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Diabetes Research Made Significant Strides in Past Year
Date:11/13/2010

By Serena Gordon
HealthDay Reporter

FRIDAY, Nov. 12 (HealthDay News) -- Even as the threat of diabetes continues to grow, scientists have made significant discoveries in the past year that might one day lead to ways to stop the blood sugar disease in its tracks.

That's some good news as World Diabetes Day is observed this Sunday. Created in 1991 as a joint project between the International Diabetes Federation and the World Health Organization to bring more attention to the public health threat of diabetes, World Diabetes Day was officially recognized by the United Nations in 2007.

One of the more exciting findings in type 1 diabetes research this year came from the lab of Dr. Pere Santamaria at University of Calgary, where researchers developed a vaccine that successfully reversed diabetes in mice. What's more, the vaccine was able to target only those immune cells that were responsible for destroying the insulin-producing beta cells in the pancreas.

"The hope is that this work will translate to humans," said Dr. Richard Insel, chief scientific officer for the Juvenile Diabetes Research Foundation. "And what's exciting is that they've opened up some pathways we didn't even know were there."

The other avenue of type 1 research that Insel said has progressed significantly this year is in beta cell function.

Pedro Herrera, at the University of Geneva Medical School, and his team found that the adult pancreas can actually regenerate alpha cells into functioning beta cells. Other researchers, according to Insel, have been able to reprogram other cells in the body into beta cells, such as the acinar cells in the pancreas and cells in the liver. This type of cell manipulation is called reprogramming, a different and less complex process than creating induced pluripotent stem cells, so there are fewer potential problems with the process, he said.

Another exciting development that came to fruition this past year was in type 1 diabetes management. The first closed loop artificial pancreas system was officially tested, and while there's still a long way to go in the regulatory process, Insel said there have been "very promising results."

Unfortunately, not all diabetes news this past year was good news.

One of the biggest stories in type 2 diabetes was the U.S. Food and Drug Administration's decision to restrict the sale of the type 2 diabetes medication rosiglitazone (Avandia) amid concerns that the drug might increase the risk of cardiovascular complications. The manufacturer of Avandia, GlaxoSmithKline, was also ordered to get an independent review of clinical trials run by the company.

Dr. Joel Zonszein, director of the Clinical Diabetes Center at the Montefiore Medical Center in New York City, said one of the biggest problems he's seen stem from the Avandia debate is that many people don't want to be on any diabetes medications now. Unfortunately, he noted, unless people can really make lifestyle changes and stick with them for the long term, they may need medication to get their diabetes under control.

Perhaps the most disheartening diabetes news came just last week when the U.S. Centers for Disease Control and Prevention announced that if America stays on its current path, one in three Americans will have diabetes by 2050. Currently, the number of new diabetes cases annually is about 8 per 1,000 people, and that number is predicted to jump to 15 per 1,000 in 2050, according to CDC estimates.

One bright note in type 2 research was the most recent finding from the Look AHEAD study, a 10-year prospective study to chart the effects of aggressive weight loss efforts and compare those to standard care. This year, the four-year results came in, finding that "weight loss is clearly beneficial," said Dr. Sue Kirkman, senior vice president of medical affairs and community information for the American Diabetes Association.

"That message tends to get lost, but the effects of weight loss look as good as the results would for a drug that would end up getting approved. And, you don't have to lose huge amounts of weight to make a difference. In terms of diabetes prevention, losing 5 to 7 percent of your weight will help," she said.

Another piece of good news was continued research that showed that for patients who are morbidly obese, bariatric weight-loss surgery can help stop type 2 diabetes almost immediately.

"For the right patient, bariatric surgery is a good surgery. But it has risks and it has side effects, and really it's just putting a big band-aid on the problem," said Zonszein.

"The magic bullet is prevention," said Zonszein. "We have to give the message that prevention helps. If you're at risk of diabetes, or you're early in the disease, you need a plan to lose weight and exercise. Ask your doctor for help. With the right treatment plan, you may be able to delay diabetes for years," he said.

More information

To learn more about World Diabetes Day, visit the International Diabetes Federation.

SOURCES: M. Sue Kirkman, M.D., senior vice president, Medical Affairs & Community Information, American Diabetes Association; Joel Zonszein, M.D., professor, clinical medicine, and director, Clinical Diabetes Center, Montefiore Medical Center and Albert Einstein College of Medicine, New York City; Richard Insel, M.D., chief scientific officer, Juvenile Diabetes Research Foundation; April 4, 2010, Nature, online; April 14, 2010, Science Translational Medicine; April 23, 2010, Immunity; U.S. Centers for Disease Control and Prevention, news release, Oct. 22, 2010; Sept. 27, 2010 Archives of Internal Medicine


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