Diabetes is a serious disease affecting millions of people in the United States, adults and children alike. While there is yet no cure for diabetes, researchers are gradually learning more about the mechanism behind the illness. New research identifies how insulin-producing cells can change to avoid the autoimmune attack present in type 1 diabetes.

The Centers for Disease Control and Prevention (CDC) report that more than 29 million people (or over 9 percent of the population) currently have diabetes in the U.S.

Although type 1 diabetes is the least prevalent - accounting for only 5 percent of diabetes cases - it is not yet known how to prevent the illness.

Type 1 diabetes is an autoimmune disease. The body does not recognize its own insulin-producing beta cells, so the immune system attacks and destroys them as if they were invaders. The body needs insulin to metabolize sugar and turn it into energy.

However, of these beta cells, some manage to survive. In fact, some of the cells persist and proliferate for years after the disease has started.

New research, led by professor of immunobiology Dr. Kevan Herold of Yale University in New Haven, CT, identifies the mechanism that explains how these beta cells survive the immune attack. The study was a collaboration with the Broad Institute of Massachusetts Institute of Technology and Harvard.

The findings were published in the journal Cell Metabolism.

The scientists investigated the adaptive changes in beta cells that take place during the immune attack in both mouse models and in human cell culture. They used cyclophosphamide to accelerate the diabetes onset.

Herold and colleagues identified a resistant subpopulation of beta cells in 9-week-old, non-obese diabetic mice. The new subpopulation seems to develop from normal beta cells when they detect infiltration into the islet.

These new cells have a lower granularity, and they develop during the progression of type 1 diabetes.

"During the development of diabetes, there are changes in beta cells so you end up with two populations of beta cells. One population is killed by the immune response. The other population seems to acquire features that render it less susceptible to killing."

Dr. Kevan Herold

The new subpopulation is also less differentiated and displays stem-like properties. Much like stem cells, they have the ability to revert to a previous stage of development that enables them to survive and continue to replicate despite the immune attack.

As the study's senior author explains, these cells "duck and cover" as they develop molecules that inhibit the immune response. Human beta cells were revealed to go through similar changes when the researchers cultured them together with immune cells.

Although the cells do eventually die, the authors explain, the mechanism they uncovered might account for the long-term development of type 1 diabetes.

"Eventually, in [non-obese diabetic] mice as in humans, the majority of - if not all - [beta] cells are destroyed by immune effectors and products. However, the process is protracted. We have identified mechanisms that [beta] cells use to survive. Future studies that can recover mature [beta] cells from the pool of modified cells may identify ways of restoring normal metabolic function together with immune therapy," the authors conclude.

As Herold notes: "The next question is, can we recover these cells so that there is insulin production in someone [with] type 1 diabetes?"

Herold and team intend to conduct clinical trials to test drugs that might have the potential to change this subpopulation of beta cells, and transform it into insulin-producing cells.

Learn how interspecies transplantation may be a viable treatment for type 1 diabetes.

Written by Ana Sandoiu

Original post:
Why does type 1 diabetes kill some cells but not others? - Medical News Today

Breaking through technology to help diabetes

WATERVILLE, Maine (NEWS CENTER) --More than one million people in the U.S. have type 1 diabetes, a disease where patients don't produce insulin to manage blood sugars. Left unchecked it can lead to blindness, damage to vital organs and even death.

Diabetics have to monitor their blood sugars all day, every day. With no cure in sight, a group of parents tired of waiting for technology to better manage their children's diabetes are hacking into medical devices and creating systems that work with their smart phones.

It all started with a Facebook group of tech-savvy parents who took matters in their own hands, tinkering with medical devices to track their children's blood sugar levels remotely. Other patients also transformed their insulin pumps and monitors into 'artificial pancreas systems'.

Now families in Maine are using the software to build devices not approved by the FDA but they say keeping their children safe outweighs the risks.

