New Focus in Diabetes Research
Researchers at Boston Children’s Hospital appear to have discovered the root cause of type 1 diabetes, also known as juvenile diabetes. It most commonly affects kids and young adults who cannot produce insulin that tissues need to use glucose. Hundreds of pathways were analyzed from animal models but it was the ATP/P2X7R pathway that was tied to the disease. This pathway tells T-cells to attack the pancreas containing made of islets of alpha and beta cells. Normally functioning beta cells produce insulin. While treatments targeting this pathway are years away, researchers are excited about having a specific target they can develop treatments for. Current treatments involve insulin injections and islet cell transplants which require lifelong immunosuppressant drugs to prevent rejection.
Artificial sweeteners, specifically sucralose which was the subject of a Washington U study, raised blood sugar and insulin levels in test subjects, 17 obese non-diabetic people who don’t use artificial sweeteners regularly. Participants were given either water or sucralose to drink before taking a glucose challenge test. Each participant was tested twice, drinking either water or sucralose for each test. It had been thought that artificial sweeteners did not affect metabolism but recent animal studies - and this one - indicate that sucralose does more than just sweeten foods and beverages. Researchers say that further studies are needed to learn more about the mechanism through which sucralose may influence glucose and insulin levels, as well as whether those changes are harmful.
No Need to Wait
Type 2 diabetics are often advised to wait 20 to 30 minutes after taking insulin before they can eat. Now, a new study from Germany shows this is not necessary. The study of about 100 diabetics showed that blood sugar levels remained steady whether or not participants waited between using insulin and eating. About 87% of participants said they “significantly preferred” not having to wait between insulin use and meals. "It's a very promising result. It will lead to better adherence and satisfaction," says Dr. Aaron Cypess, Joslin Diabetes Center, Boston who was not involved in the study. However, warns Cypess, people should talk with their doctors before making any changes in their routine. He adds that people should not assume these results apply to people with type 1 diabetes.
First in Its Class
The FDA voted 10 to 5 to approve canagliflozin to treat Type 2 diabetes. Developed by Johnson & Johnson, its the first in a new class of drugs in the US and lowers blood sugar by causing it to be excreted in the urine. Many diabetes drugs work by affecting the body’s use of insulin. The drug was tested clinically on more than 10,000 patients worldwide and successfully lowered blood sugar and blood pressure and led to weight loss. However, some panel members expressed concerns about cardiovascular risks and the risk to those with moderate kidney disease. The drug, which is to be taken once a day, is not recommended for those with severe kidney disease. In the end, panel members weighed the benefits of the drug against its detriments and voted for its approval.
Adults with "Juvenile Diabetes"
Results from a study conducted in Maryland over a six-year period found that approximately 32 out of 92 people who died from diabetic ketoacidosis (DKA), a consequence of untreated diabetes, had no history of the disease. Out of those people, 50 percent were in their 40s, a little over half were Black and 84 percent were men. The elevated blood sugar levels point to type 1 which occurs when the pancreatic beta cells stop producing insulin. More adults are being diagnosed with Type 1 diabetes which is also known as “juvenile diabetes.” Researchers believe that many adults who develop type 1 go through a period where they appear healthy but are not producing insulin. They also stress that these results illustrate the importance of regular checkups and testing glucose levels.
Insulin Thought to Play a Role
A study involving approximately 335,000 European women has found a possible link between consuming high amount of carbohydrates with developing estrogen-receptor (ER) negative breast cancer, a less common but more aggressive and deadly form of the disease. Eating food loaded with starchy and sweet carbohydrates causes a rapid spike in blood glucose levels which results in high amounts of insulin being released to lower them. Previous research has shown that elevated insulin levels are directly linked to some cancers because it may promote tumor growth. ER-negative breast cancers grow fast and do not respond to hormone-based therapies because there is no estrogen receptor. These results will likely lead researchers to determine if insulin pathways play a role in this type of cancer.
Adds to Cognitive Decline
A new study demonstrates that insulin resistance in the brain adds to the symptoms people with Alzheimer’s disease (AD) experience. Postmortem examinations of brain tissues from non-diabetic individuals with AD showed that resistance in the brain was independent of diabetes and found that pathways that signaled insulin had lower activity levels and abnormal protein, one which was tied to memory problems, cognition and amyloid plaques. Insulin helps tissues to use glucose and brain cells need it to function normally. There are three FDA-approved diabetes drugs that increase insulin sensitivity and cross the blood-brain barrier. They may have the potential to modulate resistance, a potentially symptoms, in people with AD and mild cognitive impairment.
