Here's a great little story about people with diabetes living into their 80s. It seems that because of their overall awareness of healthful habits, people with diabetes can actually avoid those medical issues that kill the rest of us early.
Published Sunday, Sept. 26, 2004
Growing old with diabetes
By WILLIAM KATES, THE ASSOCIATED PRESS
SYRACUSE, New York -- Day in and day out, for seven decades, brothers Robert and Gerald Cleveland have meticulously managed their blood glucose levels, fending off a disease that typically gives its victims just 20 or 30 years. On Thursday, the world's leading diabetes research centre paid tribute to the Clevelands for their longevity and everyday perseverance.
According to the Boston-based Joslin Diabetes Center, they are the first siblings known to have lived with Type 1 diabetes for 50 years or longer.
DIABETES FOR 79 YEARS
Robert, 84, has lived with Type 1 diabetes for 79 years and, according to the centre's Dr. Hillary Keenan, is the longest known survivor. Gerald, 88, has had diabetes for 72 years.
"It's a minor distraction from a normal person's life. It doesn't have to interfere with any activities," said Robert, who believes he is probably in better overall health today because of his meticulously healthful habits.
Diabetes makes people more prone to heart disease, stroke, high blood pressure, blindness, kidney disease, nervous system disease and amputations.
"You're not handicapped with diabetes," Gerald said. "You just have a special job to do."
A diabetic doesn't produce or properly use insulin, the hormone needed to convert food into energy. The reason why continues to be a mystery, although genetics and factors such as obesity and lack of exercise appear to play roles, according to the American Diabetes Association.
DIABETES KILLED 69,301 IN 2000
Since the Joslin Center began its 50-year medal awards in 1972, more than 2,200 Americans have been identified as living with diabetes for 50-plus years, said Dr. George King, research director at the centre, which has more than 300 doctors and scientists. Eleven patients have lived 75-plus years with diabetes, he said. In 2000, the disease claimed 69,301 lives.
Over that time, Joslin researchers have studied the group to better understand what biological and genetic factors may contribute to a long life with diabetes, Keenan said.
Today, in the United States, there are 18.2 million diabetics, a third of whom aren't aware they have the disease.
Robert, a retired accountant, was diagnosed at age five in 1925 - three years after insulin was invented. He nearly died. Seven years later, Gerald, a former Syracuse school superintendent, was diagnosed at age 16.
Sunday, September 26, 2004
Wierd story from Boston
The Boston Globe carried the following story on Sunday, Sept. 26. Though I didn't find anything scientific about it, I thought it was interesting enough to share.
One quick note for our friends in Boston: You can't catch diabetes. It's not a contagious disease, like say tuberculosis or even AIDS. I'm thinking the school buildling probably isn't the problem here, but that's just my guess. I'll keep you updated on any new developments.
Some suspect school building in student diabetes cases
Mayor asks state to probe possible link
By Maureen Costello, Globe Correspondent | September 26, 2004
The diagnoses of Type 1 diabetes in seven students who attended the Goodyear Elementary School have prompted Woburn officials to ask for the state's help in investigating whether environmental factors in or near the building may have contributed to the children's sickness.
"There is some concern," said Mayor John C. Curran, who last month asked the state's Department of Public Health to investigate a possible link between the diagnoses and the condition of the 77-year-old school, where 231 students attend kindergarten through Grade 5. "I think it's highly unlikely that it's the school, but we're going to check it out. We're just trying to rule everything out."
Nicole St. Peter, a spokeswoman for the state public health department, confirmed that a preliminary assessment of the building was conducted Sept. 2 and final results are expected soon. Families and school officials will receive a copy of the findings.
Coincidentally, a new elementary school opened this month, allowing some families to send their children to another school. Parents Tammie Brinkley, Justine Cromer, and Kristin Ahearn opted out of Goodyear, claiming the physical condition of the building may be responsible for triggering Type 1 diabetes, formerly known as juvenile diabetes, in their boys.
"We were looking for a common denominator, and all information pointed that way," said Brinkley, whose son Tyler, 7, was diagnosed in June, and son Christian, 5, was diagnosed two months later. Christian began kindergarten at the new Malcolm White School this year, but his mother said he spent a week at the Goodyear during a kindergarten readiness program last winter.
