1 Diabetes
Type 1 diabetes is a lifelong illness that requires careful, daily management of blood sugar levels. The constant need to be thinking about diabetes can grow tiresome and frustrating for many young people, says Thomas. While their journey will be different from the experience of those who dont have type 1 diabetes, they can still live a fulfilling, successful life, and they may find that their unique experience gives them the ability to tap into an inner power they didnt realize they had.”
Dutta strikes a similarly optimistic tone. Do we have a cure? No. We have advances in the clinic, but not yet an approved therapy that cures type 1 diabetes. But, he adds, continuing advances in glucose monitoring and insulin delivery are making it easier for people to manage life with the disease.
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Living With Diabetes In Adults
Regardless of if youre diagnosed with diabetes as a child, adolescent, teen, or adult, youre going to need to make some lifestyle changes to stay healthy. The problem is that adults who are diagnosed with type 1 diabetes tend to already have very firm or established habits, making change more difficult. On a positive side, adults who are diagnosed with type 1 diabetes and who manage it properly are less likely to develop more serious complications since the condition doesnt have as long to affect other organs.
Being diagnosed with adult-onset diabetes may cause mental or emotional challenges, but you can still do the things you love every day. The best way to ensure that youre managing your diabetes is to eat a healthy, nutritious diet, limit alcohol consumption, get plenty of exercise, prioritize a healthy sleep schedule, and make sure that youre managing any signs of diabetes distress.
To help you get the most out of your life, manage your diabetes with ease, and avoid any long-term complications, has a range of diabetes management products, including our Caring Touch at Home Program. Browse our product catalog today and get your supplies delivered directly to your door.
Other Symptoms Of Type 1 Diabetes In Adults
Other diabetic symptoms in adults include feeling drowsy or lethargic sudden vision changes fruity or sweet-smelling breath heavy or labored breathing and stupor or unconsciousness. If you do have high blood sugar and it goes untreated, it could develop into diabetic ketoacidosisa life-threatening condition. So please see your doctor immediately if you are exhibiting these warning signs.
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Why Are Diabetes Types Controversial
First, a bit of history. Way back when, there was diabetes mellitus. This came from the Greek word diabetes meaning siphon, to pass through, and the Latin word mellitus, meaning honeyed or sweet. That eventually changed to Insulin Dependent Diabetes Mellitus and Non-IDDM or . These pretty much came with distinctions of juvenile diabetes that required insulin once diagnosed, and adult diabetes being seen as the type that did not.
Then in 1979, there was a whole renaming effort by a panel of experts, and the terms were replaced with our modern type 1 and type 2 designations. Gestational diabetes was thrown in to describe a sometimes temporary type of diabetes diagnosed during pregnancy, and the experts thought they had all the bases covered.
But then a problem arose.
Some people who developed the autoimmune T1D, especially as adults, were different. The disease didnt follow the normal rules most in the medical community had come to know. In particular, adults with this slow-motion T1D could go for many months, sometimes years, before insulin had to be started. So eventually in the mid-1980s, the research community coined the term LADA.
So how is this even a thing? Why is the term still used, and how is it defined?
In fact, the only professional diabetes organization that officially recognizes LADA is the Immunology of Diabetes Society, which proposes a definition that boils down to:
Can A Blood Glucose Meter Help To Diagnose Type 1 Diabetes
A blood glucose meter may be helpful in indicating whether you or a family member may have diabetes.
It is not essential to have a blood glucose meter but it may be considered useful in a family with a history of type 1 diabetes or autoimmune conditions.
A blood glucose result, taken over 2 hours after eating, of over 7.8 mmol/l could indicate a presence of diabetes.
If high results are being recorded 2 hours after eating for consecutive meals, contact your GP who will be able to carry out a diagnosis
It is important that devices used to draw blood from fingers are not shared to prevent the risk of blood borne illnesses.
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Symptoms And Risk Factors
It can take months or years for enough beta cells to be destroyed before symptoms of type 1 diabetes are noticed. Type 1 diabetes symptoms can develop in just a few weeks or months. Once symptoms appear, they can be severe.
Some type 1 diabetes symptoms are similar to symptoms of other health conditions. Dont guessif you think you could have type 1 diabetes, see your doctor right away to get your blood sugar tested. Untreated diabetes can lead to very seriouseven fatalhealth problems.
Risk factors for type 1 diabetes are not as clear as for prediabetes and type 2 diabetes, though family history is known to play a part.
It Gets Better And Better
It should also be emphasized that the prognosis for type 1 diabetes has improved enormously in recent decades. The annual report from the National Diabetes Register shows that risk factor control is improving every year and the use of modern methods of glucose measurement and insulin pumps is steadily increasing. This means that people living with type 1 diabetes today, as well as those who will develop the disease in the future, can forward to constant improvement in the quality of life and prognosis.
Hopefully, the study can trigger clinics and decision-makers to start cardioprotective treatment earlier and increase the use of technical aids that improve blood sugar.
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Financial Support And Benefits
Some people with diabetes may be eligible to receive disability benefits and incapacity benefits, depending on the impact the condition has on their life.
