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Diabetes, The pancreas and Stem Cells

What is Diabetes?

Paraphrased from Wikipedia
Diabetes mellitus often referred to as diabetes is a condition in which the body either does not produce enough, or does not properly respond to insulin, a hormone produced in the pancreas. Insulin enables cells to absorb glucose in order to turn it into energy. In diabetes, the body either fails to properly respond to its own insulin, does not make enough insulin, or both. This causes glucose to accumulate in the blood, often leading to various complications.[

Many types of diabetes are recognised: The principal three are: *

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Acute complications including hypoglycaemia, diabetic ketoacidosis, or nonketotic hyperosmolar coma may occur if the disease is not adequately controlled. Serious long-term complications include cardiovascular disease, chronic renal failure, retinal damage, which can lead to blindness, several types of nerve damage, and microvascular damage, which may cause erectile dysfunction and poor wound healing. Poor healing of wounds, particularly of the feet, can lead to gangrene, possibly requiring amputation.

Diabetes research appears to be one of the most exciting areas of stem cell research with real progress being made and cures being claimed in the press. This section will focus on recent academic research.

Research into treating or curing Diabetes with Stem Cells

Stem cells and a cure for type 1 diabetes?

John A. Todd from proceedings of the National Academy of Sciences of the USA

The discovery that adult stem cells can be reprogrammed, backwards, to induced pluripotent stem cells (iPS) was a remarkable and landmark breakthrough in 2006 ... Type 1 diabetes is one of the most common diseases in childhood, causing significant morbidity and mortality and enormous healthcare and economic costs. Worse still, its incidence in children aged under 5 years is set to double by 2020. Currently, we have no idea how to prevent this rapid increase, which must be caused by an increasing permissiveness of the environment acting on a genetic susceptibility background in many countries worldwide.

What are the implications of this advance for research and clinical application in type 1 diabetes? Read more here

 

Stem Cells and Diabetes

from the National Institutes of Health Resource for Stem Cell Research

This is a wonderful resource of information on the treatment of diabetes with stem cells.

Introduction

For decades, diabetes researchers have been searching for ways to replace the insulin-producing cells of the pancreas that are destroyed by a patient's own immune system. Now it appears that this may be possible.

later the article says

Development of Cell-Based Therapies for Diabetes

In developing a potential therapy for patients with diabetes, researchers hope to develop a system that meets several criteria. Ideally, stem cells should be able to multiply in culture and reproduce themselves exactly. That is, the cells should be self-renewing. Stem cells should also be able to differentiate in vivo to produce the desired kind of cell.

Efficacy Of Autologous Bone Marrow Derived Stem Cell Transplantation In Patients With Type 2 Diabetes Mellitus

anil bhansali, Vimal Upreti, N Khandelwal, N Marwaha, Vivek Gupta, Naresh Sachdeva, R R Sharma, Karan Saluja, Pinaki Dutta, Rama Walia, Ranjana Minz, Sanjay Bhadada, Sambit Das, Santosh Ramakrishnan. Stem Cells and Development. August 17, 2009

BACKGROUND Progressive and inexorable β – cell dysfunction is the hallmark of T2DM and β – cell regeneration using stem cell therapy may prove to be an effective modality.

METHODS 10 patients (8 men) with T2DM having duration of disease >5 years, failure of triple oral antidiabetic drugs and currently on insulin (≥0.7 U/kg/day) at least for one year, glutamic acid decarboxylase antibody negative were included. Patients on stable doses of medications for past 3 months were recruited. Primary end points were reduction in insulin requirement by ≥50% and improvement in glucagon stimulated C– peptide levels at the end of 6 months of autologous bone marrow derived stem cell transplantation, while, secondary end points were a change in weight, HbA1c and lipid levels as compared to baseline.

RESULTS Seven patients were responders and showed a reduction in insulin requirement by 75% as compared to baseline. Mean duration to achieve the primary objective was 48 days. Three patients were able to discontinue insulin completely, although it was short-lived in one. Mean HbA1c reduction was 1.1% and 3 of the 7 responders had HbA1c value < 7%. A significant weight loss of 5.5 kg was noted in the responders, whereas, nonresponders gained 2.2 kg of weight. However, weight loss did not correlate with reduction in insulin requirement (r=0.68, p=0.06). There was a significant improvement in both fasting and glucagon stimulated C- peptide level in the group (p=0.03) and responders (p=0.03). HOMA-B increased significantly in the whole group (p=0.02) and responders (p=0.04). Reduction in insulin doses correlated with stimulated C- peptide response at the baseline (r=0.83, p=0.047) and mononuclear cell count of infused stem cells (r= 0.57, p= 0.04). No serious adverse effects were noted.

CONCLUSIONS Our observations indicate that stem cell transplantation is a safe and effective modality of treatment to improve β– cell function in patients with T2DM.[clinical trials.Gov. Identifier: NCT00644241] Buy the full report here

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