Brinkley and Cromer said there is no history of diabetes in their families. But Ahearn said her cousin's son was diagnosed with diabetes six years ago and noted that she, her cousin, and Brinkley grew up in East Woburn. When Ahearn's son Kyle, 13, was diagnosed in January 2003 and her other son, Ethan, 9, was diagnosed in June, she began to think that their neighborhood had something to do with the disease.
But Ahearn said last month's diagnosis of Cromer's child, Nick, 9, undermined that theory. Cromer and her family moved to Woburn from Seattle in July 2003. Cromer said her son began experiencing allergy-like symptoms after entering Goodyear, and became unable to quench his thirst beginning in June. Excessive thirst and frequent urination are typical symptoms of Type 1 diabetes.
"I truly believe it's a complicated combination of the environment and stress," said Cromer.
None of these five students is attending Goodyear this year. The two other students who were diagnosed with diabetes continue to attend the school. School officials would not identify these students.
In Type 1 diabetes, the pancreas produces little or no insulin, which is used to transfer sugar from the blood to fuel the cells. Once diagnosed, the disease means a lifetime of dependency on insulin shots. Complications may include blindness, kidney failure, amputation of lower extremities, and a life expectancy 15 years shorter than average.
The cause is not yet known, but genetics do play a factor, though not in as simple a pattern as inheriting brown eyes, said James H. Warram, an investigator at the Joslin Diabetes Center at Harvard Medical School.
"There is overwhelming evidence, no question, that genetics is suspected, but only about 5 to 10 percent of the people who are susceptible get it," he said. "There is no one trigger, but probably a whole sequence of triggers."
Diet and cold temperatures are two factors that could trigger diabetes, Warram said. He also cited a theory by British researcher Edwin Gale that suggests extremely clean environments could contribute to Type 1 diabetes. "Now, I'm sure these mothers aren't going to want to hear that," said Warram, who added that exposure to many types of bacteria helps develop healthy immune systems.
Warram said the cluster of cases in Woburn ''is definitely higher than average, but it's one of the most common childhood diseases."
On average, the onset of Type 1 diabetes affects one out of 100 people before age 70, and typically three out of 1,000 people are stricken before age 20. Boys, especially teens, are more susceptible, said Warram, who cautioned that the cluster in Woburn may stem from mere chance rather than a common trigger. He said it takes years for the pancreas to break down, so it is unlikely these boys, who must have been genetically predisposed to get the disease, all experienced the same trigger.
Still, Warram said, environment is an important factor. ''The environment is somehow or other getting worse for these kids."
Superintendent of Schools Carl R. Batchelder said that 15 of the city's 4,700 students have Type 1 diabetes, a ratio he likened to the national average. However, he took the parents' concerns seriously and accompanied the state investigator on rounds of the building early this month. School officials also sent a letter about the concern to all Goodyear parents before school opened for the year, Batchelder said.
Batchelder said, besides diabetes, he has seen a rise in a number of other childhood illnesses, such as nut allergies, in his 10 years with the city. This has prompted officials to hire a full-time nurse for every school building.
Youngsters with Type 1 diabetes must have their sugar and insulin levels constantly monitored, and their insulin dosage calculated by the amount of sugar and carbohydrates they eat. ''It's major math, and my youngest couldn't do it," said Ahearn, adding that Ethan must visit the school nurse at least four times a day for monitoring, and Kyle spends his lunch period there.
The children also have to beware of treats and other foods they come across at school, friends' homes, and other locations. Before their diagnoses, Ahearn said, neither child ever visited the nurse.
One quick note for our friends in Boston: You can't catch diabetes. It's not a contagious disease, like say tuberculosis or even AIDS. I'm thinking the school buildling probably isn't the problem here, but that's just my guess. I'll keep you updated on any new developments.
Some suspect school building in student diabetes cases
Mayor asks state to probe possible link
By Maureen Costello, Globe Correspondent | September 26, 2004
The diagnoses of Type 1 diabetes in seven students who attended the Goodyear Elementary School have prompted Woburn officials to ask for the state's help in investigating whether environmental factors in or near the building may have contributed to the children's sickness.
