Obesity and type 2 diabetes link identified | Futurity

KING’S COLLEGE LONDON (UK) — Researchers are hopeful that obesity can be “uncoupled” from insulin resistance after finding that the immune system and a key protein link the two disorders.

There are an estimated 371 million people with diabetes in the world and around 90 percent of these cases are type 2 diabetes. By 2030, there will be some 550 million with the condition based on current trends.

Cases of diabetes have more than doubled since 1980, with 70 percent of the trend due to aging populations worldwide and the other 30 percent estimated to be due to increasing prevalence of risk factors including obesity.

New research published in Cell Metabolism identifies a key mechanism in the immune system involved in the development of obesity-linked type 2 diabetes. The findings open up new possibilities for treatment and prevention of this condition, which is becoming increasingly prevalent worldwide.

The association between obesity and diabetes has long been recognized but the molecules responsible for this association are unclear.

Lead author Jane Howard and her colleagues from King’s College London studied mice genetically engineered to lack T-bet, a protein that regulates the differentiation and function of immune cells. They found that the mice had improved insulin sensitivity despite being obese.

“When T-bet was absent this altered the relationship between fat and insulin resistance; the mice had more intra-abdominal fat but were actually more sensitive to the glucose lowering effects of insulin,” says Howard. “As fat accumulation in the abdomen is typically associated with worsening insulin resistance and other features of the metabolic syndrome, the findings seen were both unusual and unexpected.”

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It turned out that the intra-abdominal fat of these mice contained fewer immune cells and was less inflamed than that of normal mice. The researchers then went on to discover that by transferring immune cells lacking T-bet to young, lean mice they were able to improve insulin sensitivity. “It appears that T-bet expression in the adaptive immune system is able to influence metabolic physiology,” adds Professor Graham Lord.

Although human obesity is often associated with insulin resistance and diabetes, this is not always the case.

“Our data suggests that obesity can be uncoupled from insulin resistance, through the absence of T-bet,” says Howard. Several of the main drugs currently used to treat type 2 diabetes work by improving insulin sensitivity.

Further studies are needed to identify other molecules in the pathway of action of T-bet which could pave the way for future drug development in the treatment of type 2 diabetes. The administration of specific immune cells as immunotherapy to improve insulin resistance may also one day become a therapeutic possibility.

“This is just the start,” says Howard. “The idea that the immune system can impact on metabolism is very exciting, but more research needs to be done before we can bring this work from the bench to the bedside for the benefit of patients.”

The UK Medical Research Council funded the study.

Source: King’s College London

Diabetes drug: Ban lifted after talks with experts

After the health ministry consulted the Drug Testing Advisory Board and experts in diabetes, the ban on Pioglitazone drug was lifted.

The ministry concluded that, if used appropriately in the right type of patients, the drug is effective and safe for treatment of Type 2 diabetes.

Welcoming the lifting of the ban, Dr KP Singh of Fortis Hospital said Pioglitazone was safe and the decision to ban the drug was taken in haste by the central government.

Dr Singh said, “There are over 6 crore diabetes patients in India. Over 30 lakh of these take Pioglitazone due tot its favourable action.”

He added that about 95 per cent of patients suffer from Type 2 diabetes, in which the patient becomes insulin resistant.

Pioglitazone is the most commonly used drug for treatment of this disorder.

“Pioglitazone remains among the most effective and economical Type 2 diabetic drugs in the market and patients should consult their doctors for queries. In general, doctors prescribe the drug only after knowing the patient’s history and eligibility of the drug for the particular patient,” Dr Singh added.

The drug improves blood sugar levels in people with Type 2 diabetes by increasing the patient’s reactivity to insulin, which makes it an important prescription choice for doctors.

It is an economical alternative to insulin and is also cost-effective.

Talking about the precautions while taking the drug, Dr Singh said, “The drug should not be used as a first choice. Doctors should check the status after three to six months. The drug should not be prescribed to those suffering from cardiac or renal failure. It should not be given to those who have active or a history of urinary bladder cancer or Haematuria (blood in urine).”

When asked if any incidence of cancer had been reported in north India because of Pioglitazone he said not a single case had been reported. The drug is commonly available in market as Pioglit, Pionorm and Pioglar.


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School shows the door to diabetic boy

The roots of education are bitter, but the fruit is sweet. Tanishq Jaiswal has learnt it the harsh way. For no fault of his, the boy is being denied education. His only fault is that he has contracted diabetes at an early age.

St. Paul’s High School, Hyderguda, where he is studying fourth class, has served marching orders on the nine-year-old kid. The school authorities have asked his parents to seek a Transfer Certificate (TC) and take the boy out of the school within a week. Tanishq has been taking insulin injections during the lunch break for the last one year. But now the school management feels enough is enough and has asked the parents to withdraw their child at the earliest. The boy’s parents are already upset at their son falling prey to diabetes. But the stubborn attitude of the school has shattered their peace of mind and shocked them beyond words. “Diabetes is not a disease, much less infectious. Moreover, our son has been taking the insulin injection on his own without causing disturbance to anyone. How can the school remove him?” asks Neeraj Jaiswal and his wife, Vaishali Jaiswal.

