Curing Type 1 Diabetes

Type 1 Diabetes is an autoimmune disease where the pancreas
cease producing insulin, which is essential for the body to process hormones
for regulating bodily fuel or sugar. Without insulin Type 1
Diabetics will die. At present there is no cure for diabetes, but the
administration of insulin allows most diabetics to function normally. However,
the disease is fraught with all kinds of comorbidities or side affects such as
failing vision, circulatory problems, nerve damage, and increased risk of infections
frequently leading to amputations. Diabetics often end up on kidney dialysis,
which reduces life expectancy and increases the risk of infections even more. According to the Centers for Disease Control and Prevention (CDC) 50% of patients with chronic kidney disease are diabetic.

Approaches to Curing Diabetes

Scientific studies for potential cures for Type 1-Diabetes
  1.  Cellular manipulation
    by removing the attacking mutation to restore normal pancreatic
  2. Possible vaccines to prevent diabetes
  3. Increased public
    health surveillance to screen for those at risk of diabetes before they lose
    their pancreatic function

 All approaches are
focused on preventing damage and intervening before diabetes has ravaged the
pancreas. Once a person ceases to create insulin the only way to change that is
through a transplant, which must come from a deceased donor, as a pancreas is
an essential organ.

Current Research to Detect Those at Higher Risk for Diabetes
The T-1 study through Benaroya Research Institute examines tissue samples from people with increased risk of diabetes, which is based on a screen for the presence of islet autoantiboides and the genetic risk for diabetes. Through the application of scientific methods Dr. Marika Bogdani, MD, PhD and her research team at BRI have identified cellular behaviors indicating which individual human samples likely represent early and advanced stages of damage in insulin making tissue inside the pancreas. Her team is researching this cellular behavior with the goal of blocking the agent which damages the pancreas in high-risk individuals. Dr. Bogdani’s research shows that people with Type 1 Diabetes have a modified islet cell which produces more Hvaluronan (HA). Her research recently showed these cells are modified earlier before the onset of diabetes in individuals whom have these hostile islet autoantibodies. The very presence of these antibodies is an indication of cellar damage for insulin producing cells. In scientific terms, possessing two or more of these antibodies and the presence of the observed genotype is an indication of increased risk for developing Type 1 Diabetes. There are stages of diabetes before someone requires insulin and the first stage of the disease is the presence of these antibodies. The second stage is called dysglycemia and the third stage is insulin dependency.
Next Steps in Research and Clinical Application

Dr. Bogdani’s group is now studying how the timing of this cellular modification impacts insulin cell function and survival, which will illuminate how to effectively minimize pancreatic damage. Current study of islet cells will also reveal which cells, such as endocrine or mesenchymal, are creating the HA growth and what causes the cells to make HA. This will lead to further refinements in potential clinical interventions.  

Current Clinical Applications at the Patient Level
Scientifically there is enough information to be able assess
individual risk for diabetes through blood samples. The increased presence of
HA in the islet cells is an indication of Type 1 Diabetes at a very early stage
and the Trialnet study screens for these antibodies. For more information on
participating in the Trialnet study go to Benaroya Research Institute’s site:
Next Steps in A Public Health Intervention
 Primary healthcare
should include diabetic screening tests, not just for adults, but for children
as well, as Type 1-Diabetes primarily strikes children and young adults. Screenings
could be done by individual clinicians during the annual wellness exams.


A more comprehensive approach would be to screen all
school-age children. Since many diabetics do not realize they have the disease
until quite late in its gestation, this would provide greater population
surveillance of this costly disease. The earlier a person is screened for
diabetes the less damage the antibodies can cause to pancreatic function. It is
possible to intervene while an individual still has pancreatic function.
Earlier diagnosis in disease progression is best.

The author rode from Washington State to Napa,
California in eight days, to raise awareness about the plight of diabetics, and raised $5,000 for the Benaroya Research Institute, to fund medical research to cure Type 1 Diabetes. She is the author of a guidebook to the U.S.
healthcare system, which was published by Rowman and Littlefield in 2013.
This column has been continuously published since November 2007, the year her brother, Russell died from complications of Type 1 Diabetes.
This is the healthpolicymaven signing off, encouraging you not to sign blanket releases, but do specify that for which you consent and that for which you do not before you undergo a medical procedure.

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