Leo Koch was diagnosed with Type 1 diabetes when he was two years old. When he sleeps at night extremely high and low sugar levels could put him in a potential fatal diabetic coma.

'It's a very real fear at night time, when they're asleep because he wouldn't necessarily say I don't feel well, I feel sick and their blood sugar plummets and you wouldn't have any kind of warning," said Koch.

The 5th grader wears a continuous glucose monitor with a hair-thin sensor placed under his skin on his arm. It records precise readings every five minutes. He also wears a pump so he can inject insulin when he needs it. Desperate to keep better track of her son's unpredictable blood sugars Koch joined a Facebook group of parents called 'WeAreNotWaiting'.

'We are absolutely not waiting, we're done waiting. It's taken too long we know there is technology out there that makes his life better,' said Koch.

Dubbed "Nightscout', the parents designed a system that hacks into continuous glucose monitor and uploads the data to a cloud via smartphone or smartwatch connected to the device.

Hilary down loaded the free software and built a website that displays Leo's data. It also sends alerts if his sugars are too low or too high. Leo's phone and texts from his Mom remind him to take insulin or eat something. With Leo participating in a variety of sports his mother needed better way to control his blood sugar levels but there wasn't anything available approved by the FDA.

Following instructions shared online, which hacked an old insulin pump so it could automatically dose insulin in response to blood sugar levels, Koch built an 'artificial pancreas'. Also called a closed loop, she had to buy a special transmitter that allows Leo's glucose sensor and insulin pump to communicate with each other for the first time.

Dr. Mick Davidson is an endocrinologist at Wentworth Health Partners in Dover, New Hampshire. A specialty that treats diabetics. Diagnosed with Type 1 at a young age, he joined the do-it-yourself revolution to help manage his disease.

Dr. Davidson uses both Nightscout and the closed loop system which he controls with this app on his iphone. Dr. Davidson says since using the device his blood sugar levels have become more stable. His finger stick blood sugars have gone from as much as 15 a day to less than four.

He feels the system helps patients better control their blood sugar especially while sleeping. Because the system is not FDA approved, he nor his practice can help a patient in building a system but.

'If someone is interested and willing to build it on their own and again trouble shoot it using the help of all the members of this huge online community, I have no hesitation recommending it," said Dr. Davidson.

Koch and other volunteers are helping families in Maine build Nightscout websites and closed loop systems. Ashley Thomass husband Ross and 5 year-old son Liam have Type 1 diabetes. Liam went online with his artificial pancreas a couple of months ago.

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Hackers are sparking a do-it-yourself revolution in diabetes care - WCSH6.com

Buncombe County, like much of the nation, has a diabetes problem. The diseasewas ranked as the 10th-leading cause of death in the countyin the 2015 Community HealthAssessment, an annual gathering of data from residents to determine local wellness in relation to state and national averages. While there are numerous reasons why this has become an epidemic, the assessment found that23.5 percent of Buncombe adults are obese, and that just over 30 percent of students in K-5 public schools are overweight or obese, factors that increase the incidence of diabetes.

The good news: Asheville-area health professionals say there are affordable and accessible ways to address this growing risk for generations young and old. A wealth of information, diet trends and practiceshas emergedto address weight loss and the prevention of diabetes.

Christin Banman, a registered dietitian with Mountain Kidney and Hypertension Associates, is accustomed to dealing with the factors that lead to diabetes, Type 2 in particular. You immediately have to get into the home life situation with these issues, she says.Who does the cooking? Whos in the house? The majority of her patients have fought weight gain, high blood pressure and long-standing medical issuestheir entire lives. Their multiple problems create the onset of Type 2 diabetes, she says, which in turn causes kidney malfunction due to higher levels of blood sugar.

