November: National Diabetes Month

Diabetes affects an estimated 29.1 million people in the U.S and is the seventh leading cause of death. The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) www.niddk.nh.gov supports basic, clinical, and translational research to combat diabetes and associated complications.

NIDDK researchers are developing new ways to improve blood glucose monitoring and insulin delivery in Type 1 diabetes, conducting clinical trials, testing new preventative and treatment strategies for diabetes and its complications, and researching the fundamental cellular and molecular pathways underlying the development of diabetes and ensuing complications.

Researchers know that when pancreatic islets that include beta cells are transplanted into people whose own beta cells are not functioning properly, this could possibly be a treatment for diabetes. However, islet transplantation has been hindered partly due to the limited quantities of donor islets. Researchers are studying to see if stem-cell derived beta cells (SC-beta cells) are similar enough to pancreatic beta cells and might effectively respond to fluctuating glucose levels.

So far, researchers have transplanted human embryonic stem cell-derived beta cells into mice genetically engineered displaying Type 1 diabetes symptoms. After two weeks, the SC-beta cells were producing significant amounts of insulin in response to glucose and prevented the mice from developing dangerously high blood glucose levels. Further tests must be conducted to see if this improved process could lead to advancing the treatment for diabetes.

Researchers are studying the artificial pancreas or the closed-loop system by linking a glucose-sensing component, an insulin delivery device, and a computer capable of calculating the amount of insulin needed in response to the blood glucose level. Use of these technologies look promising but more testing needs to be done.

In another study, researchers tested a wearable automated bihormonal bionic pancreas releasing insulin and its counteracting hormone, glucagon. By including both of these hormones, the scientists hope to replicate more closely the sophisticated glucose control of the biological pancreas.

The National Center for the Advancement of Translational Sciences (NCATS) www.ncats.nuh.gov at NIH, is supporting a diabetic project through their “Bridging Interventional Development Gaps (BriDGs) www.ncats.nih.gov/research/rare-diseases/bridgs/bridgs.html program. Research is ongoing to develop a therapy for diabetic keratopathy, a condition that can cause people to lose their sight.

In a unique study, a researcher at Wayne State University’s College of Engineering with NIH grant funding of $475.752 is searching for ways to develop the next generation of vaccines against autoimmune diseases such as Type 1 diabetes. A major barrier to treating Type 1 diabetes is the difficulty to deliver therapeutics to targeted sites such as the lymph nodes. Studies are ongoing to find a new way to deliver drugs to targeted sites to enable development of molecular vaccines for Type 1 diabetes.

Telehealth can also play an important role to help people to treat and live with diabetes and improve the long-term outcomes among diabetic patient populations. In the private sector, Broad Axe Care Coordination http://broadaxecarecoordination.com located in Virginia, is using telehealth solutions to provide effective chronic disease management in high-risk and high-cost patient populations.

Working with the Commonwealth of Virginia’s Departments of Health www.vdh.state.va.us and the University of Virginia Health System www.uvahealth.com, the company has developed a model of remote care management called the C3 approach.

The C3 approach for remote care combines telehealth platforms with clinicians and robust analytics to provide a fully outsourced remote care coordination solution for healthcare providers and payer clients.

As part of the C3 program, Broad Axe uses Honeywell’s www.honeywell.com Genesis family of remote patient monitors and Bayer Contour glucometers are used in conjunction with the Honeywell LifeStream software system capable of measuring and tracking analytics.

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