The main groups likely to qualify for welfare benefits are children, elderly people, people with learning disabilities or mental health problems, and those with complications of diabetes.
People over 65 who are severely disabled, may qualify for a type of disability benefit called Attendance Allowance.
Carers may also be entitled to some benefit too, depending on their involvement in caring for the person with diabetes.
Staff at your local Citizens Advice Bureau can check whether you’re getting all of the benefits you’re entitled to. Both they and your diabetes specialist nurse should also be able to give you advice about filling in the forms.
Can Type 1 Diabetes Be Cured
Currently, there isnt a cure for type 1 diabetes. However, what we know about the condition is constantly evolving, new technologies and medicines are being developed, and researchers are making important breakthroughs. Right now, people of all ages are leading full, healthy lives with type 1 diabetes. You can too!
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The Factors Affecting Life Expectancy
Experts are unanimous that proper glycemic control, and the avoidance of chronic high blood sugar, is key to reducing your risk factors for early death from type 1 diabetes. Good blood sugar stability also makes sudden death from hypoglycemia or DKA less likely.
A 2020 article published in the journal Cardiovascular Endocrinology & Metabolism devised a model to estimate the impact of suboptimal blood sugar control. The model predicts that today, the average adult with type 1 diabetes can expect to lose 7.6 years of life compared to the non-diabetes population. This was a crude measure, because the authors assumed that early deaths were entirely attributable to time spent above international benchmarks for blood sugar control: We estimate that for both T1DM and T2DM, one year with HbA1c > 58mmol/mol loses around 100 life days.
While tight blood sugar control helps reduce the risk of cardiovascular disease, we do not know if there is any level of glucose control that actually eliminates the risk of early death. And glucose control isnt everything: there are innumerable other factors to consider, all of the factors that affect lifespan in people without diabetes.
An article focusing on especially long-lived patients found that they tended to share the following features:
- Reasonable glycemic control
- High HDL-cholesterol level
- Low daily insulin requirements
- Normal body weight
- Lower blood pressure
- Family history of longevity
Type 1 Diabetes Cure On The Horizon
In a very exciting research development from the Salk Institute, scientists created the first insulin-producing cells that can evade detection by the immune system. This breakthrough could represent a cure for type 1 diabetes, since the cells function just like normal insulin-producing cells but are not targeted or destroyed by the immune system. Also, because the cells appear invisible to the immune system, a person receiving a transplant of these lab-created cells would not need to take immunosuppressive drugs to avoid rejection of them.
Currently, these insulin-producing cells have only been tested in mice, which means it will take many more years of study before the cells might be ready for human trials. Nonetheless, this is a significant research breakthrough that could ultimately cure type 1 diabetes.
Until that time, people with type 1 diabetes should carefully monitor their blood glucose levels and strive to manage their sugar levels as tightly as possiblea task often easier said than done. Because some research shows that poorly controlled glucose levels may result in a shortened life expectancy for people with diabetes, its worth your while to follow your treatment plan as carefully as you can, so you can lead a healthy, active life for a long time to come.
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What Is Late Onset Type 1 Diabetes
A spectrum of autoimmune diabetes presents in adulthood, with type 1 diabetes characterised by the requirement of insulin at diagnosis to control glycaemia and prevent ketogenesis. Latent autoimmune diabetes of adulthood also occurs but with much slower progression to requiring insulin after initial diagnosis.
How common is late onset type 1 diabetes?
In the 3050 year age group, type 1 diabetes accounts for 13% of all new cases of diabetes1
Annual incidence is 15/100000 in the 1534 year age group, increasing by 2.8% annually,2 and is 7/100000 in the 3050 age group1
How Is Type 1 Diabetes Diagnosed
The following blood tests help your healthcare provider diagnose diabetes:
- Blood glucose test: Your healthcare provider uses a blood glucose test to check the amount of sugar in your blood. They may ask you to do a random test and a fasting test .
- Glycolated hemoglobin test : If blood glucose test results indicate that you have diabetes, your healthcare provider may do an A1c test. This measures your average blood sugar levels over three months.
- Antibody test: A blood test checks for autoantibodies to determine if you have Type 1 or Type 2 diabetes. Autoantibodies are proteins that attack your bodys own tissue by mistake. The presence of certain autoantibodies means you have Type 1 diabetes. Autoantibodies usually arent present in Type 2 diabetes.
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Were We Meant To Eat Three Times A Day
Ive written before about the mismatch hypothesisthe idea that our genes have not caught up to our modern lifestyle. Our huntergatherer ancestors probably had periodic variation of food scarcity and hunting success and likely rarely ate three times a day. The ability of animals to deal with food deprivation is an adaptive response that is conserved across species. In times of scarcity, a mild atrophy of tissues and organs minimizes energy expenditure. Upon refeeding, the body can build these tissues back up to their normal volume .
This raises a few interesting questions: is expression of these embryonic genes in adulthood really abnormal? Or is it possible that we are meant to have transient expression of these embryonic genes periodically throughout our lifetime? Could our constantly fed state in most of the Western world be the true abnormal gene expression pattern? I certainly hope to see more research in this area, especially in humans.