Is Diabetes Reaching Epidemic Proportions? Yes, but New Discoveries Offer Hope.

Diabetes has reached epidemic proportions in the U.S. – genetics, sugary diets and the lack of exercise all play a part. In a recent Instagram survey ( it is now the second largest search engine in the world, btw) it was found 97% of us know someone with diabetes.  That number surprised me, as I assumed it would be 100%.

The CDC reports the prevalence of diagnosed diabetes increased from 0.93% in 1958 to 9.40% in 2015. In 2015, 23.4 million people had diagnosed diabetes, compared to only 1.6 million, and it is estimated that number has now risen to above 30 million.   If current disease rates continue, one in three Americans will have diabetes by 2050. Over time, the condition can lead to kidney failure, limb amputations and blindness, among other complications.

The CDC report called the trend alarming, yet there is hope.

A Little History – Insulin Isolated in Toronto

On this day in 1958, at the University of Toronto, Canadian scientists Frederick Banting and Charles Best successfully isolate insulin–a hormone they believe could prevent diabetes–for the first time. Within a year, the first human sufferers of diabetes were receiving insulin treatments, and countless lives were saved from what was previously regarded as a fatal disease.

Diabetes has been recognized as a distinct medical condition for more than 3,000 years, but its exact cause was a mystery until the 20th century. By the early 1920s, many researchers strongly suspected that diabetes was caused by a malfunction in the digestive system related to the pancreas gland, a small organ that sits on top of the liver. At that time, the only way to treat the fatal disease was through a diet low in carbohydrates and sugar and high in fat and protein. Instead of dying shortly after diagnosis, this diet allowed diabetics to live–for about a year.

A breakthrough came at the University of Toronto in the summer of 1921, when Canadians Frederick Banting and Charles Best successfully isolated insulin from canine test subjects, produced diabetic symptoms in the animals, and then began a program of insulin injections that returned the dogs to normalcy. On November 14, the discovery was announced to the world.

Two months later, with the support of J.J.R. MacLeod of the University of Toronto, the two scientists began preparations for an insulin treatment of a human subject. Enlisting the aid of biochemist J.B. Collip, they were able to extract a reasonably pure formula of insulin from the pancreases of cattle from slaughterhouses. On January 23, 1921, they began treating 14-year-old Leonard Thompson with insulin injections. The diabetic teenager improved dramatically, and the University of Toronto immediately gave pharmaceutical companies license to produce insulin, free of royalties. By 1923, insulin had become widely available, and Banting and Macleod were awarded the Nobel Prize in medicine.

8 Amazing Breakthroughs Giving Us Hope

According to recent research, we’re not entirely sure how many diseases the label ‘diabetes’ covers. But no matter what causes our bodies to struggle with their blood sugar levels, it’s a serious condition that requires daily care.  Scientists have been working hard to find cures, new treatments, and better management techniques for the millions of people worldwide dealing with diabetes.

Here are a few of the latest developments you need to know about.

  1. Insulin producing implants made from stem cells

Clinical trials began last year for testing for ViaCyte’s PEC-Direct device; a credit-card sized implant containing insulin-producing cells derived from stem cells. Previous research had shown the implants could mature and function inside patients. Together with a cohort of volunteers who started testing in January, the new research should tell us soon whether the technology can help people with type-1 diabetes.

  1. Brand new beta cells

Type 1 diabetes develops when a person’s immune system wipes out insulin-producing beta cells in the pancreas. But it turns out that another type of immature beta cell has been hiding in our pancreases all along, and scientists think it might be possible to use these ‘virgin beta cells’ to restore the functionality of the pancreas.

  1. A common blood pressure medication

A drug on the World Health Organization’s list of essential drugs could have another purpose; blocking a molecule implemented in the autoimmune response that can give rise to type-1 diabetes.

Called methyldopa, the compound already has an important job treating high blood pressure in pregnant women and children. It’s left to be seen if it could help reduce the incidence of diabetes in some way, but the fact it’s already being used – rather than being stuck in the lab – makes for a promising find.

  1. A unique transplant

One woman with severe type 1 diabetes has spent a year without insulin injections thanks to an experimental transplant. Doctors implanted insulin-producing cells into a fatty membrane in the stomach cavity, and the success of the operation is paving the way towards more people receiving artificial pancreases.

