Diabetic Live

With diabetes becoming an even bigger problem around the world, more and more medical advances are being discovered to try and find a cure for the disease.

Recently, researches have designed a fresh type of biosensor which can identify small amounts of concentrations of glucose in the body’s natural fluids such as urine, tears and saliva. This new biosensor could be manufactured at a very low cost because it does not require very many procession steps in order to produce it.

Jonathan Claussen, a former Purdue University doctoral student and now a research scientist at the U.S. Naval Research Laboratory said “It’s an inherently non-invasive way to estimate glucose content in the body.”Because it can detect glucose in the saliva and tears, it’s a platform that might eventually help to eliminate or reduce the frequency of using pinpricks for diabetes testing.  We are proving its functionality.”

Leaders of the project were Claussen, Purdue doctoral student Anurag Kumar, a Purdue professor of mechanical engineering Timothy Fisher, D. Marshall Porterfield, a professor of agricultural and biological engineering and other researchers at the university’s Birck Nanotechnology Center.

“Most sensors typically measure glucose in blood. Many in the literature aren’t able to detect glucose in tears and the saliva. What’s unique is that we can sense in all four different human serums: the saliva, blood, tears and urine. And that hasn’t been shown before.” Claussen said.

There are three main parts to the sensor: the layers of nanosheets, which resemble tiny rose petals that are made from the material, graphene. Graphene is a single-atom-thick film of carbon, platinum nanoparticles and the enzyme glucose oxidase.

Within each petal are a few layers of stacked graphene. Each edge of the petals has incomplete, dangling chemical bonds which are defects where platinum nanoparticles can attach to. Electrodes are then formed by combining the nanosheet petals and platinum nanoparticles. The enzyme the convert’s glucose into peroxide which then generates a signal on the electrode.

Kumar said, “Typically, when you want to make a nanostructure biosensor you have to use a lot of processing steps before you reach the final biosensor product. That involves lithography, chemical processing, etching and other steps. The good thing about these petals is that they can be grown on just about any surface, and we don’t need to use any of these steps, so it could be ideal for commercialization.”

“Because we used the enzyme glucose oxidase in this work, it’s geared for diabetes. But we could just swap out that enzyme with, for example, glutamate oxidase, to measure the neurotransmitter glutamate to test for Parkinson’s and Alzheimer’s, or ethanol oxidase to monitor alcohol levels for a breathalyzer. It’s very versatile, fast and portable.” Claussen said.

The biosensor is also being used with a variety of chemical compounds to test for other medical conditions as well, other than diabetes.

A trial led by Carla Greenbaum, MD, Diabetes Research Program director at Benaroya Research Institute (BRI) at Virginia Mason and sponsored by the Immune Tolerance Network (ITN) and funded by the National Institutes of Health shows a new break in reversing autoimmunity in Type 1 diabetes.

The trial involved a two-pronged approach; two drugs were administered as a combination. The first drug in the combination interferes with the immune response that ultimately causes type 1 diabetes. The second drug boosts the part of the immune response that regulates overactive immune cells.

There are over one million people in the United States that have type 1 diabetes and that number is growing every year. With type 1 diabetes, the body’s immune system begins to attack and destroy insulin-producing cells that are in the pancreas which are referred to beta cells. When diagnosed with type 1 diabetes there are still a number of beta cells that are active in the body. Because these beta cells are natural insulin producers and can decrease over the long-term effects of diabetes, there are many therapies that are needed for the cure of diabetes.

The two drugs Proleukin (IL-2) and Rapamune (sirolimus) were administered to patients to find out whether or not the drugs would affect the immune system and halt the autoimmune destruction of the remaining beta cells. The researchers of a study describe a flourishing boost of regulatory components of the immune system also were prolonged that were not expected. Due to the temporary impairment of the beta cell function that was lead by the researchers, they concluded that the drug combination was not having a desired effect. Monitoring of the insulin production in the nine subjects indicated that the beta cell preservation goal was therefore not achieved and the study was then halted.

Dr. Greenbaum said, “This study result has been extremely important to scientists looking for ways to stop the immune attack. Our aim would be to harness the good effects of this therapy while preventing the bad effects.” Participants who haven’t yet completed the study will continue to be followed.”

Gerald Nepom, MD, PhD, Director of ITN said, “The clinical and mechanistic findings from this study can help guide future treatments that boost good immunity. This was an important clinical trial that will improve the design of subsequent trials to rescue beta cells in Type 1 diabetes.”

Diabetes affects more than 24 million people in the United States. New technology and medical advances surface everyday that get us one step closer to find the cure.

