Determining The Role Of Bpa In Type 2 Diabetes Risk
Many synthetic chemicals have infiltrated our food system during the period in which rates of diabetes has surged. Data has suggested that one particular synthetic chemical, bisphenol A , may be associated with increased risk for developing type 2 diabetes. However, no study to date has determined whether consumption of BPA alters the progression to type 2 diabetes in humans. Results reported this year by Dr. Hagobian demonstrated that indeed when BPA is administered to humans in a controlled manner, there is an immediate, direct effect on glucose and insulin levels.
Now, Dr. Hagobian wants to conduct a larger clinical trial including exposure to BPA over a longer period of time to determine precisely how BPA influences glucose and insulin. Such results are important to ensure the removal of chemicals contributing to chronic diseases, including diabetes.
Hagobian, T. A., Bird, A., Stanelle, S., Williams, D., Schaffner, A., & Phelan, S. . Pilot Study on the Effect of Orally Administered Bisphenol A on Glucose and Insulin Response in Nonobese Adults. Journal of the Endocrine Society, 3, 643654.
A Cure For Type 1 Diabetes For One Man It Seems To Have Worked
A new treatment using stem cells that produce insulin has surprised experts and given them hope for the 1.5 million Americans living with the disease.
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Brian Sheltons life was ruled by Type 1 diabetes.
When his blood sugar plummeted, he would lose consciousness without warning. He crashed his motorcycle into a wall. He passed out in a customers yard while delivering mail. Following that episode, his supervisor told him to retire, after a quarter century in the Postal Service. He was 57.
His ex-wife, Cindy Shelton, took him into her home in Elyria, Ohio. I was afraid to leave him alone all day, she said.
Early this year, she spotted a call for people with Type 1 diabetes to participate in a clinical trial by Vertex Pharmaceuticals. The company was testing a treatment developed over decades by a scientist who vowed to find a cure after his baby son and then his teenage daughter got the devastating disease.
Mr. Shelton was the first patient. On June 29, he got an infusion of cells, grown from stem cells but just like the insulin-producing pancreas cells his body lacked.
Now his body automatically controls its insulin and blood sugar levels.
Its a whole new life, Mr. Shelton said. Its like a miracle.
But, he said, bottom line, it is an amazing result.
The Journey Towards A Cure
There are efforts to try to cure Type 1 diabetes so that people with T1D do not need to use insulin every day,” Hsu says. “One method is to reintroduce functioning beta cells.”
An islet transplant uses cells from a donor pancreas to help those living with T1D regain beta cells and improve their quality of life. Hsu says that other initiatives include stem cell therapies as well as injectable drugs that stimulate the body to create its own functional beta cells. However, he says that these developments are still in their infancy.
These therapies, often collectively referred to as beta cell replacement, have become one of the most promising scientific developments in diabetes research. But, according to the Juvenile Diabetes Research Foundation , beta cell replacement is only available to a small number of people living with Type 1 diabetes.
The challenge of not only producing but also maintaining beta cells remains a barrier for researchers. They are still looking for ways to prevent these cells from being destroyed by the autoimmune system.
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The Reality Of A Cure
Though scientists can reverse Type 2 diabetes in some patients by inducing a loss of 1 gram of weight from the pancreas, by bariatric surgery or increased energy expenditure. However, they have not been able to do this with people with more advanced Type 2 diabetes. They have only been able to do this with people who have had diabetes for less than 5 years.
This is due to the gradual progression of the disease and continued beta cell destruction. Still, we must consider that it has only been since the 1920s that insulin was discovered. Much headway had been made in diabetes. A disease that once could not be survived can now be lived with. Living healthy with diabetes is now possible, when once it was not.
Lets examine the current research that is going on, and investigate the possibility of a cure for diabetes. How plausible is it? Will we be alive to see it? What does cure really mean, and what will a cure look like? Put on your time travel gear and lets see where all of this can take us.
The American Diabetes Association looked at the estimated costs of diabetes, and they rose markedly between 2007 and 2012 from $174 billion to $245 billion in 2012. Thats no little increase. In fact, its a whopping 41% increase, which coincides with the national diabetes epidemic. The study looks at gender, race and ethnicity, and also looks at costs for individual states.
Vitamin D Sleep Apnea Gut Health And Diabetes
A consequence of our poor diets is we have crowded teeth and smaller airways. You might be surprised to hear it wasnt always that way our ancestors had straight teeth, robust jaws, and never brushed or flossed. As a result 22 million Americans suffer from sleep apnea.
I bring this up because sleep apnea increases a persons risk for developing type 2 diabetes. Also, sleep-disordered breathing is also related to proper nutrition throughout life. And perhaps most importantly, the first line of defense in catching sleep-disordered breathing in patients early, are dentists. This is another area where dentists must get involved if we want to tackle the issue of pervasive type 2 diabetes with any success.
Dentists can tell early on if children are getting the right nutrition and ensure their airway remains open so they can benefit from quality sleep for the rest of their life. This is essential to preventing not only diabetes, but heart disease, cognitive decline, and more.