The world of the working couple came crashing down when their son was diagnosed with Type 1 diabetes in April 2012. An insulin-dependent diabetes, it occurs when the pancreas fail to produce enough insulin to control the body’s sugar level. It is not hereditary, but could be triggered by environmental factors, doctors feel. The number of children affected with Type I diabetes is said to be on the rise.

Insulin shots

Right now Tanishq is under the treatment of endocrinologist Dr. Bipin K Sethi. He has learnt to take four insulin shots everyday, one in school, on his own. “My son has never poked the syringe at any other child or created nuisance as the authorities fear,” says Ms. Vaishali in a choked voice. A teacher herself at the Azra Public School, she is worried about the psychological effect of all this on her child.

Last year itself, school principal Bro. Sudhakar Reddy reportedly objected to Tanishq taking insulin injections in the classroom. But a Good Samaritan teacher intervened and the boy stayed put. But two days ago the principal called the parents and told them to take away their child. “Worse, he asked us to pay the fee for the entire year as well,” Mr. Neeraj said. The principal was not available for comment.

Interestingly, despite his diabetic condition, Tanishq is regular to the school with 98 per cent attendance. His academic record is also equally good. Penalising a kid for what? For getting an ailment he has no control on?

Type 1 Diabetes Drug Proves Effective in Clinical Trial

An experimental drug designed to block the advance of type 1 diabetes in its earliest stages has proven strikingly effective over two years in about half of the patients who participated in the phase 2 clinical trial.

Jeffrey Bluestone, PhD

Patients who benefited most were those who still had relatively good control of their blood sugar levels and only a moderate need for insulin injections when the trial began. With the experimental drug, teplizumab, they were able to maintain their level of insulin production for the full two years – longer than with most other drugs tested against the disease.

Results are published online in the journal Diabetes, and will appear in the November issue of the print edition.

The treatment did not benefit all patients. Some lost half or more of their ability to produce insulin – a drop similar to many of the controls not receiving the drug. Reasons for the different responses are unclear, but likely involve differences in the metabolic condition of the patients and in the severity of their disease at the trial’s start, the researchers said.

Kevan Herold, MD, PhD

“The benefits of treatment among the patients who still had moderately healthy insulin production suggests that the sooner we can detect the pre-diabetes condition and get this kind of drug onboard, the more people we can protect from the progressive damage caused by an autoimmune attack,” said Jeffrey Bluestone, PhD, co-leader of the research and A.W. and Mary Clausen Distinguished Professor at UC San Francisco, who collaborated in developing the drug. 

The clinical trial was led by Kevan Herold, MD, PhD, a professor of immunobiology and deputy director for translational science at Yale University. He and Bluestone have collaborated on four previous clinical trials of the experimental drug.

“We are very excited by the efficacy of the drug,” Herold said. “Some of our patients and families have described a real impact on their diabetes.”

Bluestone, an immunologist who is now executive vice chancellor and provost at UCSF, developed teplizumab in collaboration with Ortho Pharmaceuticals in 1987. He is a leader in research that aims to understand how and why the immune system attacks the body’s own tissues and organs, and to develop drug strategies to eliminate the autoimmune response without producing severe side effects.

Catching Diabetes in Earliest Stages

The results underscore the importance of diagnosing and treating diabetes in its earliest stages, the researchers said. Current treatment studies include “pre-diabetes” patients who have abnormal blood sugar levels but do not need to take insulin.

Formerly referred to as juvenile diabetes because it disproportionately strikes children, type 1 diabetes is caused by an autoimmune condition in which the body’s immune system destroys insulin-producing beta cells in the pancreas. Even with insulin treatments, the blood glucose levels fluctuate abnormally, and as the disease progresses, diabetes increases the risk of kidney failure, heart disease and other serious disorders.

According to JDRF, as many as 3 million American have type 1 diabetes, and each year, more than 15,000 children and 15,000 adults are diagnosed with the disease in the United States. For reasons still unknown, the incidence of type 1 diabetes is increasing, and the age of onset is decreasing.

Controlling Autoimmune Reactions

Teplizumab is one of a number drugs under active investigation to control autoimmune reactions. Teplizumab uses an antibody targeted against a molecule called CD3 to bind to the immune system’s T-cells and restrain them from attacking beta cells.

Immunotherapies are designed to treat organ transplant rejection and autoimmune diseases, including multiple sclerosis, Crohn’s disease, rheumatoid arthritis and asthma. The use of these agents in type 1 diabetes is emerging based on work in preclinical models and clinical trials.