  1. An extreme diet

A clinical trial conducted on just 298 volunteers in the UK last year found an intensive weight management program could put type-2 diabetes into remission for those who lose a significant amount of weight. The subjects were limited to roughly 850 calories a day for three to five months, consuming mostly soups and health shakes, before having more food introduced.

A similar study conducted on rats last year in the US also showed low calorie diets might help those who can stick to it reverse their condition.

  1. Glucose-monitoring contact lenses

Until we can nail down a cure, there will always been a need to monitor those messy blood glucose levels. Checking your tears for glucose using a smart contact lens, or monitoring your sweat with color changing ink, could be a whole lot less invasive than drawing blood. They’re not new ideas, but constant improvements in miniaturizing technology could mean these kinds of devices aren’t too far off.

  1. Loneliness could make us prone

While we can list a variety of genetic and lifestyle factors that affect a body’s growing resistance to insulin, there’s still a lot to learn. A study published late last year involving nearly 3,000 subjects aged 40 to 75 found there seems to be a significant relationship between social isolation and type-2 diabetes.

It’s not clear what the link might be, but having a few housemates or a local social group could make all the difference.

  1. Mexican cavefish evolved to be diabetic

While developing a resistance to insulin is bad news in humans, the pale, eyeless animal known as a Mexican cavefish evolved a new version of the insulin receptor that makes it harder for the hormone to bind.  This isn’t exactly a problem for the fish, which have also evolved other features to help it compensate. Studying its biology might help shine a light on how diabetes evolved in humans, and maybe even lead to new treatments.

  1. There is a gene for that (?)

By studying one family with rare blood sugar disorders, scientists have identified a gene mutation that can give rise to both high and low blood sugar. This discovery could lead to new treatments for diabetes.

Diabetes is a condition in which the body is unable to produce enough of the hormone insulin, or it cannot use it effectively.  As a result, blood sugar levels become too high.  It is estimated that around 30.3 million people in the United States are living with diabetes. Type 2 diabetes is the most common form, followed by type 1 diabetes.

One of the commonest forms of monogenic diabetes is maturity onset diabetes of the young, which accounts for approximately 2 percent of all diabetes cases in the U.S. among people under the age of 20;   but there are some rarer forms that account for just 1–4 percent of cases in the U.S. These are known as monogenic diabetes, and they arise from a mutation in a single gene that is passed down from one or both parents.  Such mutations impair the function of beta cells, which are cells in the pancreas that secrete insulin.

For this latest study, lead author Prof. Márta Korbonits — of the William Harvey Research Institute at Queen Mary University of London (QMUL) in the United Kingdom — and her colleagues studied a unique family, some members of which had diabetes, while others had insulinomas, or insulin-producing tumors in the pancreas.

Notably, diabetes is characterized by high blood sugar levels, while insulinomas cause blood sugar levels to become too low. How can both of these conflicting conditions run in the same family?  According to Prof. Korbonits and team, a single gene mutation is to blame.

MAFA mutation uncovered

By analyzing the genomes of the family, the researchers were surprised to find a single mutation in the MAFA gene that was present in both the family members with diabetes and those with insulinomas.  The MAFA gene normally regulates the production of insulin in beta cells. A mutation in this gene leads to the production of an abnormal MAFA protein, which seems to be more abundant in beta cells than normal MAFA proteins.

The researchers were able to confirm the presence of the MAFA gene mutation in another family, which also had members with both diabetes and insulinomas.  Overall, the results indicate that a mutation in the MAFA gene may be a cause of both high and low blood sugar levels, but precisely how the mutation causes such conditions remains unclear.

“We believe,” explains first study author Dr. Donato Iacovazzo, also of the William Harvey Research Institute at QMUL, “this gene defect is critical in the development of the disease and we are now performing further studies to determine how this defect can, on the one hand, impair the production of insulin to cause diabetes, and on the other, cause insulinomas.”

These results — now published in the Proceedings of the National Academy of Sciences — represent the first time that a mutation in the MAFA gene has been associated with disease, and the researchers believe that they could pave the way for new treatments for common and rare forms of diabetes.

