Artificial pancreas in final testing phase

The 'artificial pancreas', which has been developed by the University of Virginia School of Medicine, is to enter its final testing phase.

The announcement was made in a press release issued on January 4. The 'artificial pancreas' would allow type one diabetics to automatically monitor and manage their blood sugar levels; two clinical trials are due to get underway in early 2016.

Studies are to be conducted in nine locations throughout the United States and Europe. If successful, the management system could ultimately one day lead to regulatory authorities approving the 'artificial pancreas' for the treatment of type one diabetes.

240 patients will take part in the first study, while 180 will participate in the second trial.

Lead researcher of the first study, Boris Kovatchev, PhD, director of the UVA Center for Diabetes Technology, said:

“To be ultimately successful as an optimal treatment for diabetes, the artificial pancreas needs to prove its safety and efficacy in long-term pivotal trials in the patient's natural environment.”

“Our foremost goal is to establish a new diabetes treatment paradigm: the artificial pancreas is not a single-function device; it is an adaptable, wearable network surrounding the patient in a digital treatment ecosystem."

What is the artificial pancreas?

If it proves successful, the artificial pancreas could eliminate the need for  finger prick blood tests and the manual injection of insulin.

Source:
http://www.newswise.com/articles/pioneering-artificial-pancreas-to-undergo-final-tests

Type 2 diabetics benefit from glucose monitoring

Type 2 diabetics can make improvements to their glucose control even if they aren't on insulin, according to research presented at the Americian Association of Diabetes Educators Annual Meeting and Exhibition.

The research indicates that by having a personalised glucose testing regime in place, Type 2 diabetics feel motivated to watch their diet more carefully and to take their medications. Glucose monitoring also encouraged Type 2 diabetics to be more active. This makes it possible for Type 2 diabetics to lower their blood sugar levels and to reap the benefits of improved glucose control.

Diabetes educator Dana Brackney, PhD, RN, CDE, assistant professor of nursing at Appalachian State University, Boone, N.C, said:

"Participants in this study said that sticking to a regular SMBG schedule really helped them to know where their blood levels were and take appropriate action, such as adding physical activity or choosing a healthy snack."

“They said it helped them accept that they had diabetes, but also feel confident that they could control it rather than letting it control them.”

Although the study was small, the results are ecnouraging. The 11 participants were able to bring their A1C levels down from an average of 7.3 per cent to 6.2 per cent.

Type 2 diabetics are often told they do not need to test their glucose levels, but the study shows the value of glucose testing for Type 2 diabetics.

Source: http://www.newswise.com/articles/view/638062/?sc=mwhn

Smart Insulin in Development

Imagine a "smart insulin" that acts in accordance to the body's natural highs and lows in blood sugar levels. As a type one diabetic, it would be a dream come true, and it is a dream that has moved one step closer to reality.

A team at the University of Utah have been testing Ins-PBA-F out on a mouse model; he insulin activates when the blood sugar increases, helping to effectively manage the peaks in blood sugars. Each injection will be active for at least 14 hours and it is said to be faster acting than Levimir.

Early trials show that when used in mouse models, the "smart" insulin works just as well as the insulin produced by healthy mice.

Co-first author Danny Chou, Ph.D., USTAR investigator and assistant professor of biochemistry at the University of Utah, said:

"This is an important advance in insulin therapy,"

However, as Chou goes on to explain, it will be sometime before it becomes available for human use:

“Our insulin derivative appears to control blood sugar better than anything that is available to diabetes patients right now.” He will continue evaluating the long-term safety and efficacy of Ins-PBA-F. The insulin derivative could reach Phase 1 human clinical trials in two to five years."

Matthew Weber, Ph.D., co-first author with Chou and Benjamin Tang, Ph.D., who performed the work together while postdoctoral fellows at MIT in collaboration with senior authors and MIT professors Robert Langer, Ph.D., and Daniel Anderson, Ph.D., said:

At present, there is no clinically approved glucose-responsive modified insulin,”

“The development of such an approach could contribute to greater therapeutic autonomy for diabetic patients.” 