Banmans advice for someone who has contracted the disease and is seeking reversal of the diagnosis is similar to that shed offeranyonewho is prediabetic. She recommends affordable and simple dietary solutions that include buying frozen vegetables for cost and longevity, avoiding most beverages in favor of purchasing foods, buying grains in bulk, and shopping at Aldi and other affordable markets in their area.

Watchingyour weightis key to help preventing Type 2 diabetes, Banman says. I really feel like if someone can jump start or hit the restart button with the sugar busters or Atkins diet just to get an initial amount of weight off, Im a supporter of that. I think the long-term benefits of just getting a little bit of weight off exceed the consequences of that diet.

I think what were dealing with is whats referred to as a toxic food environment, where we have heavily marketed, very inexpensive, unhealthy foods on every corner in hospitals, airports and even in our school systems, she continues. This food environment surrounds us. So its hard for me to argue with someone who says, The croissant sandwiches were two-for-one on the way in. With someone that has limited food money, that speaks. So thats part of the food environment were dealing with.

Diabetes and lifestyle

Type 2 diabetes affects 29.1 million people in the U.S., according to the Centers for Disease Control and Prevention.The most common causes for the onset of this illness are obesity, smoking, physical inactivity, age, family history, high blood pressure and a high alcohol intake,according to WebMD.

Diabetes causes blood glucose levels to rise above normal. When people eat, their bodies turn food into glucose, or sugars, for their body to use as energy. The pancreascreates the hormoneinsulin, which allows those sugars to get into the cells of the body. But with Type 2 diabetes, thebody is no longer able to use its own insulin as well as it should, causing sugar to build up in theblood.

In 2014, the North Carolina State Report nameddiabetes as the seventh-leading cause of death in the state, the fourth-leading cause for African-Americans and the third-leading causefor American Indians. In WNC, the rate of white people living with the disease is highest, at 11.6 percent, while the rate of African Americans in the eastern part of the state is 15.3 percent.

Harvard UniversitysPATHS (Providing Access to Healthy Solutions) report for North Carolina in 2014outlined how legislation could mitigatethe disease, including a mandate for insurers to cover diabetes-related services as well as the creation of a unified public health system to providewhole-person care. The PATHS report is funded through Together on Diabetes,a philanthropic program of the Bristol-Myers Squibb Foundation,and was launched in 2010 to improve the health outcomes of people living with Type 2 diabetes bystrengthening patient self-management education, community-based supportive services and broad-based community mobilization.

Short of legislative measures, how can the millions of Americans seeking to control their weight and improve their health avoid Type 2 diabetes?

Dr. Daniel Stickler of the Apeiron Center for Human Potential in Asheville relates the illness tolifestyle. Type 2 diabetes is not truly a disease, he says.Type 2 diabetes is a lifestyle aspect. You can progress to the point where you actually poison your beta cells in the pancreas after years of being Type 2 diabetic, but it really is a lifestyle. Weve seen plenty of reversals on people that were diabetic or prediabetic that changed their lifestyle and completely reversed the disease without medication.

Stickler saysthat a whole-person approach is needed. Apeiron uses that approach, looking closely at a persons genetics and at about 75 different genomic variations that help predict appetite, hunger and nutrient selection from fats to carbs and proteins.Apeiron tailors diets specifically around a persons genomics, goals and experiences to create a program that is individualized, rather than using a diet from a book.

The problem that you run into is that when you diagnose someone with a disease, they become the disease, Stickler says. The title becomes them, and until they can get to the point where they understand they are not Type 2 diabetes, youre not going to make any progress with them. Were treating it with these medications that arent treating the core cause, which is lifestyle. Its OK to bridge that to get things under control, but the whole focus needs to be on treating the core cause, which is a lifestyle component that has created an insulin resistance in the body. And it is easily reversible.

We have epigenetic coaches that work with clients and read their genetic data, looking at 500 genetic variations and working with sleep, stress, nutrition, exercise and human movement environment, thoughts, etc. So were venturing into all realms in how we address health.