“While the disease we have characterized is very rare, studying rare conditions helps us understand more about the physiology and the mechanisms underlying more common diseases. We hope that in the longer-term this research will lead to us exploring new ways to trigger the regeneration of beta cells to treat more common forms of diabetes.”

– Study co-author Prof. Sian Ellard, University of Exeter, U.K.

Overall Numbers, Diabetes and Prediabetes

  • Prevalence: In 2015, 30.3 million Americans, or 9.4% of the population, had diabetes.
    • Approximately 1.25 million American children and adults have type 1 diabetes.
  • Undiagnosed: Of the 30.3 million adults with diabetes, 23.1 million were diagnosed, and 7.2 million were undiagnosed.
  • Prevalence in Seniors: The percentage of Americans age 65 and older remains high, at 25.2%, or 12.0 million seniors (diagnosed and undiagnosed).
  • New Cases: 1.5 million Americans are diagnosed with diabetes every year.
  • Prediabetes: In 2015, 84.1 million Americans age 18 and older had prediabetes.
  • Deaths: Diabetes remains the 7th leading cause of death in the United States in 2015, with 79,535 death certificates listing it as the underlying cause of death, and a total of 252,806 death certificates listing diabetes as an underlying or contributing cause of death.

If your system seems to be handling sugar poorly, consider talking to a physician.  You can quickly find and connect with one in the largest ever healthcare ecosystem designed to vastly improve the relationship doctors and patients are meant to enjoy and find great value in….

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Sources

 

Diabetes: Surprising gene discovery could fuel new treatments

Published: Tuesday 16 January 2018 Written by: Honor Whiteman

 

8 Amazing Breakthroughs in Diabetes Research That Are Giving Us Hope

BY SIGNE DEAN & MIKE MCRAE

APRIL 02, 2018

 

 

 

Will We Soon Reverse Diabetes and Obesity with Gene Therapy?

New research shows that gene therapy can completely reverse markers of Type 2 diabetes and obesity in rodents.  If the theory holds, small alterations to our genes could soon repair metabolic disorders such as obesity and Type 2 diabetes in humans.

The prevalence of diabetes, or the total number of existing cases, is on the rise in the United States and globally.  According to recent estimates, over 30 million U.S. adults had diabetes in 2015.

Although the number has been relatively steady in the past few years, rates of newly diagnosed cases among children and teenagers have increased sharply.  And, worldwide, the situation is even more alarming; the number of people with diabetes almost quadrupled between 1980 and 2014, according to the World Health Organization (WHO).

Now, new research brings much-needed hope of curing this metabolic disorder.  Scientists led by Fatima Bosch, a professor at the Universitat Autònoma de Barcelona (UAB) in Catalunya, Spain, have successfully reversed the disorder in rodents.  Prof. Bosch and her colleagues achieved this using gene therapy, a technique that introduces new genetic material into cells to create beneficial proteins or to offset the effects of malfunctioning genes.  The findings were published in the journal EMBO Molecular Medicine.

Using the FGF21 gene to reverse diabetes

Prof. Bosch and team designed two mouse models of obesity and type 2 diabetes. One was diet-induced, and the other one was genetically modified.  Using an adeno-associated viral vector as “transport,” the team delivered the fibroblast growth factor 21 (FGF21) gene.

This gene is responsible for encoding the FGF21 protein, which is seen as a “major metabolic regulator” that stimulates the absorption of blood sugar in adipose tissue.  By delivering this gene, the researchers stimulated the production of the protein, which caused the rodents to lose weight and lowered their insulin resistance — a major risk factor for type 2 diabetes. Additionally, the mice lost weight and the treatment reduced the fat and inflammation in their adipose tissue.

The fat content, inflammation, and fibrosis of the rodents’ livers were completely reversed, with no side effects. In turn, these improvements increased insulin sensitivity.  These beneficial effects were noted in both murine models. Also, the team found that administering FGF21 to healthy mice prevented age-related weight gain and led to healthy aging.