New technology that delivers a sustained release of therapeutics for up to six months could also be used to help with routine injections for health conditions like HIV/AIDS, various forms of cancer and diabetes.

Researchers from the University of Cambridge have created reformable, injectable and spreadable hydrogels that can be loaded with proteins and various other therapeutics. These hydrogels contain 99.7 percent of water by weight with the remaining percent being made up of cellulose polymers that are held together by cucurbiturils, which are barrel-shaped molecules that can act as a miniature pair of handcuffs.

Leader of the research and the Department of Chemistry, Dr Oren Scherman said, “The hydrogels protect the proteins so that they remain bio-active for long periods, and allow the proteins to remain in their native state. Importantly, all the components can be incorporated at room temperature, which is key when dealing with proteins which denature when exposed to high heat.”

Scherman, DrXian Jun Loh and PhD student Eric Appel, who developed that hydrogels, says that “they are capable of delivering a sustained release of the proteins that they contain for up to six months, compared with the current maximum of three months”. The rate of release can be controlled due to the ratio of materials that are in the hydrogel.

Hydrogels double the window of content release and use less non-water material than the current technology does. An extra material serves as scaffolding of sorts that holds the hydrogel together. However, the performance can be affected, so the lesser structure formation material that is contained in the hydrogel can help it to perform more effectively.

Drug therapy is moving further away from small molecule drugs and more toward protein-based therapy. Applications of insulin treatment, wound healing and hormone therapy are all ideal candidates for hydrogels.

More than a quarter of the 2.9 million individuals within the UK who have been diagnosed with diabetes have to inject themselves daily with insulin so that they can control their blood sugar levels. By using the insulin that is injected with the hydrogel the number of daily injections could be reduced to just two a year.

Appel said, “There’s been a lot of research that shows patients who need to take a pill each day for the rest of their lives, especially HIV patients in Africa who do not show any obvious symptoms, will take the pills for a maximum of six months before they stop, negating the point of taking the medication in the first place. If patients only have to take one shot which will give them six month’s worth of medication, we’ll have a much greater chance of affecting an entire population and slowing or stopping the progression of a disease.”

The research team is working with other researchers at the Brain Repair Center in the Department of Clinical Medicine. They are hoping to find out how the technology can be used to treat brain cancer.

New findings suggest that a group of hormone-producing cells in the brain can actually control blood sugar levels. This new finding could result in both a diabetes treatment and a weight loss drug.

Typically, in fruit flies both starvation and reduced diet will lead to hyperactivity. When a fly is hungry, they buzz around with intense aggravation, trying to find more food. This happens due to enzyme, which is called AMP-activated kinase. This enzyme stimulates the secretion of the adipokinetic hormone, which is similar to glucagon. This hormone acts differently than insulin, it acts like an opposite. It tells the body when to release sugar or food that is needed for hyperactivity. The body will use up its energy stores until it finds food.

Associate professor of biology Erik Johnson and his research team at Wake Forest University turned off the AMP-activated kinase, the cells the decreased the sugar release and the hyperactivity response stopped nearly completely. Even when the fruit flies where facing starvation.

Johnson said, “Since fruit flies and humans share 30 percent of the same genes and our brains are essentially wired the same way, it suggests that this discovery could inform metabolic research in general and diabetes research specifically. The basic biophysical, biochemical makeup is the same. The difference in complexity is in the number of cells. Why flies are so simple is that they have approximately 100,000 neurons versus the approximately 11 billion in humans.”

Due to the findings of this investigation, neat future medical advances could take place.

One of those medical advances is in diabetes research. The adipokinetic hormone in an insect is similar to the hormone glucagon found in humans. Glucagon raises the blood sugar levels and insulin reduces them. In humans, it is very hard to study the glucagon system because the pancreatic cells are hard to pull apart. By studying the fruit flies remarkable similar hormone, a cure for diabetes could be just around the corner.

Another medical advancement is in weight loss.

Johnson said, “Exercise stimulates AMP-activated kinase, so manipulation of this molecule may lead to getting the benefits of exercise without exercising. When you turn off AMP-activated kinase, you get fruit flies that eat a lot more than normal flies, move around a lot less, and end up fatter.”

A new chemical could be the answer to treating metabolic disorders such as type 2 diabetes suggests biologists at the UC San Diego.

Diabetes is a huge concern across the United States, particularly due to obesity. However, there are many other reasons why a person might develop type 2 diabetes.

The chemical does not directly control the glucose production in the liver, it affects the activity of a key protein that regulars the internal mechanisms of our daily night and day lives, out biological clock.

