Islet transplantation improves with drug combination
Filed under: Type 1, Childhood, Research
Islet transplantation is an exciting frontier of diabetes research as it can reverse diabetes. A recent study from researchers at the University of Alberta in Edmonton showed promising results when a combination of intensive insulin and heparin is used to garner better success of islet transplantation from a single donor.
Due to inefficiencies in islet harvest, islet transplants usually require harvesting from more than one donor. Not only does the drug combination yield more islets from a single donor, early results suggest patients receiving islets from one donor realize longer insulin independence. Study researchers hypothesized heparin, an anticoagulant, could prevent damage from clotting, while intensive insulin could relieve stress and inflammation on the islets during transplantation.
13 patients received the insulin/heparin (IH) combination. 6 of the 13 IH patients (46%) were able to give up insulin treatments. This was compared to a previous 66-patient cohort that had received islet transplants via intraportal cultured islet-alone infusions, followed by immune system suppression via three different drugs. Of these 66 patients, only 5 (8%) were able to give up insulin. Furthermore, 55% of patients reaching insulin dependence via one donor maintained independence after 60 months, compared to only 9% of patients receiving islets from more than one donor.
To learn more about the metabolic wonders of islets of Langerhan, please see this previous post.
Pig Islets 10 Years and Counting
Filed under: Type 1, Childhood, Lifestyle, Research, Events, Support
In 1996 a 41 year old male (a type 1 diabetic for 18 years) was injected with biocapsules containing pig islets to regulate his blood sugar level. The transplanted cells helped reduce the patient's insulin requirement by 34% for over a year, which provided better control. By 2005 the patient's glycated hemoglobin levels (HbA1c) remained lower than the pre-transplant levels.
Ten years later, the patent contacted Living Cell Technologies to inform them that he believed the transplanted pig islets were still alive and well. After tests were conducted, it was concluded that the pig cells were (as he reported) still functioning. This proved that the LCT patented technology for xenotransplantation was effective. It allows the islets to survive at least ten years in a micro-capsule coating and continue to release insulin into the patient's bloodstream without immune suppression. After tests we conducted on the type of insulin present in the patients blood - it was with 100% certainty that it was pig and not human insulin.
LCT has significantly advanced the encapsulation process since the 1996 clinical trial and there is an even greater understanding and control over the longevity and robustness of the encapsulation process, as well as the porcine islet cells. LCT will be trialing the DiabeCell pig islet cell transplant in patients in a phase I/IIa clinical trial, expected to begin in Quarter 2, 2007. In addition, LCT is awaiting approval to conduct an additional trial in New Zealand this year with a different treatment protocol. Subsequent trials in the US or Europe are intended following initial results from these studies.
If overseas trials are coming through with flying colors - why aren't we doing this yet? C'mon USA - where's your competitive spirit? All these pigs up in Spring Point might be put to good use, after all. Oink Oink.
The thing that people with diabetes.hate the most
Filed under: Type 1, Type 2, Childhood, Drugs, Opinion, Allie Beatty, Retro Review, Personalities
I don't mind high sugars as much as I loathe lows. Personally I'm not so ruffled by shots either (but my liver begs to differ). However, in a message posted on The Islet Foundation, Pfizer reported that insulin-dependent diabetics declared they most hate taking shots. Was this the warm-up for the Exubera campaign? Here's a fact I support! A close second to this hatred is the hypos. Any diabetic will confess -- hypos are unforgiving. So what if you could catch two birds with one capsule?
I must reiterate the scientific genius behind the Oramed gel caps. The encapsulated insulin bypasses destruction in the stomach cavity. It reaches an entry point in the intestines where it reports for duty to the liver. This allows the liver to resume command of the glucose metabolism, just like Mother Nature intended. Whey you inject insulin - you are overriding the livers ability to monitor blood sugar and putting yourself in the line of fire for the dangerous lows. We all know this state of derangement too well. You won't find my lows picture on a milk carton if I happen to lose it, either.
Frequent episodes of hypoglycemia (even mild ones) force the brain to become accustomed to the low glucose. Unfortunately this also causes suppressed signaling of adrenaline, the livers last resort before dangerous lows. More specifically, the glucose transporters located in the brain cells are damaged from frequent episodes of hypoglycemia. So what was once the hypo threshold for the brain to signal adrenalin release becomes lower. Clinically, the result is hypoglycemic unawareness. Down with the shots, down with the lows and big ups with the future of diabetes control! Now we're getting somewhere.
Edmonton Protocol on Hold
Filed under: Type 1, Childhood, Drugs, Research, Daily News, Events
The Edmonton Protocol has been temporarily put on hold due to fears the human form of mad cow disease might infect patients.