"There is some concern," said Mayor John C. Curran, who last month asked the state's Department of Public Health to investigate a possible link between the diagnoses and the condition of the 77-year-old school, where 231 students attend kindergarten through Grade 5. "I think it's highly unlikely that it's the school, but we're going to check it out. We're just trying to rule everything out."
Nicole St. Peter, a spokeswoman for the state public health department, confirmed that a preliminary assessment of the building was conducted Sept. 2 and final results are expected soon. Families and school officials will receive a copy of the findings.
Coincidentally, a new elementary school opened this month, allowing some families to send their children to another school. Parents Tammie Brinkley, Justine Cromer, and Kristin Ahearn opted out of Goodyear, claiming the physical condition of the building may be responsible for triggering Type 1 diabetes, formerly known as juvenile diabetes, in their boys.
"We were looking for a common denominator, and all information pointed that way," said Brinkley, whose son Tyler, 7, was diagnosed in June, and son Christian, 5, was diagnosed two months later. Christian began kindergarten at the new Malcolm White School this year, but his mother said he spent a week at the Goodyear during a kindergarten readiness program last winter.
Brinkley and Cromer said there is no history of diabetes in their families. But Ahearn said her cousin's son was diagnosed with diabetes six years ago and noted that she, her cousin, and Brinkley grew up in East Woburn. When Ahearn's son Kyle, 13, was diagnosed in January 2003 and her other son, Ethan, 9, was diagnosed in June, she began to think that their neighborhood had something to do with the disease.
But Ahearn said last month's diagnosis of Cromer's child, Nick, 9, undermined that theory. Cromer and her family moved to Woburn from Seattle in July 2003. Cromer said her son began experiencing allergy-like symptoms after entering Goodyear, and became unable to quench his thirst beginning in June. Excessive thirst and frequent urination are typical symptoms of Type 1 diabetes.
"I truly believe it's a complicated combination of the environment and stress," said Cromer.
None of these five students is attending Goodyear this year. The two other students who were diagnosed with diabetes continue to attend the school. School officials would not identify these students.
In Type 1 diabetes, the pancreas produces little or no insulin, which is used to transfer sugar from the blood to fuel the cells. Once diagnosed, the disease means a lifetime of dependency on insulin shots. Complications may include blindness, kidney failure, amputation of lower extremities, and a life expectancy 15 years shorter than average.
The cause is not yet known, but genetics do play a factor, though not in as simple a pattern as inheriting brown eyes, said James H. Warram, an investigator at the Joslin Diabetes Center at Harvard Medical School.
"There is overwhelming evidence, no question, that genetics is suspected, but only about 5 to 10 percent of the people who are susceptible get it," he said. "There is no one trigger, but probably a whole sequence of triggers."
Diet and cold temperatures are two factors that could trigger diabetes, Warram said. He also cited a theory by British researcher Edwin Gale that suggests extremely clean environments could contribute to Type 1 diabetes. "Now, I'm sure these mothers aren't going to want to hear that," said Warram, who added that exposure to many types of bacteria helps develop healthy immune systems.
Warram said the cluster of cases in Woburn ''is definitely higher than average, but it's one of the most common childhood diseases."
On average, the onset of Type 1 diabetes affects one out of 100 people before age 70, and typically three out of 1,000 people are stricken before age 20. Boys, especially teens, are more susceptible, said Warram, who cautioned that the cluster in Woburn may stem from mere chance rather than a common trigger. He said it takes years for the pancreas to break down, so it is unlikely these boys, who must have been genetically predisposed to get the disease, all experienced the same trigger.
Still, Warram said, environment is an important factor. ''The environment is somehow or other getting worse for these kids."
Superintendent of Schools Carl R. Batchelder said that 15 of the city's 4,700 students have Type 1 diabetes, a ratio he likened to the national average. However, he took the parents' concerns seriously and accompanied the state investigator on rounds of the building early this month. School officials also sent a letter about the concern to all Goodyear parents before school opened for the year, Batchelder said.
Batchelder said, besides diabetes, he has seen a rise in a number of other childhood illnesses, such as nut allergies, in his 10 years with the city. This has prompted officials to hire a full-time nurse for every school building.