The journal’s print edition will include a commentary by Jay S. Skyler, MD, chairman of the National Institutes of Health-funded Type 1 Diabetes Trial Net, an international network of researchers that also studies teplizumab for prevention of type 1 diabetes. Skyler writes that the new results make a compelling case for U.S. Food and Drug Administration approval to launch a much larger-scale, phase 3 clinical trial of the drug’s effectiveness.

The study focused on 52 participants, most of whom were less than 14 years old, who had been diagnosed with “new-onset type 1 diabetes” within eight weeks of the trial’s start. All 52 were treated with the experimental drug for two weeks at diagnosis and again one year later, and their capacity to produce their own insulin to control their blood sugar was compared with a non-treated group.

Because the participants received daily insulin injections before and throughout the trial, researchers instead monitored their blood levels of C-peptide, a molecule produced in the pancreas at the same rate as insulin.

Watch this video to learn more about the groundbreaking work of the UCSF

Diabetes Center.

This research was a project of the Immune Tolerance Network (NIH contract #NO1 AI15416), an international clinical research consortium supported by the National Institute of Allergy and Infectious Diseases and the Juvenile Diabetes Research Foundation. It also was supported by NIH grants UL1 RR024131 and UL1 RR024139.

Co-authors on the paper and collaborators in the clinical trial with Herold and Bluestone include Stephen E. Gitelman, MD, UCSF; Mario R. Ehlers, PhD, and Peter H. Sayre, MD, of the Immune Tolerance Network (ITN), San Francisco; Peter A. Gottlieb, MD, University of Colorado;  Carla J. Greenbaum, MD, Benaroya Research Institute, Seattle; William Hagopian, MD, Pacific Northwest Diabetes Research Institute, Seattle; Karen D. Boyle, MS, and  Lynette Keyes-Elstein, DrPh, Rho Federal Systems Division, Chapel Hill; Sudeepta  Aggarawal, PhD, and Deborah Phippard, PhD, ITN, Bethesda; James McNamara, MD, National Institutes of Allergy and Infectious Diseases.

Conflict of interest statement: Jeffrey Bluestone has a patent on the teplizumab molecule. Kevan Herold has received grant support from MacroGenics, Inc., a company that owns rights to the drug.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.

Diabetes! You got to be kidding.

It is not exactly a lifestyle issue. Nor does it spread through human contact or viruses. Nevertheless, it is raging ahead, disrupting lives of many children, making them dependent on syringes and pumps for insulin.

Juvenile or type-I diabetes, which forces dependency on insulin, is on a rapid rise in the city.

It is only when parents consult doctors after noticing symptoms like sudden weight loss, frequent urination, restlessness, fatigue, increased hunger and thirst in their child, that this dark truth stems out.

Dr Sharath Chandran from a diabetes centre, Diabetacare, says many children and adolescents are getting detected, “some as young as a few months, to those in their late teens.”

Doctors say that unlike type-II diabetes, which generally strikes during adulthood and is a consequence of lifestyle reasons like obesity, juvenile diabetes does not have any particular lifestyle causes.

“It is usually owing to the destruction of the insulin-producing cells of the pancreas. But why exactly does this happens to some kids is not really known,” says Dr Anjana Hulse, paediatric endocrinologist from Apollo Hospital.

However, if one parent has type-I diabetes, chances of the child being a juvenile diabetic are high, says Dr Hulse.

Challenges for kids

Furthermore, the ailment hampers social and emotional well-being of children to a certain extent, say doctors.

“The child has to be cautious of his or her sugar levels, since they can experience very high or low sugar. And control their diets. All this requires lot of preparations and acceptance, specially on the part of the child,” says
Dr Hulse.

Deepa Lokhande, a diabetes educator in the city, says counselling and confidence-building are important among children.

“Since it calls for insulin, helping them overcome needle phobia and training them to take their insulin shots is crucial as it involves specified areas for taking insulin, right time etc.”

Meanwhile, parents say being diagnosed with juvenile diabetes affects children in every possible way, right from playing, eating, school, friends to birthday parties and so on.

Diet restrictions at a tender age

Madhu L, mother of a 14-year-old diabetic boy in the city, says, though her son has accepted his ailment, there are times when he broods as he cannot eat everything like his friends do.

“Initially, it was really tough to convince him that insulin is good for him and he needs to take it regularly. He would often ask why his friends don’t take it.”

While Prakash Kumar, father of a 15-year-old diabetic boy, says monitoring if the child has taken insulin on time during the school and tuition hours is difficult.

“My son has to be physically active to control his diabetes. With increasing studies and tuitions, it is not always possible to find time for exercises,” says Prakash.