Ways to approach diet, exercise

Banman notes thatMedicare initially covers only three hours a year of dietary intervention and just two hours annually thereafter. This is where support becomes very limited, she says, adding that a majority of her patients arediagnosed in their mid-60s, which makes it difficult for them to get up and get moving. In addition, stress from finances, work and family are debilitating factors, pushing diet and exercise to the bottom of their priorities. Im struck with the layers in their lives that are making things so complicated, and Im very sympathetic to it and help however I can, she says.

Stickler and Banman both recommend the Mediterranean diet, which is in concert with the diabetic diet, according to Banman, and which research has consistently shown to bean effective way to also reduce the risk of heart disease, lower low-density lipoproteins (or bad cholesterol) and lower risks associated with cancer, Parkinsons and Alzheimers diseases.

The American Diabetes Association outlinesa Mediterranean meal plan on itswebsite. Key components of the diet, according to the Mayo Clinic, are limiting red meat;eating fish at least twice a weekand otherwise primarily plant-based food, whole grains and nuts; replacing butter with olive oil; and using herbs and spices instead of salt.

In Buncombe County, residents can address stress, exercise and dietthrough the Diabetes Wellness and Prevention Program offered by the YWCA, a program designed specifically for adults with or at risk for Type 2 diabetes. Preventive health coordinatorLeah Berger-Singer saysthatparticipants are given a gym membership, bimonthly personal training, aweekly support group (which discusses health-related topics such as living healthy on a budget) and tips onstress management. Were aiming to provide access to people that may not otherwise have access to a gym, cooking classes, swim lessons and other options, she says.We also provide monthly dinner lectures or lunch and learns, hands-on cooking demos, field trips and other extracurricular activities.

Chiropractor and yoga instructor J. Anya Harris of Crystalign Chiropractic in Asheville saysthat stress-reduction techniques coupled with group exercise can be keys to combating many diseases, including diabetes.Getting out of your routine and your house and away from your cellphone is really important, she advises. Her approach with patients is to address both spinal health and overall physical health, as well as stress and energy levels. Chiropractic care helps to create arange of motion and mobility, freeing up the body to get patientsto the point where they feel good enough to exercise again or continue exercising, she explains. It also opens up the neural pathways that keep the organs, muscles and spine balanced, she adds. With the energy work, Im shifting relationships and trauma to give them the spark to get them moving. Its all about setting up the mind, body and soul to help them feel at ease in their own skin and really define their why. If you dont know your why, then none of it matters, because you wont stay consistent. The why will give them reframing in their consciousness that will keep them moving toward their goal.

For more information:

Mountain Kidney & Hypertension, 10 McDowell St., Asheville, offers a variety of services, including diet and meal planning for diabetics and services for those suffering from hypertension and kidney disease. 258-8545

The Apeiron Center for Human Potential, 190 Broadway, focuses on preventive wellness, including genomic assessments, epigenetic coaching and human potential assessments and coaching. (888) 547-1444

Crystalign Chiropractic,36 Clayton St., off Charlotte Streetin Asheville, offers head-to-toe chiropractic adjustments, trigger-point muscle therapy, energy work, nutrition analysis and wellness coaching. 335-2208

The YWCAs Diabetes Wellness and Prevention Program operates atthe YWCA in downtown Asheville, offering a comprehensive diabetes program to prevent or reverse the illness.Preventive health coordinator Leah Berger-Singer can be reached at 254-7206, ext.212, or Leah.bs@ywcaofasheville.org.

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Exercise and a healthy diet help prevent Type 2 diabetes - Mountain Xpress

Xeno-created pancreata the future of diabetes treatment? Nature.com New research published in Nature has demonstrated that glycaemic control can be restored in mice with streptozotocin-induced diabetes following the transplantation of mouse islets that were grown in rats. Using pancreatogenesis-disabled rats to ...

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Xeno-created pancreata the future of diabetes treatment? - Nature.com