Youngsters with Type 1 diabetes must have their sugar and insulin levels constantly monitored, and their insulin dosage calculated by the amount of sugar and carbohydrates they eat. ''It's major math, and my youngest couldn't do it," said Ahearn, adding that Ethan must visit the school nurse at least four times a day for monitoring, and Kyle spends his lunch period there.
The children also have to beware of treats and other foods they come across at school, friends' homes, and other locations. Before their diagnoses, Ahearn said, neither child ever visited the nurse.
Thursday, September 09, 2004
Islet transplant results compiled
From the National Institutes of Health:
Centers Report Islet Transplant Results in Patients with Type 1 Diabetes
Sept. 7, 2004 -- Researchers from 12 medical centers in the United States and Canada, who have performed islet transplants in 86 patients with type 1 diabetes, published their results today in the first annual report of the Collaborative Islet Transplant Registry (CITR). The report (www.citregistry.org ) analyzes many factors that can affect the outcome of this experimental procedure for people with severe or complicated type 1 diabetes.
The report provides data on recipient and donor characteristics, pancreas procurement and islet processing, immunosuppressive medications, function of the donated islets, patients’ lab results, and adverse events. “We now have much-needed information on the short-term results of islet transplantation,” said Dr. Thomas Eggerman of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the part of the National Institutes of Health (NIH) that funds the project. “Our goal is to collect data on both short- and long-term outcomes for all patients who receive islet transplants so we can better define the overall risks and benefits of this exciting but still experimental procedure.”
Type 1 diabetes, which affects up to 1 million people in the United States, develops when the body’s immune system destroys the insulin-producing beta cells of the pancreas. This form of diabetes usually strikes children and young adults, who need several insulin injections a day or an insulin pump to survive. Insulin, however, is not a cure, and eventually most people with type 1 diabetes develop one or more complications of the disease, including damage to the heart and blood vessels, eyes, nerves, and kidneys.
In islet transplantation as performed by these centers, insulin-producing cells derived from donor pancreata were infused into patients with difficult-to-control type 1 diabetes though the portal vein of the liver. When successful, the transplanted islets took up residence in the liver’s small blood vessels and began producing insulin.
The 86 recipients, who had type 1 diabetes for an average of 30 years, received a total of 158 infusions of islets extracted from 173 donor pancreata. Twenty-eight patients received one islet infusion, 44 received two, and 14 received three. At 6 months after the last infusion, 61 percent of recipients no longer had to inject insulin. At 1 year after the last transfusion, 58 percent were still insulin independent. Some insulin-independent patients, although not receiving insulin, did have higher-than-normal blood glucose levels. Researchers will continue to monitor patients to see how long they remain insulin independent.
Recipients, 66 percent of whom were women, were an average age of 42 years (range 24 to 64 years) and average weight of 143 lbs. (range 103 to 213 lbs.). Before the procedure, nearly half the recipients were using an insulin pump. Most had recently experienced at least one episode of hypoglycemia, or dangerously low blood glucose, requiring another person’s help. Their average level of hemoglobin A1c (HbA1c), which reflects blood glucose control over the previous 3 months, was 7.7 percent, compared to a normal HbA1c of 6 percent.
HbA1c levels generally improved with each infusion, as did levels of fasting blood glucose and C-peptide, which reflect insulin production. One infusion, though rarely providing enough islets to free a person from the need to inject insulin, alleviated episodes of severely low blood glucose. After the first infusion of islets, only two recipients had a low blood sugar problem requiring the help of another person. None of those who received a single infusion reported a problem with hypoglycemia a year after the procedure.
“Data collection on islet transplantation has been difficult, because most of the 750 islet transplants performed worldwide since 1974 have been done as part of small, single-center pilot trials,” said Dr. Bernhard Hering of the University of Minnesota, who chairs CITR’s scientific advisory committee. “This report is an important collaborative effort to combine data from 12 centers on the risks and successes of islet transplantation and to make the information widely available to patients and investigators.”
From 1990 to 1999, only 8 percent of islet transplants resulted in insulin independence for more than 1 year. In 2000, however, a group of researchers led by Dr. James Shapiro at the University of Alberta in Edmonton, Canada, reported much greater success in patients transplanted with islets from two to four donor pancreata and treated with an immunosuppressive regimen that left out glucocorticoids, now thought to be toxic to islets. In the next few years, other researchers replicated the “Edmonton protocol” pioneered by the Canadian team, and many centers are now using this approach to islet transplantation.