Source:

Glucose-responsive insulin activity by covalent modification with aliphatic phenylboronic acid conjugates. Danny Hung-Chieh Chou, Matthew J. Webber, Benjamin C. Tang, Amy B. Lin, Lavanya S. Thapa, David Deng, Jonathan V. Truong, Abel B. Cortinas, Robert Langer, and Daniel Anderson. PNAS Early Edition, Feb. 9, 2015

The press release can be viewed here.
 

FDA approves Jardiance for treatment of type 2 diabetes

The FDA has approved jardiance for the treatment of type 2 diabetes, it was announced today. Jardiance, which is also known as empagliflozin, is used alongside exercise and a balanced diet to help improve glycemic control in adults with type 2 diabetes.

Jardiance works by preventing the re-absorption of blood sugar by the kidneys and increases glucose excretion. It also lowers the blood sugars of patients with type 2 diabetes when their glucose levels are elevated.

Commenting in a press release, Curtis J. Rosebraugh, M.D., M.P.H., director of the Office of Drug Evaluation II in the FDA’s Center for Drug Evaluation and Research, said:

"Jardiance provides an additional treatment option for the care of patients with type 2 diabetes."
“It can be used alone or added to existing treatment regimens to control blood sugar levels in the overall management of diabetes.”

Nearly 5,000 patients with type 2 diabetes took part in the trial and it was found that the drug effectively improved the AIc levels when compared to a placebo.

Studies have been conducted into using jardiance as a standalone treatment for type 2 diabetes and it has also been used in conjunction with other forms of drugs such as metformin.

However, the drug can't be taken by patients with type 1 diabetes, patients on kidney dialysis, end stage renal disease, or by patients with high levels of ketones in their blood or urine.

The original press release can be found here.

American Association of Diabetes Educators offers Travel Tips

Holiday season will soon be in full swing so the American Association of Diabetes Educators have issued a press release detailing some travel tips.

Newswise — AAA estimates 36.1 million people will travel this Memorial Day weekend. If diabetes is your constant companion, that doesn’t mean you can’t enjoy traveling, whether traversing America in an RV or flying to the far reaches of the globe. Ensuring you stay healthy and keep your glucose levels on an even keel does require a little bit of organization and planning ahead, though.

The American Association of Diabetes Educators suggests a plan of attack for ensuring your next travel adventure is safe and successful:

- Over-pack your medications – Gone for a week? Pack two weeks’ worth of your diabetes medications in case of travel delays or misplaced supplies (insulin, syringes, testing strips, extra batteries for your pump, a first-aid kit, glucagon emergency kit, etc.). If you use a pump, ask the company if you can bring a backup in case yours fails. Have a prescription from your doctor for insulin or oral medication in case of an emergency.

- Protect your supplies – Keep your medications and supplies close at hand and don’t put them in checked luggage or in the trunk, where they can be exposed to harmful extreme temperatures (too hot or too cold). If you’re flying, keep them in the original packaging (so no one questions they’re yours) in a bag separate from your toiletries, as requested by the Transportation Security Administration (TSA), which manages airport security. Don’t worry, the TSA allows you to go over the 3.4 liquid-ounce carry-on limit for diabetes medications and supplies.

- Identify yourself – Wear your medical bracelet or necklace that notes you have diabetes and take insulin (if you do). Bring a doctor’s note that explains you have diabetes and lists your medications, as well as a prescription in case you need more. Carry a health card that includes your emergency contact and doctor’s name and phone number. Learn how to say “I have diabetes,” “sugar,” and “orange juice, please” in the language of the country you are visiting.

- Carry snacks and low blood sugar treatment – Low blood sugar (hypoglycemia) can strike any time and food access during travel is unpredictable, so be sure to bring plenty of snacks such as peanut butter crackers, granola bars and trail mix as well as glucose tablets or gel.

- Simplify flying – Tell the TSA folks that you have diabetes (they’re used to accommodating people with health issues). Visit http://www.tsa.gov/traveler-information/passengers-diabetes before your trip to learn about current screening policies. If you plan to inject insulin while flying, be forewarned – the pressurized air can make it more challenging to draw up your insulin, if using a vial and syringe, so be extra careful not to inject air into the bottle.

