Cure Research for Type 1 diabetes
Medical Research Breakthroughs and Type 1 diabetes
Suspected cause of Diabetes type1 discovered: Researchers were able to examine the immune cells from isolated insulin-making
structures in the pancreas known as the islets of Langerhans. They caught the
immune cells, known as dendritic cells, "red-handed" carrying insulin
and fragments of insulin-producing cells known as beta cells. This can be the
first step toward starting a misdirected immune system attack that destroys the
beta cells, preventing the body from making insulin and causing type 1
diabetes.
The results push scientists a step closer to finding ways to treat this
condition. The American Diabetes Association estimates that 1 million to 2
million Americans suffer from type 1 diabetes, which is also called juvenile
diabetes because it frequently develops in children. Patients require insulin
injections to survive because the immune system has destroyed the islets of
Langerhans, which contain the body's only beta cells. The insulin these cells
make is required for the critical task of regulating blood sugar levels.
During the study they found
indications that the cells were carrying granules of insulin and pieces of
proteins from beta cells on their cell surfaces. To test whether this cargo
carried by the dendritic cells had the potential to trigger an immune attack on
beta cells, Calderon exposed the dendritic cells to lymphocytes taken from
diabetic mice. The lymphocytes were activated by the dendritic cells of the
islets and switched into attack mode. In a separate line of research, they also
learned that dendritic cells in the pancreas may normally have beneficial
effects on the health of beta cells. They've shown that when dendritic cells
are absent from the pancreas, the beta cells are smaller, an indication that
they're not as healthy.
Cure Research discussion for Type 1 diabetes:
Genes and Disease by the National Center for Biotechnology (Excerpt)
Conscientious patient care and daily insulin dosages can keep patients comparatively healthy. But in order to prevent the immunoresponses that often cause diabetes, we will need to experiment further with mouse models of the disease and advance our understanding of how genes on other chromosomes might add to a patient's risk of diabetes.
(Source: Genes and Disease by the National Center for Biotechnology)
Devices for Taking Insulin: NIDDK (Excerpt)
Implantable insulin pumps are surgically implanted, usually on
the left side of the abdomen. The pump is disk shaped and weighs about 6
to 8 ounces. It delivers a basal dose of insulin continuously. Users
deliver bolus insulin doses with a remote control unit that prompts the
pump to give the specified amount of insulin.
An advantage of this method is that, like insulin produced naturally
from the pancreas, the insulin from the pump goes directly to the liver to
prevent excess sugar production there.
The insulin patch, placed on the skin, gives a continuous low
dose of insulin. To adjust insulin doses before meals, users can pull off
a tab on the patch to release insulin. The problem with the patch is that
insulin does not get through the skin easily.
The inhaled insulin delivery system, provides insulin as a dry
powder inhaled through the mouth directly into the lungs where it passes
into the bloodstream. This aerosol delivery system is about the size of a
flashlight and uses rapid-acting insulin. (Source: excerpt from Devices for Taking Insulin: NIDDK)
Diabetes Control and Complications Trial (DCCT): NIDDK (Excerpt)
The DCCT is a clinical study conducted from 1983 to 1993 by the
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
The study showed that keeping blood glucose levels as close to normal as
possible slows the onset and progression of eye, kidney, and nerve
diseases caused by diabetes. In fact, it demonstrated that any sustained
lowering of blood glucose helps, even if the person has a history of poor
control.
The largest, most comprehensive diabetes study ever conducted, the DCCT
involved 1,441 volunteers with type 1 diabetes and 29 medical centers in
the United States and Canada. Volunteers had diabetes for at least 1 year
but no longer than 15 years. They also were required to have no, or only
early signs of, diabetic eye disease.
The study compared the effects of two treatment regimens--standard
therapy and intensive control--on the complications of diabetes.
Volunteers were randomly assigned to each treatment group. (Source: excerpt from Diabetes Control and Complications Trial (DCCT): NIDDK)
Noninvasive Blood Glucose Monitors: NIDDK (Excerpt)
Over the years, scientists have been trying to find noninvasive ways
for people with diabetes to measure their blood glucose. Most methods of
monitoring blood glucose require a blood sample, usually obtained by using
an automatic lancing device on a finger. Some meters use a blood sample
from a less sensitive area, such as the upper arm, forearm, or thigh. Some
devices use a beam of light instead of a lancet to pierce the skin.
(Source: excerpt from Noninvasive Blood Glucose Monitors: NIDDK)
Pancreatic Islet Transplantation: NIDDK (Excerpt)
In pancreatic islet transplantation, cells are taken from a donor
pancreas and transferred into another person. Once implanted, the new
islets begin to make and release insulin. Researchers hope that islet
transplantation will help people with type 1 diabetes live without daily
injections of insulin. (Source: excerpt from Pancreatic Islet Transplantation: NIDDK)
Pancreatic Islet Transplantation: NIDDK (Excerpt)
Scientists have made many advances in islet transplantation over the
past 25 years. Dr. James Shapiro and colleagues at the University of
Alberta in Edmonton, Canada, have used a new procedure called the Edmonton
Protocol to treat eight patients with type 1 diabetes. These patients have
been completely freed from insulin injections since the first transplant
in mid-1999.