The centers reported 45 serious adverse events but no deaths in the recipients. The 27 percent of events that were classified as life-threatening included those linked to the transplant procedure itself (e.g., infection, bleeding into the chest or abdomen, low hemoglobin, high liver enzymes) and to medications that suppress the immune system (e.g., anemia, nerve damage, meningitis, and low numbers of white blood cells). Most recipients received the same drug regimen used in the Edmonton protocol: daclizumab at induction to prevent the immune system from rejecting the donor islets and sirolimus combined with tacrolimus to maintain immunosuppression.
The CITR’s mission is to expedite progress and promote safety in islet transplantation by collecting analyzing, and communicating data on islet transplantation. NIDDK established the registry in 2001 through a contract awarded to EMMES Corporation in Rockville, Maryland.
In the CITR's first report, 12 islet transplant centers detail the experiences of 86 patients who received at least one islet transplant from 1999 to 2003. Omitted from the report are outcomes for 74 other recipients at these centers and data on about 40 people who received islet transplants in other centers during this time. "We're continuing to receive additional data from the inaugural 12 centers and from new centers joining and contributing data, so future reports will be even more comprehensive," noted Dr. Eggerman.
"The CITR will prove invaluable, not only to investigators, but to all parties with an interest in moving the field forward," added Dr. Brian Flanagan, Scientific Program Manager at the Juvenile Diabetes Research Foundation International (JDRF). Recently, five islet transplant centers in Europe, with JDRF funding, began contributing data to the CITR.
“In addition to collecting data on islet transplant outcomes, the CITR is integrating data from other sources, such as the United Network for Organ Sharing (UNOS) and the Islet Cell Resource Centers. This effort will give us critical information on donor characteristics, organ procurement, islet processing, and other key variables that influence the success of islet transplantation,” said Dr. Camillo Ricordi of the Diabetes Research Institute at the University of Miami, who serves on the CITR’s scientific advisory committee.
The CITR is supported by a special funding program for type 1 diabetes research, which provides a total of $1.14 billion from fiscal year 1998 through fiscal year 2008 to supplement other funds for type 1 diabetes research made available through the regular NIH appropriations process.
Because only about 6,000 donor pancreata become available each year, and many are used for whole organ transplantation, the scarcity of islets poses a major obstacle to wider testing of islet transplantation as a treatment for type 1 diabetes. To improve the potential of cell replacement therapy for type 1 diabetes, NIH-funded research is focusing on understanding the beta cell and its regeneration and on efforts to develop alternative sources of beta cells. Researchers are also working on ways to coax the immune system into accepting donated cells or tissues without suppressing the whole immune system.
Centers Report Islet Transplant Results in Patients with Type 1 Diabetes
Sept. 7, 2004 -- Researchers from 12 medical centers in the United States and Canada, who have performed islet transplants in 86 patients with type 1 diabetes, published their results today in the first annual report of the Collaborative Islet Transplant Registry (CITR). The report (www.citregistry.org ) analyzes many factors that can affect the outcome of this experimental procedure for people with severe or complicated type 1 diabetes.
The report provides data on recipient and donor characteristics, pancreas procurement and islet processing, immunosuppressive medications, function of the donated islets, patients’ lab results, and adverse events. “We now have much-needed information on the short-term results of islet transplantation,” said Dr. Thomas Eggerman of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the part of the National Institutes of Health (NIH) that funds the project. “Our goal is to collect data on both short- and long-term outcomes for all patients who receive islet transplants so we can better define the overall risks and benefits of this exciting but still experimental procedure.”
Type 1 diabetes, which affects up to 1 million people in the United States, develops when the body’s immune system destroys the insulin-producing beta cells of the pancreas. This form of diabetes usually strikes children and young adults, who need several insulin injections a day or an insulin pump to survive. Insulin, however, is not a cure, and eventually most people with type 1 diabetes develop one or more complications of the disease, including damage to the heart and blood vessels, eyes, nerves, and kidneys.