Sleep apnea is also linked to vitamin D deficiency and gut microbiome changes. So by addressing these three factors in type 2 diabetes, we provide the foundation to cure type 2 diabetes.
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Whole Genome Sequencing For Type 1 Diabetes
Using very new genome technologies and cutting edge scientific methods, my team is embarking on a new program with the aim of functionally annotating the gene changes in type 1 diabetes. To start, we have sequenced the entire genomes of 50 individuals with type 1 diabetes.
Already, even at this early stage of this newest program, we have made an exciting discovery. We have shown how single-nucleotide polymorphism changes in one particular gene called A20 not only contributes to diabetes susceptibility, but also enhances rejection in islet transplantation.
This exciting data provides tantalising new information that will help to bring us closer to a better understanding of type 1 diabetes and hopefully, to a cure.
Every day, scientists all around the world are making progress toward a cure for type 1 diabetes. While it is difficult to say how long it will be before a cure is finally realised, we can reflect on how far we have come since the discovery of insulin in the early twentieth century, and look forward to more new and exciting discoveries that will bring us closer to a cure for type 1 diabetes.
Vaccine For Type 1 Diabetes
The Faustman Lab at Massachusetts General Hospital are only interested in curing Type 1 Diabetes. They strive to reverse Type 1 in advanced stages. Currently, they are looking at whether or not a certain bacteria called bacillus Calmette-Guerin can get rid of T-cells that destroy the pancreas in people with Type 1 diabetes. BCG is not new.
It was used in development of other vaccinations in the past, and what it does is it elevates Tumor Necrosing Factor , that may have the ability to destroy T-cells that attack the pancreas. Clinical trials are underway, and have shown promise that the vaccine can, if only briefly, destroy these damaging T-cells. Funding is currently going on for a 2nd phase in this promising trial3. Getting closer? Lets see.
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Identification Of A New Player In Type 1 Diabetes Risk
Type 1 diabetes is caused by an autoimmune attack of insulin-producing beta-cells. While genetics and the environment are known to play important roles, the underlying factors explaining why the immune system mistakenly recognize beta-cells as foreign is not known. Now, Dr. Delong has discovered a potential explanation. He found that proteins called Hybrid Insulin Peptides are found on beta-cells of people with type 1 diabetes and are recognized as foreign by their immune cells. Even after diabetes onset, immune cells are still present in the blood that attack these HIPs.
Next, Dr. Delong wants to determine if HIPs can serve as a biomarker or possibly even targeted to prevent or treat type 1 diabetes.Baker, R. L., Rihanek, M., Hohenstein, A. C., Nakayama, M., Michels, A., Gottlieb, P. A., Haskins, K., & Delong, T. . Hybrid Insulin Peptides Are Autoantigens in Type 1 Diabetes. Diabetes, 68, 18301840.
What This Means For You
Around 5% to 10% of individuals with diabetes have Type 1 diabetes. Often diagnosed during childhood or adolescence, people living with Type 1 diabetes grow up having to learn how to manage this complex condition for the rest of their lives. For this reason, researchers, such as those affiliated with the aforementioned study, continue to pursue a cure.
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Preliminary Study Shows Promise For Long
Human embryonic stem cells
Wikimedia Commons
This story is part 8 of an occasional series on the current progression in Regenerative Medicine. In 1999, I defined regenerative medicine as the collection of interventions that restore to normal function tissues and organs that have been damaged by disease, injured by trauma, or worn by time. I include a full spectrum of chemical, gene, and protein-based medicines, cell-based therapies, and biomechanical interventions that achieve that goal.
Results of a preliminary study show that we may be one step closer to achieving a long-term cure for Type 1 diabetes. After decades of research, there now seems to be at least partial success at transplanting functional insulin-producing islet cells into the human pancreas.
Type 1 diabetes is a major public health crisis. The disease occurs when the bodys immune system attacks its own insulin-producing pancreatic cells. Without these insulin-producing cells, patients are at risk for blindness, disabilities, and are at increased risk for Covid-19.
The process of developing this method began with understanding which chemical signals were needed to steer stem cells into insulin-producing cells. Stem cells are a type of cell that can be reprogrammed into earlier, embryonic stages of development. With the right chemical signals, stem cells can then be transformed into almost any other cell in the body.
Replacing Missing Cells With Cell Therapy
Although still in the very early stages of development, cell therapy is one of the biggest hopes towards developing a cure for diabetes, especially for type 1 diabetes. Replacing the missing insulin-producing cells could potentially recover normal insulin production and cure patients.
However, early attempts to transplant pancreatic cells have largely failed, mostly due to immune reactions that reject and destroy the implanted cells. The lack of donors is also a limitation.
One of the most advanced alternatives comes from the Diabetes Research Institute in the US, which is developing a bioengineered mini-organ where insulin-producing cells are encapsulated within a protective barrier. This mini-pancreas is then implanted into the omentum, a part of the abdominal lining. A phase I/II trial is ongoing, but the DRI announced its first successful results in 2016, revealing that the first patient in Europe treated with this approach no longer requires insulin therapy.
