Diabetes (Type 1)

 

Diabetes is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Insulin is a cellular protein that regulates glucose levels in the blood.

Type 1 diabetes is often called “juvenile diabetes? because it generally appears during childhood or adolescence. It develops when the body’s immune system mistakenly destroys the insulin-producing islet cells of the pancreas, a small gland behind the stomach. As a result, the body is unable to properly utilize energy in food or control sugar levels in the blood stream.

Diabetes can lead to many serious long-term health problems and early death. It can cause blindness, kidney failure and severe problems involving the gums and teeth. It can also cause nerve damage and blood flow problems that result in impaired sensation or pain in the feet or hands and amputation of limbs.

One of the most serious problems caused by diabetes is heart disease. People who have diabetes are more than twice as likely to develop heart disease or a stroke as people without diabetes.

Type 1 diabetics must endure many painful insulin injections each day in order to live and function normally and, at present, there is no cure.

However, recent research indicates that a cure may be possible through transplants of pancreatic islet cells.

 

Human and Social Costs

World Health Organization estimates that by 2030, that number of people living with diabetes will more than double.  Afflicts 180 million people Worldwide.

Today, diabetes takes more lives than AIDS and breast cancer combined — claiming the life of 1 American every 3 minutes.  It is a leading cause of blindness, kidney failure, amputations, heart failure and stroke.

In the last decade, the cases of people living with diabetes jumped more than 40 percent – to almost 26 million Americans.

  • Over 1 million new cases are diagnosed every year.
  • Diabetes contributes to over 200,000 deaths annually nationwide. [American Diabetes Association]
  • 60% to 70% of people with diabetes have mild to severe forms of nervous system damage. The results of such damage include slowed digestion of food in the stomach, carpal tunnel syndrome and other nerve problems.

 

Living with diabetes places an enormous emotional, physical and financial burden on the entire family.

  • Annually, diabetes costs the American public more than $174 billion in direct medical costs and costs related to disability, work loss and premature death.
  • Diabetes accounts for 1 of every 4  Medicare dollars spent in the U.S.

 

 

Potential for Cures

Type I diabetes is caused by the autoimmune destruction of pancreatic β-cells, and has emerged as a case study for stem cell-based “regenerative medicine.

Scientists from across the United States and throughout the world believe that stem cell research, especially embryonic stem cell research, holds great promise in the search for a cure and better treatments for diabetes. Stem cell research allows scientists to better explore ways to control and direct stem cells so they can grow into other cells, such as insulin-producing cells.

Important advances have been made through embryonic and adult stem cell research. There is very strong support for all forms of stem cell research within a strong ethical framework.

Indications that stem cells could benefit diabetes patients have been provided by a number of recent studies.  Scientists continue to pursue several different avenues of stem cell research that are yielding a variety of promising insights.  This critical research include:

 

Research has shown that insulin-producing islet cells can be transplanted into patients with Type 1 diabetes and that such transplants could potentially provide a cure.  However, the only current source of replacement islet cells is from human cadavers and not enough donated islet cells are available from this source to treat the many children and adults who have Type 1 diabetes. In addition, because donated islet cells are not a perfect genetic match with the patient’s DNA, patients who receive donated islet cells must take powerful drugs to prevent rejection. These drugs have severe and potentially fatal side effects and rejection often occurs despite the medication.

 

SCNT could help overcome these limitations and revolutionize the treatment of Type 1 diabetes by providing a way to make virtually unlimited supplies of transplantable islet cells that match a patient’s DNA.

 

SCNT could also play an important role in developing future “gene therapy? treatments for inherited diseases like Type 1 diabetes, which develop because the patient has an abnormal or malfunctioning gene. If the gene that causes a disease can be identified, scientists could take a patient’s somatic cell, such as a skin cell, and replace the defective gene with a normal gene inserted using recombinant DNA techniques. The “corrected? cell could then be used in the SCNT procedure to generate stem cells with normally functioning genes. These could then be directed to develop into islet cells and put back into the patient’s body, potentially providing a cure. This technique would overcome some of the most difficult hurdles facing gene therapy today.

Understanding the signals that promote β-cell formation in the embryo and adult should facilitate efforts to derive clinically-useful β-cells, either from adult ducts or embryonic stem cells.

Thus, the consensus of the medical and patient community is that all types of stem cell research should be pursued in the effort to find a cures for diabetes, and that cells can play an important role in this effort.

Stem cell research is strongly supported by the overwhelming majority of medical researchers; medical organizations like the American Medical Association; and disease and patient advocacy groups like the American Diabetes Association, Juvenile Diabetes Research Foundation and Diabetes Research Institute Foundation.

 

 

Recent Advances

  • For the first time, scientists from The New York Stem Cell Foundation Laboratory and Columbia University in New York have derived embryonic stem cells from individual patients by adding the nuclei of adult skin cells from patients with type 1 diabetes to unfertilized donor eggs. The achievement is significant because such patient-specific cells potentially can be transplanted to replace damaged or diseased cells in persons with diabetes, Parkinson’s, Alzheimer’s or other diseases without rejection by the patient’s immune system. Researchers at the University of California, San Diego, also assisted. [The New York Stem Cell Foundation Laboratory, Oct. 5, 2011]
  • Researchers at San Diego-based ViaCyte Inc. plan one day to test in people a therapy that has successfully cured diabetes in hundreds of mice. The technique involves slipping under the skin an envelope filled with pancreatic cells derived from embryonic stem cells. The pancreatic cells would turn into insulin-producing beta islet cells and could reduce the need for daily insulin shots.  [Los Angeles Times, May 30, 2011]
  • Ongoing research of a product in rodents has demonstrated that within two to three months of implantation, the immature human pancreatic hormone cells mature into functional pancreatic hormone producing cells, including functional insulin producing cells that can regulate blood glucose. The therapy is a combination product that packages immature cells made from human embryonic stem cells (hESCs) that over time develop into mature pancreatic hormone producing cells (pro-islet) including insulin-producing cells. The research is an important step toward producing an unlimited source of insulin-producing cells that could serve as replacements for those destroyed in both T1D and insulin-dependent type 2 diabetes. The diabetes program is being funded by JDRF, the largest charitable funder of T1D research in the world, the California Institute for Regenerative Medicine (CIRM), and ViaCyte, a San Diego, California-based biotechnology company focused on diabetes. [PR Newswire Dec. 13, 2011]