On July 13, 2000, the National Institutes of Health (NIH) and the
Juvenile Diabetes Research Foundation International announced that they
would fund a clinical trial to test Dr. Shapiro's promising new technique
for transplanting islet cells into the large vein in the liver. The trial
will test the procedure in 40 people around the world. The NIH-funded
Immune Tolerance Network (ITN) is leading the 7-year study and will be in
charge of recruiting patients. To be considered for the trial, people must
meet the following criteria:
- Be between the ages of 18 and 65
- Have had type 1 diabetes for at least 5 years
- Be unable to control their blood sugar even with intensive
therapy
- Be unable to adequately sense the onset of hypoglycemia (low blood
sugar)
- Have had at least one hypoglycemic reaction in the past 1.6 years
that cannot be otherwise explained and required medical
attention
- Have diabetes complications--such as blurred vision or kidney,
nerve, or blood vessel problems--despite efforts to control blood
sugar
(Source: excerpt from
Pancreatic Islet Transplantation: NIDDK)
Diabetes: NWHIC (Excerpt)
In recent years, advances in diabetes research have led to better ways
to manage diabetes and treat its complications. For example, the insulin
pump, new oral medications, and better ways of monitoring blood glucose
have become available. In the future, it may be possible to administer
insulin through inhalers, a pill, or a patch. Devices are also being
developed that can monitor blood glucose levels without having to prick a
finger to get a blood sample. Researchers continue to search for the cause
or causes of diabetes and ways to prevent and cure the disorder. (Source: excerpt from Diabetes: NWHIC)
Medical research for Type 1 diabetes: medical news summaries:
The following medical news items
are relevant to medical research for Type 1 diabetes:
Type 1 diabetes Treatment: Book Excerpts
Clinical Trials for Type 1 diabetes
Some of the clinical trials for Type 1 diabetes include:
Evidence Based Medicine Research for Type 1 diabetes
Medical research papers related to Type 1 diabetes include:
- Metformin added to insulin therapy for type 1 diabetes mellitus in adolescents
- C-peptide levels and insulin independence following autologous nonmyeloablative hematopoietic stem cell transplantation in newly diagnosed type 1 diabetes mellitus.
- Central nervous system function in youth with type 1 diabetes 12 years after disease onset
- Diabetes Education for Children With Type 1 Diabetes Mellitus and Their Families
- Intermediate acting versus long acting insulin for type 1 diabetes mellitus
- Diabetes education for children with Type 1 diabetes mellitus and their families
- Insulin glulisine (Apidra) Type 1 diabetes mellitus in adolescents and children 6 years or older
- Suggested insulin regimens for patients with type 1 diabetes mellitus who wish to fast during the month of Ramadan
- Insulin therapy, hyperglycemia, and hypertension in type 1 diabetes mellitus
- In women with type 1 diabetes is the levonorgestrel releasing intrauterine system a safe option in terms of its effect on glucose metabolism?
- Should angiotensin converting enzyme inhibitors be used in children with Type 1 diabetes and microalbuminuria?
- Clinical effectiveness of a brief educational intervention in Type 1 diabetes: results from the BITES (Brief Intervention in Type 1 diabetes, Education for Self-efficacy) trial
- Role of blood pressure in development of early retinopathy in adolescents with type 1 diabetes: prospective cohort study.
- Shared and Distinct Genetic Variants in Type 1 Diabetes and Celiac Disease.
- Risk of microalbuminuria and progression to macroalbuminuria in a cohort with childhood onset type 1 diabetes: prospective observational study.
- Time trends in the incidence of type 1 diabetes in Finnish children: a cohort study.
- Type 1 diabetes, hyperglycaemia, and the heart.
- Motivational Enhancement Therapy with and without Cognitive Behavior Therapy to Treat Type 1 Diabetes: A Randomized Trial.
- Cost of severe hypoglycaemia in patients with type 1 diabetes in Spain and the cost-effectiveness of insulin lispro compared with regular human insulin in preventing severe hypoglycaemia
- A risk score for type 1 diabetes derived from autoantibody-positive participants in the diabetes prevention trial-type 1
- Thyroid peroxidase antibodies in pregnant women with type 1 diabetes: impact on thyroid function, metabolic control and pregnancy outcome
- Fetal and perinatal outcomes in type 1 diabetes pregnancy: a randomized study comparing insulin aspart with human insulin in 322 subjects.
- High prevalence of type 2 diabetes and pre-diabetes in adult offspring of women with gestational diabetes mellitus or type 1 diabetes: the role of intrauterine hyperglycemia
- Acute complications and drug misuse are important causes of death for children and young adults with type 1 diabetes: results from the Yorkshire Register of diabetes in children and young adults
- Severe hypoglycaemia and glycaemic control in Type 1 diabetes: meta-analysis of multiple daily insulin injections compared with continuous subcutaneous insulin infusion
- Comparison of once- versus twice-daily administration of insulin detemir, used with mealtime insulin aspart, in basal-bolus therapy for type 1 diabetes: assessment of detemir administration in a progressive treat-to-target trial (ADAPT)
- A randomized, controlled trial comparing twice-a-day insulin glargine mixed with rapid-acting insulin analogs versus standard neutral protamine Hagedorn (NPH) therapy in newly diagnosed type 1 diabetes
- A randomized trial comparing continuous subcutaneous insulin infusion of insulin aspart versus insulin lispro in children and adolescents with type 1 diabetes
- Treatment satisfaction and quality of life with insulin glargine plus insulin lispro compared with NPH insulin plus unmodified human insulin in people with Type 1 diabetes
- Long-term efficacy and safety of insulin detemir compared to Neutral Protamine Hagedorn insulin in patients with Type 1 diabetes using a treat-to-target basal-bolus regimen with insulin aspart at meals: a 2-year, randomized, controlled trial
Click here to find more evidence-based articles on the TRIP Database
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