Gene therapy was used to alter three tissue types: liver tissue, adipose tissue, and skeletal muscle.  “This gives a great flexibility to the therapy,” explains Prof. Bosch, “since it allows [us] to select each time the most appropriate tissue, and in case some complication prevents manipulating any of the tissues, it can be applied to any of the others.”

“When a tissue produces FGF21 protein and secretes it into the bloodstream, it will be distributed throughout the body,” adds Prof. Bosch.

First reversion of obesity, insulin resistance

Study co-author and UAB researcher Claudia Jambrina explains that their findings are particularly significant given that “the prevalence of type 2 diabetes and obesity is growing at alarming rates around the world.”

The team also says that delivering FGF21 as a conventional drug would not yield the same benefits as gene therapy; firstly, the drug would have to be administered periodically for long-term benefits, and secondly, its toxicity would be high.  Using gene therapy, however, is free of side effects, and a single administration is enough to make the mice produce the protein naturally for several years.

“This is the first time that long-term reversion of obesity and insulin resistance have been achieved upon a one-time administration of a gene therapy, in an animal model that resembles obesity and type 2 diabetes in humans.”

First study author Veronica Jimenez, a UAB researcher

“The results demonstrate that it is a safe and effective therapy,” she adds. The next steps will be to “test this therapy in larger animals before moving to clinical trials with patients,” notes Prof. Bosch.  “[The] therapy described in this study,” she concludes, “constitutes the basis for the future clinical translation of FGF21 gene transfer to treat type 2 diabetes, obesity, and related comorbidities.”

Statistics and facts about type 2 diabetes

Diabetes mellitus, or diabetes, is a disease that causes high blood sugar. It occurs when there is a problem with insulin.

Insulin is a hormone that takes sugar from foods and moves it to the body’s cells. If the body does not make enough insulin or does not use insulin well, the sugar from food stays in the blood, resulting in high blood sugar.

Diabetes is a key health concern worldwide. In the United States, the rate of new cases rose sharply from the 1990s, but it fell between 2008 and 2015, and it continues to fall, according to the Centers for Disease Control and Prevention’s (CDC) National Diabetes Report, 2017. Meanwhile, the number of adults living with diabetes continues to rise.

The most common of diabetes is type 2. According to the CDC, 90 to 95 percent of people with diabetes in the United States have type 2. Just 5 percent of people have type 1.

Key facts

Diabetes is at an all-time high in the U.S. The CDC’s Division of Diabetes Translation states that 1 percent of the population, which is about a half of a million people, had diagnosed diabetes in 1958.

In 2015, around 9.4 percent of the population in the U.S. had diabetes, including 30.2 million adults aged 18 years and over. Nearly a quarter of those with the condition do not know they have it.

Between 1990 and 2010, the number of people living with diabetes more than tripled, and the number of new cases doubled every year.

Figures suggest that the incidence is levelling off and may even be falling, but it remains unclear whether this will continue as other factors come into play, such as the aging population.

The risk of developing diabetes increases with age.

The CDC report that 4.0 percent of people aged 18 to 44 years are living with diabetes, 17 percent of those aged 45 to 64 years, and 25.2 percent of those aged over 65 years.

Causes

Type 2 diabetes is thought to result from a combination of genetic and lifestyle factors.

The exact cause is unknown, but risk factors appear to include:

  • excess body fat
  • high blood pressure or cholesterol
  • having a close family member with the condition
  • a history of gestational diabetes
  • higher age

As obesity has become more prevalent over the past few decades, so too has the rate of type 2 diabetes. In 2013, more than 1 in 3 people in the U.S. were considered to have obesity, and over 2 in 3 were either overweight or had obesity.

In 1995, obesity affected 15.3 percent of Americans, and in 2008, the figure was 25.6 percent. From 1998 to 2008, the incidence of diabetes increased by 90 percent.

Although the link between obesity and diabetes is well known, the reasons they are connected remain unclear. A report in the Journal of Clinical Endocrinology and Metabolism asks why obesity does not always lead to diabetes, given the established link between the two conditions.

The same report notes that the location of body fat appears to play a role. People with more fat in the upper body area and around the waist are more likely to get diabetes than those who carry their body fat around the hips and lower body.

Diabetes and ethnicity

Rates of diabetes vary between ethnic groups.

