The thin silicon patch – about the size of a penny – includes more than 100 microneedles, each the size of an eyelash. “The microneedles are loaded with enzymes that are able to sense blood glucose levels and trigger rapid release of insulin into the blood stream in response to high glucose,” according to the American Diabetes Association. “Dr. Gu and his colleagues have tested this technology in a mouse model of type 1 diabetes where it was able to effectively lower blood glucose levels for up to nine hours – a promising result that sets up additional pre-clinical tests (in animals) and, hopefully, eventual clinical trials (in humans).”
Effect of an 8-week very-low-calorie diet in type 2 diabetes on arginine-induced maximal insulin secretion (A), first phase insulin response to a 2.8 mmol/L increase in plasma glucose (B), and pancreas triacylglycerol (TG) content (C). For comparison, data for a matched nondiabetic control group are shown as ○. Replotted with permission from Lim et al. (21).
"We plan to account for differences from mouse to human by helping dogs first. This way, the dogs can inform us on how well the treatment might work in humans," said Clarissa Hernandez Stephens, first author on the research and a graduate researcher in Purdue’s Weldon School of Biomedical Engineering. Findings appear in early view for a forthcoming issue of the American Journal of Physiology – Endocrinology and Metabolism.
In diabetes, either the pancreas makes insufficient levels of insulin so cells absorb glucose poorly or cells themselves become insulin resistant and thus unable to absorb glucose despite adequate insulin levels. Both types of change increase blood sugar levels above normal. Parsed this way, type I and type II diabetes overlap some but also differ.
Even as things stand now, there are a lot of people left out in the cold. A 2016 study, for instance, found that only 41,000 people with diabetes annually get bariatric surgery in the US—fewer than 5 percent of the total new cases diagnosed every year. And the longer someone has diabetes, studies have suggested, the less likely they are to go into remission if they eventually get surgery. Getting those numbers up will not only require changing the minds of insurers, but public opinion, too.
The diabetes health care team also will let you know what your child's target blood sugar levels are. In general, kids with type 1 diabetes should test their blood sugar levels with a blood glucose meter at least four times a day. Depending on your child's management plan and any problems that arise, blood sugar levels could need to be tested more often.
The review affirmed how effective surgery is at treating diabetes (possibly even type 1 diabetes). Around two-thirds of patients with diabetes experience a full remission soon after surgery, while the rest are often better able to control their blood sugar through diet, exercise and medication. Other studies have shown that diabetics who have surgery outlive those who haven’t. Some longer-term research has suggested that one-third of these successes slide back into having active diabetes after five years, but to a lesser degree than they might have without surgery. By contrast, a 2014 study found that fewer than 2 percent of diabetes patients given standard care experienced any remission within a seven-year span.
Type 1 diabetes is commonly called “juvenile diabetes” because it tends to develop at a younger age, typically before a person turns 20 years old. Type 1 diabetes is an autoimmune disease where the immune system attacks the insulin-producing beta cells in the pancreas. The damage to the pancreatic cells leads to a reduced ability or complete inability to create insulin. Some of the common causes that trigger this autoimmune response may include a virus, genetically modified organisms, heavy metals, vaccines, or foods like wheat, cow’s milk and soy. (4)
Clearly separate from the characteristic lack of acute insulin secretion in response to increase in glucose supply is the matter of total mass of β-cells. The former determines the immediate metabolic response to eating, whereas the latter places a long-term limitation on total possible insulin response. Histological studies of the pancreas in type 2 diabetes consistently show an ∼50% reduction in number of β-cells compared with normal subjects (66). β-Cell loss appears to increase as duration of diabetes increases (67). The process is likely to be regulated by apoptosis, a mechanism known to be increased by chronic exposure to increased fatty acid metabolites (68). Ceramides, which are synthesized directly from fatty acids, are likely mediators of the lipid effects on apoptosis (10,69). In light of new knowledge about β-cell apoptosis and rates of turnover during adult life, it is conceivable that removal of adverse factors could result in restoration of normal β-cell number, even late in the disease (66,70). Plasticity of lineage and transdifferentiation of human adult β-cells could also be relevant, and the evidence for this has recently been reviewed (71). β-Cell number following reversal of type 2 diabetes remains to be examined, but overall, it is clear that at least a critical mass of β-cells is not permanently damaged but merely metabolically inhibited.
Researchers are working on vaccines to prevent someone with type 1 diabetes from losing their insulin producing cells. In type 1 diabetes, the body’s immune system turns on its own insulin producing cells and periodically kills them off. A successful vaccine would prevent this from happening. The vaccine has been successful in rodents but vaccines have yet to demonstrate the same success in human trials.
Meanwhile, American Diabetes Scientist Zhen Gu, PhD, a professor in the Joint University of North Carolina/North Carolina State University Department of Biomedical Engineering, is working to develop a “smart insulin” patch that imitates the body's beta cells by both sensing blood glucose levels and releasing insulin using a nanotechnology that leverages bioengineering, biochemistry and materials science.
The mice immune systems did not attack the new insulin-producing cells. Most important, according to the findings: The cells produced the right amount of insulin: not so much that they sent a mouse into a blood sugar free fall, not so little that blood sugar levels stayed high. The mice have shown no sign of diabetes for more than a year, according to the findings.
These seeds, used in Indian cooking, have been found to lower blood sugar, increase insulin sensitivity, and reduce high cholesterol, according to several animal and human studies. The effect may be partly due to the seeds’ high fiber content. The seeds also contain an amino acid that appears to boost the release of insulin. In one of the largest studies on fenugreek, 60 people who took 25 grams daily showed significant improvements in blood sugar control and post-meal spikes.
I bring this up because sleep apnea increases a person’s risk for developing type 2 diabetes. Also, sleep-disordered breathing is also related to proper nutrition throughout life. And perhaps most importantly, the first line of defense in catching sleep-disordered breathing in patients early, are dentists. This is another area where dentists must get involved if we want to tackle the issue of pervasive type 2 diabetes with any success.