Relationship between the composition of the gut microbiome and diabetes is being demonstrated repeated in studies, as reported in Endocrinology Advisor by Tori Rodriguez, August 11, 2016.

In a twin study by researchers at Harvard Medical School, MIT and Seoul National University in South Korea, published in 2016, there is an altered function and composition of the gut microbiome with biomarkers of subclinical T2 diabetes.  Among other systems and processes, microbiota has effects on the immune system, which indicates that it alters inflammatory markets and T cell subset regulation.  A shift in immune response is significant as it applies to T1 diabetes and may be of particular interest for T2 diabetes.  Indeed, as previous research has shown, “while the microbiome of healthy infants becomes more stable and diverse as they approach toddlerhood, the microbiome of those at high risk of autoimmunity become less stable and diverse, which could result in distinct differences in the autoimmune microbiome between healthy children and those with type 1 diabetes.”

gut biome

The gut microbiome may increase understanding  of the pathogenesis of type 1 and type 2 diabetes.

“The development of type 1 diabetes seems to be associated with a reduced bacterial diversity in the gut, and this phenomenon appears after seroconversion to positivity for diabetes-associated autoantibodies,” says study co-author Mikael Knip, MD, PhD, professor of pediatrics at the University of Helsinki in Finland. “This indicates that the dysbiosis may be involved in the progression from autoantibody positivity to overt disease but not with the initiation of beta-cell autoimmunity,” he said. Additionally, those who progress to type 1 diabetes show a reduced number of beneficial bacteria and an increased number of bacteria with pathogenic potential.”

Read more: Role of the Gut Microbiome in Diabetes

 

Glucagon – The Hot Topic, as reported in EndocrinologyAdvisor by John Schieszer, August 15, 2016

It may be time for clinicians to rethink how they view glucagon, noted George Grunberger, MD. New forms of glucagon and products for treatment of severe hypoglycemia are now becoming available and changing how patients with type 1 diabetes and type 2 diabetes are managed.

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Glucagon plays an important role in treating diabetes as well as hypoglycemia.

“Glucagon, after over 90 years on the scene, is ready for prime time. It needs to be recognized for its pivotal role in pathogenesis of diabetes as well as its recognition as a lifesaver for severe hypoglycemia and a target for successful therapy for both major types of diabetes,” said Dr Grunberger, chairman of the Grunberger Diabetes Institute and clinical professor of internal medicine and molecular medicine and genetics at Wayne State University School of Medicine, Detroit, Michigan. Dr Grunberger, who is also the immediate-past president of American Association of Clinical Endocrinologists (AACE), discussed glucagon and its role in diabetes at the American Association of Diabetes Educators (AADE) 2016 Annual Meeting..

Glucagon is a pancreatic hormone that counteracts the glucose-lowering action of insulin by stimulating glycogenolysis and gluconeogenesis. It is a ligand for a specific G-protein linked receptor whose signaling pathway controls cell proliferation and as a medicine, it is different from insulin.

The primary role of glucagon is to signal the body to release stored glucose and synthesize glucose from noncarbohydrate substrates when blood glucose falls too low. Dr Grunberger said for those individuals with type 1 or type 2 diabetes, inhibition of glucagon may be an important tool in improving their glycemic control.

Read more: Glucagon May Be Ready for Prime Time

 

Needles not needed, a great interview with Dr. Jon Lakey in UCI News by Tom Vasich / UCI, August 15, 2016

With JDRF grant, UCI professor pursues approach to diabetes that makes daily injections obsolete

Jonathan Lakey is a pioneer in the transplantation of insulin-stimulating islet cells to treat Type 1 diabetes, but hurdles remain. Steve Zylius / UCI UCI professor of surgery and biomedical engineering Jonathan Lakey is a pioneer in an emerging approach for treating type 1 diabetes, to free its patients from the daily injection.

Jonathan Lakey, a University of California, Irvine professor of surgery and biomedical engineering, is a pioneer in an emerging approach to treating Type 1 diabetes, an approach that frees patients from the daily needle jabs. In 2000, he helped create the Edmonton Protocol, a surgical method by which cell clusters called islets can be transplanted into the pancreas to stimulate insulin production, making injections unnecessary. It’s been shown to work, but there are still many hurdles to overcome, such as immune system rejection of the transplanted cells.

With a new $1.3 million grant from the JDRF (formerly the Juvenile Diabetes Research Foundation), Lakey, UCI associate professor of surgery and biomedical engineering Elliot Botvinick and Paul de Vos of the University of Groningen in the Netherlands are continuing to seek a way to transplant insulin-secreting, encapsulated, stem cell-derived islet cells that the immune system will not attack.

“Perhaps the greatest challenge in the field of islet transplantation is to make the metabolic benefits available to patients with Type 1 diabetes without the need for chronic immunosuppression,” says Lakey, who directs the UC Irvine Health Clinical Islet Program. “I believe that this approach has great promise for realizing our goal. And this welcome support from the JDRF should speed our progress.”

Read this wonderful interview with Dr. Lakey: Needles Not Needed

 

JDRF Announces Industry Development and Discovery Partnership with Pacific Diabetes Technologies, according to PRNewsire, August 10, 2016.

JDRF, the leading global organization funding type 1 diabetes (T1D) research, has established an Industry Development and Discovery Partnership with Pacific Diabetes Technologies (PDT), a Portland, Oregon-based medical device startup, to develop a novel treatment for type 1 diabetes. JDRF has awarded funding to further development of an advanced infusion set that combines continuous glucose monitoring (CGM) and insulin infusion into a single device.

PacDiabetesTech

PDT is developing an infusion set that brings glucose monitoring and insulin delivery together into a single package for people who use insulin pumps. This “single-port” CGM solution, as it is called, enables users to track glucose concentration from the same device used to infuse insulin, eliminating the need to wear a second device. PDT has been refining prototypes in animal studies as it prepares to seek FDA approval to test the device in people.

“JDRF is excited to partner with Pacific Diabetes Technologies to help advance infusion set technology that could improve the lives of people living with type 1 diabetes,” said Vincent Crabtree, director of Research Business Development at JDRF (who recently spoke with our GNO group).

PDT has secured more than $5 million in funding through a combination of grants from JDRF, the National Institute of Diabetes and Digestive and Kidney Health, and The Leona M. and Harry B. Helmsley Charitable Trust.

Read more: JDRF Announces Industry Development and Discovery Partnership with Pacific Diabetes Technologies

 

Three-Drug Combination Improved Glycemic Control in Type 1 Diabetes, as reported in EndocrinologyAdvisor by Jason Harris, August 09, 2016

Patients with type 1 diabetes may benefit from combination therapy. “Our research found a triple therapy approach led to impressive improvements in blood glucose control as well as weight loss,” Paresh Dandona, MD, PhD, the study’s senior author, said in a press release. Dr Dandona is chief of endocrinology, diabetes, and metabolism at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo, Buffalo, New York. “This strategy advances our previous work showing improvements in blood glucose management with the use of liraglutide in combination with insulin.”

F&V&I

Patients with type 1 diabetes assigned to a 3-drug combination — dapagliflozin (such as Farxiga), liraglutide (such as Victoza), and insulin — had superior blood glucose control compared with patients assigned to dapagliflozin monotherapy. Phase 4 results from a small clinical trial showed that patients assigned to the combination therapy also experienced significant weight loss while increasing ketosis.

Read more: Three-Drug Combination Improved Glycemic Control in Type 1 Diabetes

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