Causes Insulin Overexpression
New research has revealed that diets high in fat are linked to an increased risk of colon cancer because they modify genes associated with breaking down carbohydrates, fats and amino acids. This modification of genes that changes their expression is done via methylation, or the addition of a methyl group which is made up of one carbon atom and three hydrogen atoms. Looking at healthy colon tissue from cancer patients showed that fats alter insulin genes which cause them to overexpress the glucose-lowering hormone. Studies show that people with colon cancer have altered glucose metabolism and insulin signaling. Insulin feeds cancer cells. Researchers hope they can observe these changes in healthy tissues so colon cancer screenings and diagnosis can be done with blood or saliva.
Can Vitamin D Prevent Diabetes?
Previous studies have shown that vitamin D reduces insulin resistance which is a very early symptom of type 2 diabetes, but a new one provides insight into the vitamin’s mechanism of action. Ninety-two adults considered “pre-diabetic” took D3, calcium, both or a placebo for four months. Blood tests measured hemoglobin A1C which looks at glucose levels over time and indirectly determined pancreatic beta cells function by measuring the amount of insulin secreted into the blood. The vitamin D group saw their beta cell function improve by 15 to 30 percent and had slightly better A1C levels. Many studies have found an indirect correlation between vitamin D levels and the risk of developing diabetes but they have not always been able to show that taking it may prevent its development.
One Gene Controls Many in Fat
British scientists have discovered a gene that acts as a “master switch” in adipose tissue. The gene, KLF14 was previously shown to be associated with type 2 diabetes and cholesterol levels. Genetic analysis of 200,000 genes in subcutaneous fat from 800 British female twins found that the KLF gene controlled the expression of genes within the sample involved in body mass index, cholesterol, insulin and blood sugar levels. Stressing the importance of KLF14’s role, researcher Mark McCarthy noted that it acted “. . . as a master switch controlling processes that connect changes in the behavior of subcutaneous fat to disturbances in muscle and liver. . ." Researchers hope that understanding KLF14’s role in obesity will help them to develop better anti-obesity treatments.
The Insulin Switch
Researchers at John Hopkins discovered a protein, Snapin that regulates the secretion of insulin, offering insight the mechanism of type 2 diabetes and potentially new treatments. Mice were created to have their Snapin gene in the pancreas turned “on” all the time. Those cells and cells from normal mice were harvested and put in a petri dish with glucose. The amount of insulin secreted from the engineered mice cells was 7.3 billionths of a gram of insulin per cell compared to 2.8 billionths of a gram of insulin per cell in the normal cells. Turning off the gene reduced the insulin secretion by 80 percent and genetically modified pancreatic cells of mice with type 2 diabetes had the initial release of insulin that is absent in type 2 diabetics were restored.
Curcumin Is Key
New research from Saint Louis U shows the spice curcumin might be beneficial in preventing or treating livers damaged from a form of fatty liver disease. Non-alcoholic steatohepatitis (NASH) affects three to four percent of US adults and may lead to liver fibrosis, cirrhosis and possibly liver cancer. Obese patients with type 2 diabetes frequently have high blood levels of leptin, insulin and glucose and it’s been theorized that these may lead to liver fibrosis associated with NASH. "Leptin plays a critical role in the development of liver fibrosis,” says corresponding author Anping Chen, Ph.D, who adds, “our study suggests that curcumin may be an effective therapy to treat and prevent liver fibrosis, which is associated with non-alcoholic steatohepatitis."
Sniff Insulin to Boost the Brain
Alzheimer’s patients or those with mild cognitive impairment who received insulin through their nose for four months improved their memory recall for two months. One hundred and nine patients with either condition without diabetes were either given a placebo or different doses of insulin placed in a nebulizer. Those who got a lower dose improved in both thinking and memory. Fifteen patients agreed to a spinal tap and researchers found that the proteins associated with Alzheimer’s were altered as well. While there is no recommendation to start treating patients with early Alzheimer’s in this manner, Dr. Suzanne Craft of the VA Puget Sound Health Care System and the University of Washington in Seattle, said “We believe our results are very promising and they warrant future trials."
Prevents Insulin Resistance
A new study on the health benefits of cashew tree products on diabetes has found that cashew seed extracts could improve the body’s response to its own insulin. Extracts were taken of the leaves, bark, seeds and apples, but only the seeds were found to contain potential anti-diabetic properties. Cashew products may also be effective anti-inflammatory agents and could prevent insulin resistance from occurring. Diabetes, which affects about 220 million people, is caused when a person’s body does not respond to its own insulin and results in high blood sugar that can damage body organs and tissue. The study was conducted at the University of Montreal and the Universite de Yaounde and published in the journal Molecular Nutrition and Food Research.