There may be a combination of factors, including:

  • genetics
  • health conditions
  • lifestyle
  • finances
  • environment
  • access to healthcare

The CDC’s National Diabetes Statistics Report, 2017, found that, among people aged 20 years and over, diabetes affects:

  • 7.4 percent of Non-Hispanic whites
  • 8.0 percent of Asian Americans
  • 12.1 percent of Hispanics
  • 12.7 percent of Non-Hispanic Blacks
  • 15.1 percent of American Indians and Alaska Natives

Why diabetes is serious

Diabetes can have serious health consequences.

The ADA report that more Americans die from diabetes every year than from AIDS and breast cancer combined.

According to the CDC, 79,535 deaths occur each year due to diabetes. The number of fatalities related to diabetes may be underreported.

Why and how does diabetes damage the body and cause complications?

The ADA says:

  • Adults with diabetes are significantly more likely to die from a heart attack or stroke.
  • More than a quarter of all Americans with diabetes have diabetic retinopathy, which can cause vision loss and blindness.
  • Each year, nearly 50,000 Americans begin treatment for kidney failure due to diabetes. Diabetes accounts for 44 percent of all new cases of kidney failure.
  • Each year, diabetes causes about 73,000 lower limb amputations, which accounts for 60 percent of all lower limb amputations (not including amputations due to trauma).

Costs

Because of its high prevalence and link to numerous health problems, diabetes has a significant impact on healthcare costs.

The productivity loss for reduced performance at work due to diabetes in 2012 was 113 million days, or $20.8 billion, according to the ADA.

Diabetes cost the U.S. $327 billion in 2017, including $237 billion in medical costs and $90 billion in reduced productivity.

However, this number does not include:

  • the millions of people who have diabetes but are undiagnosed
  • the cost of prevention programs for people with diabetes, which are not counted under standard medical costs
  • over-the-counter medications for eye and dental problems, which are more common in people with diabetes.
  • administrative costs for insurance claims
  • the cost of reduced quality of life, lost productivity of family members, and other factors that cannot be measured directly

Because diabetes affects various parts of the body, the medical costs span different areas of specialty. The ADA report that:

  • 30 percent of medical costs associated with diabetes are for circulation problems that reduce blood flow to the limbs
  • 29 percent of medical costs associated with diabetes are for kidney conditions
  • 28 percent of medical costs associated with diabetes are for nervous system conditions

Despite its complications, people can manage their diabetes with a comprehensive plan that includes lifestyle changes and proper medical care. If they control their blood sugar levels well, many people with diabetes can lead full, active lives.

Difference between types 1 and 2

In type 1 diabetes, the immune system attacks the cells in the pancreas that make insulin. As a result, the body does not produce insulin, and people with this condition must take insulin by injection or pump every day.

Type 1 diabetes usually develops in children or young adults, but it can occur at any age. There is no known way to prevent type 1 diabetes, and there is no cure.

In 2011-2012, around 17,900 children under the age of 18 years received a diagnosis of type 1 diabetes in the U.S., or around 49 children each day. Type 1 diabetes affects around 1.25 million American adults and children.

People with type 2 diabetes may still have insulin in their bodies, but not enough for proper blood sugar control. Or, the body may not be able to use the insulin it has properly. As a result, blood sugar levels can become too high.

Typically, adults are diagnosed with type 2 diabetes, but children can get it too. Certain factors increase a person’s risk of getting type 2 diabetes, including:

  • obesity
  • older age
  • a family history of diabetes
  • lack of exercise
  • problems with glucose metabolism

The annual relative increase for type 1 diabetes in 2002-2012 in the U.S. was 1.8 percent, but the annual increase for type 2 diabetes was 4.8 percent.

If diabetes or any other medical concern has you  running a little slow, join our ecosystem designed to support your well being.  Here, at HealthLynked, we are building a network that connects patients to physicians in ways never before possible for the purpose of Improving HealthCare.

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Adapted from:

[1]  Murrell MD, Daniel.  “Statistics and facts about type 2 diabetes.” Medical News Today. 12 June 2018

[2]  Sandoiu, Ana. “Type 2 diabetes, obesity may soon be reversed with gene therapy.”  Medical News Today, 12 July 2018