This can be the beginning of a new era in islet transplantation. Our ultimate goal is to prevent the need for lifelong anti-rejection therapy, stated Camillo Ricordi, Director of the DRI.
A similar device is being developed by the US company ViaCyte, in collaboration with the nonprofit organization JDRF. A phase I/II trial is ongoing and has already proved the device is safe. The company is now working on improving the engraftment of insulin-producing cells.
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Using Incentives To Stimulate Behavior Changes In Youth At Risk For Developing Diabetes
Once referred to as adult-onset diabetes, incidence of type 2 diabetes is now rapidly increasing in Americas youth. Unfortunately, children often do not have the ability to understand how everyday choices impact their health. Could there be a way to change a childs eating behaviors? Davene Wright, PhD, of Seattle Childrens Hospital was granted an Innovative Clinical or Translational Science award to determine whether using incentives, directed by parents, can improve behaviors related to diabetes risk. A study published this year in Preventive Medicine Reports outlined what incentives were most desirable and feasible to implement. A key finding was that incentives should be tied to behavior changes and not to changes in body-weight.
With this information in hand, Dr. Wright now wants to see if incentives do indeed change a childs eating habits and risk for developing type 2 diabetes. She is also planning to test whether an incentive program can improve behavior related to diabetes management in youth with type 1 diabetes. Jacob-Files, E., Powell, J., & Wright, D. R. . Exploring parent attitudes around using incentives to promote engagement in family-based weight management programs. Preventive Medicine Reports, 10, 278284.
Top 10 T1d Research Breakthroughs Of 2020
JDRF
While COVID-19 has dominated the news in 2020, its also been a huge year for type 1 diabetes research. This year, weve made more progress than ever on our mission to cure, treat and prevent T1D including new insights into what causes the disease, some incredible results from prevention therapies, and the launch of two world-first clinical trials in Australia. Lets look back on 2020by celebrating the 10 biggest T1D research breakthroughs:
1. World-first clinical trial launched in Melbourne
St Vincents Institute of Medical Research, with funding from JDRF, launched a clinical trial of baricitinib a drug that aims tostop the immune system from attacking beta cells. If successful, the researchers hope that baricitinib could help people with newly diagnosed T1D keep producing their own insulin for longer.
2. Australias first population screening program for T1D
In February, JDRF announced that Dr Kirstine Bell will lead a pilot study to screen children for early signs of T1D. This study will be the first in Australia and one of only three in the world to screen people from the general population, without a family history of T1D. The screening program could identify those most at risk of T1D before they develop symptoms.
3. Teplizumab delays T1D diagnosis by 3 years
4. New insights into what causes T1D
5. Breakthrough results for closed-loop technology
6. ENDIA study extended
7. Gut bacteria and T1D
8. Two subtypes of T1D?
9. Targeting T1D complications
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More Hope: A Dramatic New Rescue For Diabetics In Danger
Elizabeth Jenkins, MD, was diagnosed with type 1 diabetes at 18. In 2002, her vision began to suffer. In her late 20s, she lost the ability to tell when her blood sugar was dipping, and by the time she was working as a pediatrician in her early 30s, she was slipping into a diabetic coma every other month or so. One day in 2008, she lost consciousness in front of a patient. This cant happen anymore, Jenkins said to herself. She consulted her doctors, one of whom told her about a clinical trial at City of Hope: People like her were receiving transplants of healthy insulin-making islet beta cells to help their body deal with the symptoms of having too little insulin. The doctor explained that the transplants wouldnt stop her diabetes, but could make living with it easier. Jenkins eagerly signed up.
After three transplants of islet cells, Jenkinss body was producing enough insulin for the first time in more than a decade. She was able to stop her injections. Her vision stabilized. She went on three-hour solo hikes in the woodswithout fearing shed black out.
Eight years later, Jenkins is married and still treating young patients. Her vision has worsened slightly, and she takes medication daily to prevent her body from rejecting the transplanted cells, but she continues to be off insulin.
A Hope For Prevention
The researchers plan to study the therapy in phase 3 clinical trials to assess its long-term safety and effectiveness. While it’s likely to be years before the treatment could be available to patients, von Herreth is hopeful about its potential.
He’s also hopeful that regulators will see the value in preserving beta-cell function in patients with type 1 diabetes. One day, von Herreth believes that a therapy like ours can potentially also be used in the prevention of diabetes in those patients identified to be at risk.”
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And In 9 Humans With Type 1 Diabetes
She has tested her research on a total of 9 patients with type 1 diabetes. While none are cured, most experienced significant reductions in insulin needs.
We have a fully enrolled Phase IIb clinical trial underway that will read out in as early as 2022, explains Faustman told DiabetesStrong. Because of the size of our Phase II trial and BCGs known safety profile and its generic drug status, we are hoping to pursue approval coming out of Phase II trial.
Faustman adds that the BCG vaccine has demonstrated a clear and clinically significant response in the primary endpoint for type 1 diabetes trials: a stable and long-term return of blood sugars to the near normal range for over 5 years without hypoglycemia.
- Read more about the clinical trials and potential to participate at Faustman Labs.