The source of an enzyme used in transplants was reported to derive from cow brains. Transplants of these treated islets have been put on hold until a source for this enzyme can be found that doesn't use cow brains. Dr. James Shapiro, the surgeon who developed the Edmontol Protocol said, "we just decided to put the program on hold". Shapiro and his team transplant healthy islet cells into the pancreas of people with Type 1 diabetes. The healthy cells allow recipients to again begin producing insulin crucial to the body's ability to regulate sugar digestion.
The National Institutes of Health was creating a similar program in the United States when it discovered that one of the biomedical compounds that Shapiro's team has been using depends on cow brains. Roche Applied Sciences was selling the team an enzyme that allows doctors to extract healthy islet cells. But Roche was buying the bacteria that secretes the enzyme from a third company, which grew the bacteria using fat from cow brains. Roche spokeswoman Michele Beaubien said from Montreal that the enzyme is sold for research purposes only.
The more I learn these days about medicine and how it is applied to diabetes - the more I feel as though everything is for research purposes only. Don't you? As Yogi Berra said, "it ain't over till it's over". A big thanks to Dave of No Sugar Tonight for bringing this story to my attention.
TrialNet researching ways to prevent or delay type 1 diabetes
Filed under: Type 1, Childhood, Adult Onset, Drugs, Research
Did you know type 1 diabetes can take months or even years to develop? It makes perfect sense considering my entire family developed type 1 diabetes at varying points in the life cycle -- teen, young adult and middle-age.
Research has shown the pancreas is stubborn and strong, requiring the loss of over half of the beta cells before symptoms of type 1 kick in. Researchers are taking the next logical step and enrolling relatives of type 1 diabetics in various studies to try and delay or even prevent the onset of the disease.
The University of Florida Health Science Center and Shands at UF are one of 14 centers nationwide dedicated to Type 1 Diabetes TrialNet, a research group dedicated to a host of prevention and early treatment studies.
Now here is a study I feel like enrolling in. TrialNet is testing whether a one-a-day oral insulin capsule can prevent or delay onset of type 1 in high-risk individuals. An earlier trial suggested oral insulin might delay type 1 diabetes up to 4 years in a portion of participants with islet cell autoantibodies in their blood. Makes me wonder if I have any autoantibodies swirling around in my blood.
Animal studies have suggested oral insulin can prevent type I, and some researchers believe oral insulin via the digestive tract can result in a more tolerant immune system.
UF's principal investigator, Dr. Desmond Schatz, explained that people with a strong genetic history and all three islet cell autoantibodies have a greater than 50 percent chance of developing type 1 within five years. Interestingly, these autoantibodies can be present up to 10 years before developing the disease.
TrialNet is also forging ahead on other studies: to retain insulin production in newly-diagnosed type 1 diabetics; to turn off the attack on beta cells with a rituximab, a monoclonal antibody; and an attempt to slow or stop the autoimmunity of type 1 with an FDA-approved drug combination normally used to prevent rejection after organ transplant. Finally, the TEDDY and TEDDY II studies are searching for type 1 genetic and environmental factors in newborns. See the recently published story in dLife or click here to read more aboutTrialNet. You can also call 1-800-HALT-DM1 to see if you are eligible to enroll in a TrialNet study.
Novocell - A stem cell engineering company
Filed under: Type 1, Childhood, Drugs, Research, Services, Support
Novocell is the first company to use polyethylene glycol (PEG) to encapsulate clusters of insulin-producing cells. This biocompatible substance allows glucose and insulin to pass freely through the coating while preventing the body's immune system from destroying the islets.
The encapsulated islets release human insulin through natural mechanisms in response to the recipient's blood glucose. The islet cells used in this study are isolated from human cadavers. The implant procedure is performed under local anesthesia and the encapsulated islets are injected into a surgically formed micropocket in the subcutaneous tissues of the thigh or lower abdomen of the recipient. The patients received temporary low dose cyclosporine (50-100 ng/ml 12hr trough) and did not receive any other form of immunosuppression.
At the American Diabetes Association 66th Annual Scientific Session in June -- Novocell announced the progress of the study. No adverse events had occurred -- no news is good news. In addition, the company also has the fortune of existing in California - where they can prosper on further stem cell research. Novocell has developed a process that efficiently converts human embryonic stem cells into insulin-producing cells. Novocell believes this study will demonstrate the safety and efficacy of the encapsulation technology that can be used with the unlimited source of insulin-producing cells developed from stem cells to treat patients with diabetes.
The specials tonight are fulminant and non- fulminant
Filed under: Type 1, Childhood, Research, Allie Beatty, Support, Complications, Personalities, Form and Function
A type 1 diabetic mystery is why do some Type 1s get complications and others seem to never get them? A massive Japanese study of Type 1 diabetics found that those with fulminant diabetes developed complications much faster and more severely than those with non-fulminant diabetes.
