Latest And Greatest Diabetes Research

As one of the many diseases that have medical options but not a cure, research into finding a permanent cure for those with type 1 and type 2 diabetes is ongoing. Several different research projects into determining specific genetic factors that contribute to the development of type 1 diabetes are showing very promising results as is increased research into sustainable cell transplants or pancreatic transplants to allow natural insulin production in those with type 1 diabetes.

For people with prediabetes, gestational diabetes and type 2 diabetes, ongoing research into genetic factors, possible metabolic deficiencies and the factors that contribute to insulin resistant are major areas of focus. In addition the many complications of both type 1 diabetes and type 2 diabetes continue to be researched as a way to minimize or eliminate the many concurrent health conditions such as a neuropathy, vision impairment, kidney problems, cardiovascular problems and increased risk of amputation.

Research Into Transplants

The goal of any whole organ transplant is to provide the recipient with a healthy, functioning organ that allows the body to function without the need for additional types of support. For those with type 1 diabetes, pancreas transplantation has long been seen as a possible solution to providing the body with insulin that is produced by the healthy transplanted organ. The problem in the past has been the immune system and existing antibodies that have, over time, attacked the healthy beta cells of the transplanted pancreas and resulted in ever decreasing insulin production.

In a longitudinal study of patient receiving a pancreas or pancreas-kidney transplant at Baylor Medical Center in Texas, promising results have been found that exceed the expected success rate. Five year pancreas graft survival rates were 67% for both kidney and pancreas and 50% for kidney transplants followed by pancreas transplants. Key to the success of the program is reported to be the consistent use of immune-suppressive therapies that include antibody induction, the use of antithymocyte globulin, the antibody to the lL-2 receptor and the use of tacrolimus as the immunosuppressant drug. 1

There are other transplant options available to type 1 diabetics. Islet cell transplantation has been explored in the past with limited results, but with recent cutting edge development in immunosuppressant drugs, this procedure is again coming to the surface as a possible cure. Increasing knowledge of the specific preparation of the islet cells prior to transplantation has increased survival rates of the individual beta cells. Computer-assisted digital imaging of the cells to be transplanted has provided further benefits and has allowed doctors and researchers to more accurately select cells that have less chance to be rejected once transplanted.

Recent studies of islet cell transplantation has shown positive results.  The studies of younger patients, although small in number, have shown that approximately three quarters of the patients that went through the islet cell transplant were insulin independent within one year. The age of the patient is seen as critical to the effectiveness of the islet transplantation. 2 Unfortunately, with all transplants, patients will need to be on immune suppression therapy, which can have significant side effects of its own. Research is ongoing to address these issues.

Research Into Diet, Lifestyles And Genetics

Those with diabetes may have specific deficiencies of trace minerals, vitamins or essential nutrients in their diet. Low levels of Vitamin D has long been associated with the development of type 1 diabetes, specifically noted in areas further from the equator where daily sunlight hours are less.

The specific ways in which Vitamin D is processed in the body is now thought to be at the center of the connection between type 1 diabetes and low levels of Vitamin D in the body. An identifiable genotype of the vitamin D-binding protein has been shown to alter the metabolic pathways in individuals diagnosed with type 1 diabetes. The changes to the metabolic pathways of Vitamin D have multiple components but ongoing research is narrowing down the changes that occur, providing potential options for using this researcher in treatment. 3

Other research into the role of low Vitamin D levels in the blood has shown a connection to an inherited genetic variation. The research demonstrated that children and adults with type 1 diabetes had lower levels of Vitamin D, specifically 25(OH)D, and had lower than average circulating rates for similar aged non-diabetics in the same population. In addition seasonal variations were noted in the circulating 25(OH)D levels with three specific metabolism genes being reported as key in the development of type 1 diabetes. 4

Research into diets and eating styles that can decrease the need for supplemental insulin for any type of diabetes, including type 1 diabetes, has been a major research focus. Studies that include low-fat vegan diets compared to diabetic diets have some positive outcomes. Both diets are considered to help decrease BMI (Body Mass Index) as well as plasma lipid concentrations. However, patients consuming a low fat vegan or vegetarian diet had improved blood glucose levels and had overall lower total cholesterol on a 74 week diet trial. 5

Increasing interest into growing obesity rates and the increase in diabetes has lead to more intense research into the genetic link between obesity and type 2 diabetes. Large scale studies have now identified over 20 different genetic loci that are associated with both conditions. However, research also shows that the environment must also promote the development of type 2 diabetes even with the genetic factors present. In addition, the research also demonstrates that lifestyle modifications, including routine exercise and diet, can control or reduce the chances of developing type 2 diabetes. Unfortunately the research also shows that inherited factors and environment can influence how likely an individual is to engage in a lifestyle modification program. 6

All current research stresses the need for doctors and the general population to have a greater understanding of the role of diet and lifestyle in the development of prediabetes, gestational diabetes and type 2 diabetes. The emphasis on this training and education needs to start early, prior to obesity becoming a major health factor.

References

1 Sanchez, E. Q., Melton, L. B., Chinnakotla, S., et al. (2010). Whole-organ pancreas transplantation at Baylor Regional Transplant Institute: a chance to cure diabetes. Baylor University Medical Center Proceedings , 3-6.

2 Jahansouz, C., Jahansouz, C., Kumer, S. C., & Brayman, K. L. (2011). Evolution of B-Cell Replacement Therapy in Diabetes Mellitus: Islet Cell Transplantation. Journal of Transplantation .

3 Blanton, D., Han, Z., Bierschenk, L., et al. (2011). Reduced Serum Vitamin D–Binding Protein Levels Are Associated With Type 1 Diabetes. Diabetes , 2566-2570.

4 Cooper, J., Smyth, D. J., Walker, N. M., et al. (2011). Inherited Variation in Vitamin D Genes Is Associated With Predisposition To Autoimmune Disease Type 1 Diabetes. American Diabetes Association .

5 Barnard, N. D., Cohen, J., Jenkins, D. J., et al. (2009). A low-fat vegan diet and a conventional diabetes diet in the treatment of type 2 diabetes: a randomized, controlled, 74-wk clinical trial. The American Journal of Clinical Nutrition , 1588S-1596S.

6 Temelkova-Kurktschiev, T., & Stefanov, T. (2011). Lifestyle and Genetics in Obesity and type 2 Diabetes. Experimental and Clinical Endocrinology and Diabetes .

This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.