Theresa May r MARTIN SCURR says Type 1 diabetes has dominated life of his …

  • Theresa May has been diagnosed with Type 1 diabetes at the age of 56
  • It will ignite attention of anyone who has an interest in this condition
  • Mrs May will have to inject herself with insulin, like my eldest son Ben

By
Martin Scurr

19:57 EST, 28 July 2013


|

02:20 EST, 29 July 2013

Sufferer: As a father I've seen first-hand how Type 1 diabetes has dominated the life of my eldest son, Ben, for the best part of 30 years

Sufferer: As a father I’ve seen first-hand how Type 1 diabetes has dominated the life of my eldest son, Ben, for the best part of 30 years

The news that Home Secretary Theresa May has been diagnosed with Type 1 diabetes at the age of 56 will ignite the attention of anyone who has an interest in this condition — especially as it is so rare for someone of her age.

I have several patients with Type 1 diabetes, but as a father I’ve seen first-hand how it has dominated the life of my eldest son, Ben, for the best part of 30 years.

In my 36 years as a GP, I can’t recall a fiftysomething patient who has developed it out of the blue. Doctors occasionally see the onset of Type 1 in teenagers or young adults in their 20s, but later than that is very unusual.

I would imagine someone as organised as the Home Secretary will be able to manage her condition and go on living a relatively normal life. But as I have seen with Ben, even if you are meticulous in your management of Type 1 diabetes, you can only minimise — never completely absolve yourself — of complications.

Mrs May, who had been strongly tipped to succeed David Cameron as Conservative leader, admits she often works an 18-hour day. And although long ministerial hours will still be achievable, she will have to ensure that she eats regular sit-down meals.

There can be no erratic snacking on chocolate or crisps for the diabetic.

Like Ben, Mrs May will have to inject herself with insulin. Some people use pumps which infuse a continuous flow of insulin rather than several large shots, but these are not as common as the injections — simply because they are formidably expensive and fairly new.

But no matter how careful you are, mistakes will be made, and we see this with Ben all the time. If he has too little insulin, or too much food and not enough exercise, he can’t go long before his blood sugar can go stormingly high.

The penalty for that is serious complications such as eye and kidney damage and a greatly increased rate of atheroma formation, the process of clogging up of arteries in the heart or brain with cholesterol deposits.

Too much insulin and he may pass out through too low a level of glucose in the blood, a so-called ‘hypo’ (hypoglycaemic attack).

Ben developed diabetes when he was seven, and as a child he would become very aggressive, spitting at us and lashing out before passing out unconscious if we couldn’t get a sugary drink or snack down him in time.

Although Ben manages his diabetes with great care and has led a full life — gaining a history degree from Manchester University and carving out a successful career in TV commercials — he has by no means been immune to complications. The Home Secretary should take heed.

Diabetes is the most common cause of acquired blindness in the western world, and six months ago Ben lost his driving licence because he has a retinopathy — where the retina at the back of the eye becomes damaged.

He has passed out on countless occasions, sometimes on his own on a train or in an airport where, distressingly, onlookers have mistaken him for a drunk. For that reason he wears a medical bracelet to alert people to his condition.

Coping: Like Ben, Home Secretary Theresa May (pictured last month) will have to inject herself with insulin

Coping: Like Ben, Home Secretary Theresa May (pictured last month) will have to inject herself with insulin

This will be something that Mrs May must be worried about. There’s every chance that she might keel over at the despatch box or in a meeting. For this reason, everyone around her — from her personal secretary to her driver — must be up to speed on her condition.

She will want to be independent, yet everyone must be aware of the signs and symptoms of her condition because every now and then a meal will get missed or she will take in too much insulin and she will go off beam.

A diabetic always wants to be independent but, as parents, we had to brief everyone from friends to teachers to skiing instructors about Ben’s condition in case he passed out.

Unfortunately, Ben has also suffered from kidney failure and had a transplant. Now, that kidney has also failed and he is due to go back on to dialysis.

One day in the next year or so, he hopes to have another transplant, this time of a kidney and pancreas, which should cure him of diabetes.

It’s very new technology and I know of no patients who have gone through this operation, but it’s part of the new world of transplanting that offers hope to diabetics everywhere. The tragedy is that he will have to wait for someone else to die before he can be cured.

Type 1 is most commonly called acute juvenile onset diabetes because it is a dramatic disease that suddenly appears and almost universally affects young people. Only last week, a child of only one was diagnosed at my practice.

This is in contrast to Type 2 diabetes, also known as maturity onset diabetes, which, although it is also recognised by the presence of high glucose levels in the bloodstream, is almost a different disease entirely.

We see Type 2 in middle-aged and older people, usually in the context of excess body weight, the problem being a relative rather than an absolute deficiency of the hormone insulin.

But Type 1 diabetes is a medical emergency and an incurable illness that occurs because of the sudden loss of insulin, a  protein hormone that is  produced by nests of cells that are situated in the pancreas.

Type 1 diabetes is a medical emergency
and an incurable illness that occurs because of the sudden loss of
insulin, a  protein hormone that is  produced by nests of cells that are
situated in the pancreas

Insulin is vital for the control of blood glucose levels. Glucose is the most important currency — the pound sterling — of energy in the body. It is the preferred fuel for our heart muscle, it is the only energy source that our brains can use, and insulin is the hormone that controls glucose levels, mobilising it from stores and enabling body tissues to use the glucose at the site needed.