It has been suspected for years that obesity and diabetes walk hand in hand and that they could both be linked to issues with the biological clock. Using this theory, lab mice were used, their biological clocks altered and dealing with issues of obesity and diabetes.

A couple of years ago, a team led by the dean of the Division of Biological Sciences at UC San Diego Steve Kay, made a discovery. The team discovered the first biochemical link between the biological clock and diabetes. Cryptochrome, a key protein that regulates the biological clocks of mammals, insects and plants and it also regulates the glucose production in the liver. They also discovered that in altering the levels of the protein, they could improve the health of the diabetic mice.

Kay and his team discovered a small molecule, one that can be created into a drug, can control the detailed molecular cogs and timekeeping mechanisms of cryptochrome so that it can be repressed by the production of glucose by the liver. Humans, much like mice and other animals have evolved biochemical mechanisms so that a steady supply of glucose can flow to the brain, when we are not active or eating.

“We found that if we increased cryptochrome levels genetically in the liver we could inhibit the production of glucose by the liver,” said Kay.

Kay said. “At the end of the night, our hormones signal that we’re in a fasting state. And during the day, when we’re active, our biological clock shuts down those fasting signals that tell our liver to make more glucose because that’s when we’re eating.”

The cause of diabetes comes from an accumulation of glucose in the blood that can lead to health issues such as blindness, kidney failure, strokes and heart disease. There are two types of diabetes; type 2 diabetes is most common in Americans and type 1 is typically caused by the destruction of insulin producing cells in the pancreas results in the high blood sugar.

Joslin Diabetes Center scientists have recently indentified biological mechanisms through glucagon-like peptide-1 (GLP-1), which is known as a gut hormone that protects against kidney disease also has the same mechanisms that slow down the same actions in diabetes. These findings will possibly lead to new therapeutic agents which can help to prevent hyperglycemia on renal endothelial cells.

Diabetic complications come in many different forms but one of those is through renal complications known as diabetic nephropathy. Diabetic nephropathy is one of the most life threatening complications from diabetes that most often leads to end-stage renal disease (ESRD). About 44 percent of people who have been diagnosed with diabetes in the United States have ESRD, which requires either a kidney transplant or dialysis.

George King, M.D., lead author of the study and chief scientific officer, head of the Dianne Nunnally Hoppes Laboratory for Diabetes Complications and a professor of medicine at Harvard Medical School said, “We are very eager to develop new treatments for diabetic kidney disease.”

GLP-1 is an incretion hormone that is produced in the intestine upon the intake of food. It increases the insulin within the pancreas and slows down the absorption of glucose from the gut which reduces the action of glucagon. This all has a huge impact on lowering glucose levels in the blood. It also reduces appetite as well.

Different studies have shown that GLP-1 also improves renal endothelial cells. These cells regulate blood clotting, blood vessel activity and immune response and other issues that are damaged through insulin resistance. GLP-1 receptors are abundant in the intestine and can also be found in the kidneys and endothelium as well.

Through the Joslin study, the effects of GLP-1 in non-diabetic and diabetic mice were investigated. These mice has and over expression of the enzyme PKCB (protein kinase C-beta). This is produced in excess when the glucose in the blood is high. Excessive amounts of PKCB can lead to diabetic complications, which includes kidney disease. Through PKCB, Ang II, a peptide hormone that affects renal filtration and blood flow and regulates blood pressure, increases and accelerates the progression of kidney disease.

Dr. King says, “We’ve been interested in diabetic kidney disease for a long time, particularly the role of PKCβ and Ang II in promoting kidney damage. We were interested in investigating how GLP-1 could protect against the effects of hyperglycemia on renal function.”

“Two major findings were discovered through the Joslin study, mechanisms were identified by which GLP-1 can induce protective actions on the glomerular (renal) endothelial cells by inhibiting the signaling pathway of Ang II and its pro-inflammatory effect and also demonstrated a dual signaling mechanism by which hyperglycemia through PKCB activation can increase the Ang II action and inhibit GLP-1’s protective effects by reducing the expression with diabetes are more sensitive to Ang II; our data suggests one reason why,” says Dr. King.

“We now know that increased PKCβ decreases GLP-1R which makes the kidney less responsive to treatment with GLP-1-based drugs. Possible new treatments could combine PKCβ inhibitors with higher doses of GLP-1 agonists. GLP-1 is one potential pharmaceutical that could both lower glucose and minimize the toxic effects of Ang II to lower the risk of kidney diseases,” says Dr. King.

