Major News!!!
The ADA (American Diabetes Association) just met in San Diego and here are some of their findings... thanks Lisa, who sent this to me! It's all very interesting but the first story was the most amazing! I am so thrilled I could dance around the room! That, combined with our recent endo appointment with a 6.3 a1c... well, we're pretty happy about these findings.
I don't know who wrote all this up (these are someone's notes from the conference), but thanks, whoever you are! I'm spreading the word!
Follow-Up Study from the DCCT Study...
The biggest news of all is the follow-up study of the Diabetes Control and Complications Trial (DCCT). You might recall that this was a study that showed that intensive glucose control reduced the rate of kidney disease, blindness, neuropathy and amputation. The trial ended some ten years ago but the people enrolled in the trial were continued to be followed. During the trial the control group's A1c was about 9 and the experimental group was at 7%. With a year and a half after the trial both groups came together and had an A1c of about 8 and they maintained that similar A1c for the duration of the 10 years of follow-up. The startling news is that brief period of intensive control - 6 years of intensive control - resulted in nearly a 50% drop in cardiovascular events, cardiovascular mortality, strokes, everything to do with cardiovascualar disease.
This is a huge story that will be covered in the newspapers. Early intensive control of blood glucose even for short periods of time results in a marked reduction of cardiovascular disease.
This may be the greatest therapy of all for people with diabetes. Have intensive glucose control - as good as possible and as early as possible in the progression of the disease - and you may significantly reduce your risk for cardiovascular disease.
Cellphone Glucose Reporting for Teens...
Two great reports showed the benefits of a technology most of us use every day - cell phones. In these reports teenagers were told to enter their blood glucose readings into cell phones which transmitted the data back to a home base. In one study the cell phone was programmed to ring to remind kids to test their blood sugar. The kids who reported values outside of a predesignated range would receive calls back on their cell phones from nurse case managers who would offer assistance.
Using The Palm of Your Hand for Glucose Testing...
Another interesting report today showed that if you prick your palm to test your blood glucose level, you get the same result as fingertip testing. As many of you know, fingertips can be very sensitive and pricking your fingertips to test can be painful. This study showed that pricking your palm can be just as effective.
This is not advice to start palm-pricking. But I think this is the first report that shows you don't have to stick your finger to get the same result as sticking other parts of your body.
Stem Cells in Adult Pancreas?
Another symposium addressed the issue of regenerating beta cells - the insulin-producing cells in the pancreas. One of the investigators was able to identify a particular cell type in the adult pancreas that acts as a stem cell to produce all the other pancreatic cell types, including beta cells. They also showed that, if treated properly, this cell could renew itself in the "undifferentiated" state (make more copies of itself). Then those cells go on to "differentiate" or become the various cell types found in the pancreas.
For the first time it indicates that there may be stem cells located within the pancreas with the abilty to produce all the various cells found there, including the insulin-producing cells. If there are significant numbers of these cells we could potentially "harness" this ability to augment the body's own insulin-producing capability.
Me Again... here is the other big story from the conference, out of Reuters... this makes me hopeful, somehow... it convinces me even more that figuring out how to "turn off" the autoimmune reaction, the destruction of the body's own pancreas... that that's such an important part of the puzzle. Anyway, read on.
Insulin Cells Persist in Long-standing Diabetes
NEW YORK (Reuters Health) - In type 1 diabetes, which by definition indicates a lack of insulin production, the insulin-producing "beta" cells in the pancreas are thought to be wiped out. However, that may not be exactly the case.
The results of a new study provide some of the first evidence in humans that the pancreas continues to form beta cells even in the setting of long-standing type 1 diabetes, suggesting a possible new treatment strategy.
"The implication is that type 1 diabetes could, theoretically, be cured if we could stop the new insulin-secreting cells being destroyed," Dr. Peter C. Butler from the University of California in Los Angeles told Reuters Health. Butler presented his team's findings at the American Diabetes Association's annual meeting in San Diego.
Type 1 diabetes results when beta cells are mistakenly attacked and destroyed by the body in an autoimmune reaction. Until now, the only hope of reversing the disease seemed to be replacement of beta cells by transplantation.
Butler's team has now shown that, among 42 individuals who had type 1 diabetes for decades -- in some cases up to 60 years -- the majority (88 percent) still had detectable insulin-producing beta cells in their pancreas.
"Most interesting," Butler said, "we note that these cells have a high death rate by autoimmune destruction, implying that there must be ongoing new insulin-producing cells being formed. Therefore, type 1 diabetes may be reversible by targeted inhibition of beta cell destruction."
A lot more work lies ahead before that becomes possible. "What we do not know yet is what rate these calls are being produced or how they are being produced," Butler said. "These questions are currently being actively addressed in studies by our group, funded by the Juvenile Diabetes Research Foundation."
2005 Reuters Health
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