With Type 1 diabetes, quite suddenly, insulin production ceases — usually because the cells making it are rapidly killed off by antibodies or a virus.

Glucose levels then soar and the patient becomes acutely ill within days, with weight loss, thirst, weakness and eventually a state called diabetic ketoacidosis — a derangement of the chemistry of the entire body, with over-breathing, vomiting and eventual loss of consciousness.

Before the Twenties, when insulin was discovered and could be purified (from beef or pig pancreatic tissue) and then injected as a treatment, death was the outcome.

Thankfully, treatment has come a long way since those dark days.

Ben was diagnosed six weeks after he had suffered a bout of chicken pox. Doctors believe that a virus may trigger Type 1 diabetes in someone who has a genetic susceptibility.

We had noticed he had started climbing up to the sink to drink water from the tap as he was suffering from extreme thirst. He was also getting up regularly in the night to urinate.

Colleagues: Home Secretary Theresa May is pictured with Prime Minister David Cameron earlier this month. Mrs May will want to be independent, yet everyone must be aware of the signs and symptoms of her condition

Colleagues: Home Secretary Theresa May is pictured with Prime Minister David Cameron earlier this month. Mrs May will want to be independent, yet everyone must be aware of the signs and symptoms of her condition

These are common symptoms of diabetes but to my shame, I didn’t spot what was happening straight away. At the time, my wife was 38 weeks pregnant with our second son, Cosmo, and I simply thought Ben was being wilful because the new baby was nearly here.

In the end, I took a urine sample which showed his sugar levels were high. So I took a blood sample and to my horror, his blood sugar reading was six times higher than it should have been.

I rang Guy’s Hospital to inform them of my boy’s symptoms and to my astonishment, they asked me to bring him in a couple of days. When I told them he would be dead by then, they admitted him straight away.

There, he was diagnosed with Type 1, and
my wife was admitted with him because she had to learn quickly how to
manage our son’s incurable illness.

Ben checks his blood glucose around four to five times a day – and it’s likely that the Home Secretary will have to do the same

His treatment involves striking a careful balance between food intake and the dose of insulin needed. Diabetics must be particularly watchful over the amount of carbohydrate and starch they consume, as glucose forms the main building bricks of much larger starch molecules.

Insulin is usually injected between two and four times daily, depending on the needs of the individual.

Ben checks his blood glucose around four to five times a day — and it’s likely that the Home Secretary will have to do  the same.

He has to prick his finger and insert a dot of blood into a portable gizmo. It means he can govern carefully what he needs to eat and also calculate the correct insulin dosage to inject into himself at that moment in time.

The Home Secretary will have to get used to this routine and fit it into her already busy schedule. How much energy she has been using a day will need to be taken into consideration. Sitting in Cabinet meetings or an office uses less fuel than dashing about to constituency meetings, going to the gym, or hill walking  on holiday.

The essence of treating a patient with diabetes is to educate them to enable them to self govern and take full responsibility for managing their own condition with rigorous self discipline and meticulous  attention to all details.

Only in this way are future complications minimised and a normal life possible — even for a future possible Prime Minister.

The comments below have not been moderated.

Perhaps Mrs May’s GP would consider offering her a DAFNE course? Dose Adjustment For Normal Eating – I have found it an extremely helpful guide in managing my “late onset” Type 1 [diagnosed as Type 2 initially just like Mrs May’s]. Diagnosed at 46, now 64, I am well, happy and still working [although part time and now in NZ] – I do think diabetes was there in the background for many years and perhaps only became a real problem following several years of overworking and long hours. Otherwise life is normal and insulin regime is a fact of life and best accepted as so.

ExPatLyn
,

Napier, New Zealand,
29/7/2013 23:10

My son was dignosed on 23/2/13 after go missed on the 21 st even though we expressed concerns he refused to test sugars but that’s another story and one that’s being investigated by the GMC as on the 23 rd he was admitted in diabetic KETO acidosis nt a nice condition and very frightening for patient and family members…..GPS need to listen to patients and parents and not stop when they make there mind up…..luckily for us we took him to hospital when we did as he would have been in a coma two hours later…..the blood test showed six times ove the limit for a child that’s a lot….his consultant says the condition was miked as my son does lots of activity so the onset was hidden until days before when his sugars were sky high…..as a paren I blame myself too but. Can’t change it he has diabetes and it could not have stopped it b getting there sooner….m son would not have been so poorly though and for a two pound blood sugar test my son could have been saved lots of pain…..