- Test often – New foods, increased activity and different time zones can throw your glucose levels out of whack, so be sure to test frequently, including before and after meals. If you take insulin, keeping your levels steady can be tricky when changing time zones, so make a plan to adjust your schedule for injecting. Before your trip, see a diabetes educator, who can help you with this challenging process.

- Favor your feet – Wear comfortable well-fitting shoes and socks at all times – never go barefoot. Check your feet frequently, especially after a hike or long walk. Feet and ankles often swell during flights so consider wearing light knee-high compression stockings (20-30 mm Hg) or bring thinner socks to change into if your feet swell. Wear a shoe that can be loosened if that occurs. Pointing and flexing your ankles during a flight can improve blood flow in your calf muscles and decrease swelling as well as lower the risk of blood clots.

- Prepare for a health emergency – If you need medical treatment, ask your hotel to recommend a local doctor who treats diabetes. Prior to an overseas trip, get a list of local English-speaking doctors through the International Association for Medical Assistance to Travelers athttp://www.iamat.org/.

The secret to any successful trip is to take plenty of time and plan far in advance of your departure – and that goes double when you have diabetes. For more information about how a diabetes educator can help you plan your next trip, visit http://www.diabeteseducator.org/.

Sources: Centers for Disease Control and Prevention (CDC), American Diabetes Association and Joslin Diabetes Clinic

The original press release can be viewed at:

http://www.newswise.com/articles/view/618258/?sc=dwhn

Stem cells and retinopathy

This is a reprint of an article that I recently published on Digital Journal:

Diabetic retinopathy is a common complication of diabetes and it is often treated with laser therapy, but researchers say that stem cells could be used as a possible treatment for diabetic retinopathy. 

Researchers at Eugene and Marilyn Glick Eye Institute and the Indiana Center for Vascular Biology at Indiana University School will be working on the $2 million study, which has been funded by the National Eye Institute, and the hope is the new research will stop vision loss and maybe even reverse it. A preliminary study has shown stem cells to be effective in restoring vision loss in rodents by helping the damaged cells of the eyes to regenerate. Rajashekhar Gangaraju, Ph.D is assistant professor of ophthalmology and cellular and integrative physiology and will lead the study.

Commenting on the potential of the new research Dr Gangaraju said:

“We know the stem cells are migrating towards the blood vessels and are trying to arrest the leakage.”

“We believe this will be a therapy helpful for early stage diabetics, or those who have begun to suffer the effects of diabetes and have early vision loss due to the leaking blood vessels.”

“This work is a precursor to clinical trials involving patients. We believe the basic science mechanisms will translate to a bedside treatment for diabetic patients if we can reach them in the early stage of diabetes.”

Symptoms of diabetic retinopathy will often go unnoticed when the condition is in its early stages but advanced symptoms can include blurred vision and sudden vision loss.

Diabetics are advised to take advantage of the eye screenings, which are offered free of charge in the UK, to detect any signs of the disease before it can cause damage to the eyesight. 

You can read the original article by going to:

http://digitaljournal.com/article/345767

Scientists at the University of Oxford - working alongside colleagues from the Babraham Institute in Cambridge and the Churchill Hospital, Oxford -  have discovered a gene called PTEN which they say is responsible for insulin sensitivity.  It is hoped that this new discovery could help find treatments with Type 2 diabetes as these patients have insulin resistance, and could lead to new drugs being developed that would increase insulin sensitivity. 

Dr Anna Gloyn of the Oxford Centre for Diabetes, Endocrinology and Metabolism at the University of Oxford, and leader of the study, said:

"Insulin resistance is a major feature of type 2 diabetes."

"The insulin-producing cells in the pancreas may be working hard and pumping out lots of insulin, but the body's cells no longer respond."

"Finding a genetic cause of the opposite – insulin sensitivity – gives us a new window on the biological processes involved. Such understanding could be important in developing new drugs that restore insulin sensitivity in type 2 diabetes."

While this new discovery shows some promise, the researchers advise that the best way of preventing type 2 is to keep your weight under control by exercising more and eating less.

Details of the study - funded by the funded by the Wellcome Trust, the Medical Research Council, the National Institute for Health Research Oxford Biomedical Research Centre, and the Biotechnology and Biological Sciences Research Council - have been published in the New England Journal of Medicine.