The difference between fulminant and non-fulminant is the speed and intensity at which the disease develops. Fulminant Type 1 diabetes typically develops suddenly with near total loss of beta cell function. This type of diabetes is confirmed with testing c-peptide levels. Non-fulminant type 1 diabetes has residual c-peptide levels that eventually taper to undetectable. Sometimes this is seen through many years of the Honeymoon Period.
This study may be the antithesis of conventional wisdom for preventing complications. Staking all hopes on blood sugar control is heavily optimistic. Yes controlling blood sugar does lessen the workload for existing beta cells, and thus extends the lifespan of each beta cell. Research suggests that c-peptide offers protection to beta cells, both from apoptosis (cell death) and encourages new cell growth. This new cell growth applies to beta cells and other cells of the body that endure long-term Type 1 diabetes complications.
Diabetics are instructed that maintaining normal blood sugars is the Holy Grail of preventing long-term complications. Yes and no. The truth is controlling your blood sugar will not allow complications of Type 1 diabetes to develop as quickly, presuming you still had some level of beta cell function upon diagnosis (i.e., c-peptide). That doesn't sound like a reward as much as it does a delayed punishment. I'd like c-peptide with my insulin, please. It's off the ?a carte menu? That's fine - serve it up! I want to thank Klausen for bringing this study to my attention.
Rats it's a Virus
Filed under: Type 1, Childhood, Lifestyle, Drugs, Research
No kidding! The rats are leading researchers to triggering events causing diabetes. The new findings suggest that there is, indeed, a genetic susceptibility to diabetes, but that the precipitating event is a viral infection.
The virus in question is the Ljungan virus. Previous reports indicate that infections with the Ljungan virus can induce diabetes in laboratory rats, and that the diabetes can be reversed if the animals are treated with antiviral drugs before the destruction of insulin-secreting islet cells becomes widespread.
I'm not sure how everybody else out there got their D-card. My diagnosing event happened shortly after I had the chicken pox, back in '85. The childhood christening event apparently left me out in the cold and caused the love-hate relationship between my islets and my insulin autoantibodies. Lucky me. Thanks to all the readers out there who have already shared their sequence of diagnosis with me. What's your story? Please, share with us.
Denver Bronco running back Damien Nash dies of heart attack
Filed under: Daily news, Celebrity news, Celebrity in memorium, Men Heart Health
Damien Nash, a Denver Broncos running back, was hosting a basketball game yesterday to benefit the Darris Nash Find a Heart Foundation, a charity that raises funds for heart transplant research. Darris Nash, the brother of Damien had to have a transplant. Darris had a weakened heart muscle condition known as dilated cardiomyopathy. The ailment can be caused by a viral infection, inflammation or other causes. Damien Nash collapsed after returning home to his wife, and was pronounced dead at the hospital at 6:41 p.m. central standard time. The family of course is in shock since he had no history of heart problems. Damien is survived by his wife Judy and a 7 month old daughter. Nash was 24. Nash was a graduate of Coffeyville Community College in Kansas and University of Missouri before getting drafted by the Tennessee Titans in 2005. Denver signed him as a free agent in 2006. He played a total of 6 NFL games.
Doctor sued for negligence in type 1 fatality
Filed under: Type 1, Childhood, Adult Onset, Daily News
Type 1 is not 'juvenile diabetes' anymore. It can strike during the adult years. My brother is the only one who got type 1 as a juvenile, my other brother and both my parents developed type 1 as adults. Undiagnosed type 1 diabetes is dangerous. In a previous post, I shared how quickly my brother deteriorated from undiagnosed type 1, but my mom's stubbornness got him diagnosed. The following news story just made me feel sad.
Doctors make mistakes, but this one cost the life of Adam Bell, 34, of Watford, England. Mr. Bell had typical symptoms of undiagnosed type 1 diabetes -- the thirst, weakness, repeated vomiting, hallucination, hyperventilation, faintness, and rapid pulse. He was so weak he could not make the two-minute walk to his doctor. So his doctor came to him.
Dr. Paul Davis missed it. During a 15-minute examination he diagnosed a viral infection and anxiety. No blood or urine test was administered. Mr. Bell died 48 hours later of ketoacidosis. This story is especially devastating for his five-year partner, Helen Rowe. She had been on vacation at the time, phoning in to see how Adam was feeling. His body was discovered after Ms. Rowe called her mother to check on him.
Ms. Rowe filed a civil claim of negligence against Dr. Davis in 2005. She has since received an undisclosed compensation (speculated as a five-figure sum), but without any admission of liability. Although there was a statement with the settlement which reads, "Dr. Davis feels terrible about Mr. Bell's death and were it possible for him to have the time again, knowing what he knows now, he would do things differently." Dr. Davis is in his forties and is still practicing. I can only imagine how he feels.
Most admirably, Ms. Rowe used the settlement to establish the Adam Bell Foundation, a charity to raise awareness of diabetes in young people. Mr. Bell was a music teacher and accomplished pianist and guitarist.