Sammy D
,

Staffordshire, United Kingdom,
29/7/2013 17:26

I have only three words for all the diabetics (type 1 or 2) out there. GOOGLE DR BERNSTEIN

kelebek
,

Turkey,
29/7/2013 16:48

WOW. you failed your child!! You are a DOCTOR and your son’s diabetes was so badly mismanaged that he has retinopathy and kidney failure? I’m 29, Type 1 since I was 10, and live in permanent fear that I will go blind etc, and had a normal teenage rebellion for a while but do not have any damage as yet. My parents didn’t pressure me, I had normal food. So how the HELL has your son become so damaged without serious failings on your behalf?! I don’t think you’re in any position to write such a stupid article. Glad you’re not my doctor, let alone my DAD!

emelsie
,

exeter,
29/7/2013 15:38

54 years and counting with Type 1, this Dr his son need to realise it is not the end of the world and get on with having a life! It hasn’t stopped me from doing anything, there are thousands, like me, that just get on with it rather than bleating about it!

Maggie
,

UK,
29/7/2013 14:46

My husband was diagnosed with Type 1 Diabetes at the age of 41, nearly 7 years ago and two years after our daughter was diagnosed with Type 1 at the age of 6. His GP thought it couldn’t be T1 and said T2 but consultant said he was Type 1. Its a misconception that they cannot develop it older. The consultant told my husband that the oldest person he had diagnosed recently with T1 was 73!!! Unfortunately we have Type 1 on both sides as my sister has been T1 for 30 years, our daughter now for 9 years, my husband for 7 years and his nephew for 5 years. He also has a cousin with T1. It takes a lot of hard work and effort to keep both of them healthy and unfortunately my daughter also has other health issues which makes it harder but she was lucky to be given an insulin pump two years ago which has made a huge difference to her overall control. Type 1 diabetes is a game of balance every day for the rest of your life and affects all the family involved.

Cat26
,

Glasgow,
29/7/2013 14:42

It always baffles me why diabetes type 1 sufferers would even consider eating anything with sugar in or even anything such as a sugar free juice? Water is sugar free, drink that! Red arrow me as I obviously don’t understand!
– LaughingGravy, Wirral, 29/7/2013 6:51.— Why shouldn’t people with diabetes have as much choice as the rest of us? Variety is the spice of life and children especially want to have something more exciting than water. Not just that but it helps people feel more normal? Also, as far as I’m aware, diabetics need sugar in their diet they just need to be careful about how much.

Charli
,

Cardiff,
29/7/2013 14:33

Like any disease, some have a harder time than others. I sympathize with those who have lost limbs or organs and congratulate those who have not. The difference is certainly not always because one person is more diligent than another. To think so is cruel and ignorant.

SantaFeJack
,

Newport News VA USA,
29/7/2013 14:33

My sister has diabetes and copes fine!

Richard M
,

Stockholm-Expat,
29/7/2013 13:47

Most people think of diabetes Type 1 2 as one condition but they’re no’s no comparison. When my 5yr old son was diagnosed with Type 1 some years ago (no family history) – I was told diabetes is nothing these days!!! However it completely changed our family life – I had needle phobia too but had to overcome it – blood samples were worse for me. Meals, snacks, exercise, illness hypo’s had to be managed as well as looking after the other 3 children one only a few days old. The belief is that many more people carry the gene for Type 1 diabetes than have it but it needs a trigger – in our case a virus, Type 2 diabetes is relatively common in the older age group but can be managed with diet, diet and tablets and in some cases with insulin – but not to be confused with Type 1 diabetes. It’s onset is usually gradual and it’s possible with proper diet and exercise to avoid type 2 diabetes. Mrs May will have to cope with the changes to her life and it’s easier if others know

JF
,

Birmingham, United Kingdom,
29/7/2013 13:24

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Now, diabetic therapy from abdominal fats

Institute of Kidney Diseases Research Centre (IKDRC) claims to have successfully used stem-cells to bring down dependence of type-I diabetics on insulin.

The institute has claimed to be the first to discover insulin producing cells in abdominal fat and use it in stem-cell therapy to bring down patient’s dependence on insulin. A paper regarding the same was presented by the research team of IKDRC — led by its director Dr HL Trivedi at the 12th International Congress of Cell Transplantation Society at Milan, Italy.

Speaking about the discovery, Dr Trivedi said that the team experimented with fat from the abdomen.

“We found three genes that were identical to the genes that produce insulin in pancreas. What were the genes doing in the abdominal fat was a question. But more important was that we managed to use them in stem-cell therapy to reduce diabetics dependence on insulin,” said Dr Trivedi.

He, however, clarified that so far the use of stem-cell has only helped reduced the dependence of diabetics on insulin and not in eliminating it. “In future we may be able to achieve that too,” said Dr Trivedi.

Associate professor in regenerative medicine and stem-cell therapy Dr Umang Thakkar, who presented the paper on use of stem-cell in type-I diabetes, said 20 patients were taken for the study.

“Ten of them had stem cells from abdominal fat of a donor while the remaining used cells from their own body fat. The latter group showed better response because your body tends to accept its own cells rather than from a donor. 45% reduction in insulin dependence was registered in the group that used its own body fat while it was 35% for the other group. The mean age of the group was 20 years,” said Dr Thakkar.