An extended trial of a drug that is commonly used for people who have been diagnosed with type 2 diabetes, an oral DPP-4 inhibitor Linagliptin (Tradjenta) is safe and effective in its ability to lower glucose levels for up to 102 weeks by itself or with a combination of other oral anti-diabetic medication.

The trial consisted of 2,121 people who took part of four recent 24-week randomized, double-blind, and placebo controlled trials and were monitored for 78 weeks more.

During the study, 1,532 people had recently received Linaglipin and continued to do so throughout the study while 589 people received placebo during the 78-week run of the trial.

Participants came from all walks of life, from 231 sites in 32 countries such as Argentina, Austria, Belgium, Canada, China, Croatia, the Czech Republic, Finland, Germany, Greece, Hungary, India, Israel, Italy, Japan, Korea, Malaysia, Mexico, the Netherlands, New Zealand, the Philippines, Poland, Romania, Russia, Slovakia, Spain, Sweden, Taiwan, Thailand, Ukraine, the United Kingdom and the United States.

David R Owens, Professor Emeritus, Centre for Endocrinology and Diabetes Sciences at Cardiff University, Wales, UK said, “Initial 24-week trials showed that linagliptin, either on its own or with other glucose-lowering agents, was effective in improving glycemic control without weight gain or an independent increased risk of hypoglycemia (reduced blood sugar levels). Linagliptin works by blocking the action of DPP-4, an enzyme that destroys the hormone GLP-1, which helps the body produce more insulin when it is needed.”

The drug was given once daily, orally, in all cases. Many times it was given on its own and other times it was used in a combination of others drugs like metformin or metformin plus a sulphonylurea or pioglitazone.

The study found that the average age among the participants was 57.5 years and 75 percent of the participants where younger than 65. 51.8 percent were male and 52.5 percent were diagnosed more than five years ago.

Some participants has side effects, however they were either mild or moderate. A rare few (3.8 percent) were severe and 3.4 percent has to stop use of the drug altogether. Collectively, 14.3 percent has drug-related adverse effects.

Some participants (13.9 percent) also experienced hypoglycemia (low blood sugar as well and 6.9 percent was related to the drug.

Professor Owens concludes, “This is the largest data set of long-term clinical evidence for linagliptin to date. Findings from the 78-week open-label extension involving 2,121 people with type 2 diabetes demonstrate sustained glycemic control for up to 102 weeks treatment duration. They also provide evidence that supports the efficacy and tolerability profile seen in previously reported 24-week studies.

“Therefore this extension study shows that linagliptin is an effective and well tolerated therapy for the long-term management of type 2 diabetes.”

Diabetes is a disease that is sweeping across the globe; so many people have been diagnosed with diabetes. Just in America alone, more than 25 million people have diabetes.

While diabetes has no cure, more drugs have shown a great improvement when it comes to the disease. One of those drugs is called Metformin and it is helping with more than just diabetes. Metformin has also shown great side effects as well, brain cell growth. This particular drug supports the growth of new neurons in the brain.

When studied, the results of Metformin were seen to make mice smarter than they were before, before the drug was administered. The result of the study has brought a great amount of hope the therapies that are designed to help to repair the brain.

Lead author of the study, Freda Miller of University of Toronto-affiliated Hospital for Sick Children said, “The discovery is an important step toward therapies that aim to repair the brain not by introducing new stem cells but rather by spurring those that are already present into action, says the study’s lead author.”

The drug is safe for the use of children who have been diagnosed with diabetes, which makes it a great alternative medication to helping children who are suffering a health issue that deals with the brain.

Recent research by Miller’s team laid out the groundwork for the recent study known as aPKC-CBP, which is well-known for its role in telling neural stem cells where and when to distinguish into mature neurons. The same pathway, aPKC-CBP is important for the metabolic effects of Metformin in liver cells.

Miller says, “We put two and two together.”

It was believed that if Metformin activated CBP in the liver, then it could possibly do that for neural stem cells of the brain and stimulate brain repair. To connect the two, a study was administered to mice. The mice began taking Metformin, which showed an increase in the birth of new neurons.

So far, there is no major evidence to see if this popular drug works in humans but it is very clear that mice are getting brain boosts with it. There is a great hope that Metformin will be a great cure where Alzheimer’s disease is concerned.

Miller says, “ It had been thought those improvements were the result of better diabetes control, but it now appears that Metformin may improve Alzheimer’s symptoms by enhancing brain repair.

Researchers hope that Metformin might be a huge help in curing brain issues that are related to cancer, trauma and even Alzheimer’s disease in the near future.