He said another encouraging factor was that in the group that used stem-cells from its own body fat there were no instances of ketoacidosis — a condition common among diabetics in which there is sudden spurt in blood sugar level accompanied by breathlessness. All the patients in the study group were type-I diabetics.

Pot-Based Diabetes Drug Maker GW Sees Slowing of Illness

The marijuana plant contains at
least 60 different chemical compounds, only one of which gets a
smoker high. GW Pharmaceuticals Plc (GWP) says one of the other 59
shows promise in treating Type 2 diabetes.

In a mid-stage study, an experimental drug, currently known
by its candidate name GWP42004, helped improve the pancreas’s
ability to produce insulin and led to a drop in blood sugar
levels between meals, among other findings, according to the
London-based company. GW plans to publish the results of that
trial this year.

GW’s drug is just one front in a wider effort to find
better treatments for diabetes, a malady that afflicted 371
million people and killed 4.8 million worldwide in 2012,
according to the International Diabetes Federation. Although
it’s still years away from regulatory approval and skeptics
question whether it will ever get there, the treatment may slow
the progression of the illness and prolong the time before
diabetics need to take insulin shots.

“For Type 2 diabetes patients, after a number of years,
all oral therapies fail, requiring them to take insulin,” said
Mike Cawthorne, director of metabolic research at the University
of Buckingham and a paid consultant to GW. With GWP42004, “they
could potentially be controlled on oral therapy for a longer
period of time and wouldn’t need to take injections,” said
Cawthorne, who led the team at GlaxoSmithKline Plc that
discovered Avandia, once the world’s best-selling diabetes pill.

People with type 2 diabetes don’t produce enough insulin, a
hormone that helps the body use or store blood sugar, or can’t
use the insulin properly. The illness, the most common form of
diabetes, often strikes people over the age of 40, and is tied
to obesity and sedentary lifestyles.

The market for drugs to treat diabetes is likely to grow to
more than $58 billion in 2018 from $35 billion in 2012, Standard
Poor’s
wrote in an October report.

Marijuana Supply

GW Pharma is also developing drugs to treat schizophrenia,
ulcerative colitis, and epilepsy from cannabinoids taken from
its own supply of marijuana grown in an undisclosed location in
southeast England. The company’s first commercialized drug,
introduced in mid-2011, is Sativex, which treats muscle spasms
in multiple sclerosis patients.

The diabetes drug could be dimming switches in the body
called cannabinoid receptors to stimulate the ability to respond
to insulin, Cawthorne said. Alternatively, the drug may be
helping to release GLP-1, a hormone that also increases insulin
sensitivity, he said.

Acomplia Comparison

GW plans to start a follow-up study this year. One possible
hurdle is that the treatment faces comparison to Sanofi’s
unsuccessful obesity drug Acomplia, which worked on the same
cannabinoid receptors, said Stephen Wright, GW’s director of
research. Acomplia was pulled from the market in 2008 because of
side effects including suicide and depression.

“The bar is possibly higher for cannabinoids because of
Acomplia,” Wright said in an interview.

GW has fallen 17 percent to 49.25 pence this year in London
trading, giving the company a market value of 87.4 million
pounds ($133.4 million).

In animal studies and in the small mid-stage study, the
diabetes drug appeared to preserve the mass and function of
cells in the pancreas that produce insulin, said Cawthorne.

Even so, GW must show the drug has an impact on insulin
resistance to slow the progression of the disease, said Sam Fazeli, a Bloomberg Industries analyst in London. Ultimately,
the company must prove that it controls blood sugar levels.

If successful, the drug will likely be taken in combination
with other therapies such as metformin, the most commonly used
medicine to lower blood sugar, and a class of drugs called DPP-4
inhibitors, which also help lower glucose levels, Cawthorne
said.

Premature Projections

Given the small size of the study– just 35 patients taking
GWP42004, early stage of research, and difficulty of developing
diabetes drugs, any projections of eventual success are
premature, said Samir Devani, an analyst at Nomura Code
Securities Ltd. who rates the company “neutral,” said in a
phone interview.

Regulators are also wary of cardiovascular risks in
diabetes drugs. Glaxo’s Avandia was withdrawn from the market in
Europe in 2010 and sales were limited in the U.S. because of an
increased risk of heart attacks. The Food and Drug
Administration
in February rejected Novo Nordisk A/S (NOVOB)’s new
insulin Tresiba, demanding a new study to assess the heart
risks.

“In diabetes, you need a massive investment, and people
are acutely aware of the challenges,” Devani said.

To contact the reporter on this story:
Makiko Kitamura in London at
mkitamura1@bloomberg.net

To contact the editor responsible for this story:
Phil Serafino at
pserafino@bloomberg.net


Enlarge image
Cannabis Drug for Diabetes Treads Ground Where Sanofi Failed

Cannabis Drug for Diabetes Treads Ground Where Sanofi Failed

Cannabis Drug for Diabetes Treads Ground Where Sanofi Failed

David Paul Morris/Bloomberg

The marijuana plant contains at least 60 different chemical compounds, only one of which gets you high.

The marijuana plant contains at least 60 different chemical compounds, only one of which gets you high. Photographer: David Paul Morris/Bloomberg


Enlarge image
GW Pharmaceuticals Plc's Director of Research Stephen Wright

GW Pharmaceuticals Plc’s Director of Research Stephen Wright

GW Pharmaceuticals Plc's Director of Research Stephen Wright

Simon Jarrett via Bloomberg

GW Pharmaceuticals Plc’s director of research Stephen Wright, said that GW Pharma is planning a follow-up mid-stage study later this year in the hopes that it works better to attack diabetes on multiple fronts compared with existing treatments.

GW Pharmaceuticals Plc’s director of research Stephen Wright, said that GW Pharma is planning a follow-up mid-stage study later this year in the hopes that it works better to attack diabetes on multiple fronts compared with existing treatments. Photographer: Simon Jarrett via Bloomberg

Geelong residents among 'most at risk' of diabetes

“We certainly know diabetes has become an epidemic and it is increasing,” she said.

As many as 280 Australians develop diabetes every day – nearly 100,000 Australians developed diabetes in the past year.

Diabetes Australia chief executive Professor Greg Johnson said the number of people being diagnosed with diabetes was continuing to grow.

“Over 1.5 million Australians have diabetes and an additional 100,000 per annum develop diabetes,” he said.

“There are hundreds of thousands of people in Australia with silent type 2 diabetes who are yet to be diagnosed.”

In her clinics around the region, Ms McMaster said many people refused to believe they had diabetes.

“They come in and say this is completely unfair and often I have people who ask to be tested again,” she said.

Lyn Curtis from Diabetes Australia’s Victorian branch said there was a large level of complacency towards the condition.

“There are two million Australians who actually have pre-diabetes currently, so that means they will go on to get type 2 diabetes within the next five years unless they do something to prevent it.”

For information, visit diabetesvic.org.au

 

 

 

Won’t stop me, says Kim 

LIVING with diabetes can be challenging but Ocean Grove’s Kim Henshaw doesn’t let it hold her back.

Mrs Henshaw who was diagnosed with type 1 diabetes 26 years ago, works for Diabetes Australia and runs an online community to support people living with the condition.

Every day she tests her blood glucose with a device attached to her smartphone and uses an insulin pump to manage her condition. 

“I don’t let it get in the way of me enjoying my life and achieving things,” she said.

Unlike the more common type 2 diabetes, which is often triggered by lifestyle choices of being inactive or carrying excess weight, type 1 is an autoimmune disease, where the the body is unable to make its own insulin.

“It’s not preventable, it can be genetic but also can be very random,” Mrs Henshaw said.

“It’s a tough disease to have, you are expected to manage it yourself 24 hours a day,” she said.

“Everybody does their best, and then to be accused of causing it can be very distressing.”

* Kim’s blog: 1type1.wordpress.com

 

 

Karnataka needs 8000 diabetes educators

With diabetes cases skyrocketing in the state and city, Karnataka urgently needs 8,000 diabetes educators. Currently there are about 400 educators in city, who also counsel patients and their relatives in the rest of the state.

These educators, who are mostly science graduates now working as either nurses, lab technicians, dietitians and social workers; work as a link between doctors and diabetics. Right from counselling patients on insulin techniques, how to test blood sugar, hypoglycemia and its symptoms, etc, the role of educators is deemed key when it comes to diabetes control.

“Once a person is diagnosed as being diabetic, he/she faces depression about his/her condition and anxiety about taking insulin. Doctors have limited time.
Hence, educators are needed to make patients self-reliant and boost their confidence,” says Dr KM Prasanna Kumar, CEO of Bangalore Diabetes Centre.

Deepa Lokhande, an educator in the city, says counselling and confidence building is more important among children who have diabetes. “Since children usually have Type I diabetes that calls for insulin, helping them overcome needle phobia and training them to take their insulin shots is crucial.”

Experts say diabetes care involves at lot of nitty-gritty including right time for taking insulin, specified areas for taking the shots, site rotation, and constant monitoring of sugar levels. “Since it is a life-long problem, patients also have to be well-trained to handle their situations. And for training patients, we need these educators,” says Kumar.

To train more and more diabetes educators, doctors are expanding the educator courses. Kumar says currently there is a six-month educator course followed by an exam, which is approved by the International Diabetes Federation.

“We are planning to roll out this course online so that more people from across the state can participate and get trained as educators,” says Kumar, adding that in a state the size of Karnataka, 400 educators is a very small number.

The online courses could start in one to two months time, and would train and certify professionals as educators. “We are also planning to enroll pharmacists for the course since they too remain in close contact with patients.”