In islet transplantation as performed by these centers, insulin-producing cells derived from donor pancreata were infused into patients with difficult-to-control type 1 diabetes though the portal vein of the liver. When successful, the transplanted islets took up residence in the liver’s small blood vessels and began producing insulin.
The 86 recipients, who had type 1 diabetes for an average of 30 years, received a total of 158 infusions of islets extracted from 173 donor pancreata. Twenty-eight patients received one islet infusion, 44 received two, and 14 received three. At 6 months after the last infusion, 61 percent of recipients no longer had to inject insulin. At 1 year after the last transfusion, 58 percent were still insulin independent. Some insulin-independent patients, although not receiving insulin, did have higher-than-normal blood glucose levels. Researchers will continue to monitor patients to see how long they remain insulin independent.
Recipients, 66 percent of whom were women, were an average age of 42 years (range 24 to 64 years) and average weight of 143 lbs. (range 103 to 213 lbs.). Before the procedure, nearly half the recipients were using an insulin pump. Most had recently experienced at least one episode of hypoglycemia, or dangerously low blood glucose, requiring another person’s help. Their average level of hemoglobin A1c (HbA1c), which reflects blood glucose control over the previous 3 months, was 7.7 percent, compared to a normal HbA1c of 6 percent.
HbA1c levels generally improved with each infusion, as did levels of fasting blood glucose and C-peptide, which reflect insulin production. One infusion, though rarely providing enough islets to free a person from the need to inject insulin, alleviated episodes of severely low blood glucose. After the first infusion of islets, only two recipients had a low blood sugar problem requiring the help of another person. None of those who received a single infusion reported a problem with hypoglycemia a year after the procedure.
“Data collection on islet transplantation has been difficult, because most of the 750 islet transplants performed worldwide since 1974 have been done as part of small, single-center pilot trials,” said Dr. Bernhard Hering of the University of Minnesota, who chairs CITR’s scientific advisory committee. “This report is an important collaborative effort to combine data from 12 centers on the risks and successes of islet transplantation and to make the information widely available to patients and investigators.”
From 1990 to 1999, only 8 percent of islet transplants resulted in insulin independence for more than 1 year. In 2000, however, a group of researchers led by Dr. James Shapiro at the University of Alberta in Edmonton, Canada, reported much greater success in patients transplanted with islets from two to four donor pancreata and treated with an immunosuppressive regimen that left out glucocorticoids, now thought to be toxic to islets. In the next few years, other researchers replicated the “Edmonton protocol” pioneered by the Canadian team, and many centers are now using this approach to islet transplantation.
The centers reported 45 serious adverse events but no deaths in the recipients. The 27 percent of events that were classified as life-threatening included those linked to the transplant procedure itself (e.g., infection, bleeding into the chest or abdomen, low hemoglobin, high liver enzymes) and to medications that suppress the immune system (e.g., anemia, nerve damage, meningitis, and low numbers of white blood cells). Most recipients received the same drug regimen used in the Edmonton protocol: daclizumab at induction to prevent the immune system from rejecting the donor islets and sirolimus combined with tacrolimus to maintain immunosuppression.
The CITR’s mission is to expedite progress and promote safety in islet transplantation by collecting analyzing, and communicating data on islet transplantation. NIDDK established the registry in 2001 through a contract awarded to EMMES Corporation in Rockville, Maryland.
In the CITR's first report, 12 islet transplant centers detail the experiences of 86 patients who received at least one islet transplant from 1999 to 2003. Omitted from the report are outcomes for 74 other recipients at these centers and data on about 40 people who received islet transplants in other centers during this time. "We're continuing to receive additional data from the inaugural 12 centers and from new centers joining and contributing data, so future reports will be even more comprehensive," noted Dr. Eggerman.
"The CITR will prove invaluable, not only to investigators, but to all parties with an interest in moving the field forward," added Dr. Brian Flanagan, Scientific Program Manager at the Juvenile Diabetes Research Foundation International (JDRF). Recently, five islet transplant centers in Europe, with JDRF funding, began contributing data to the CITR.
“In addition to collecting data on islet transplant outcomes, the CITR is integrating data from other sources, such as the United Network for Organ Sharing (UNOS) and the Islet Cell Resource Centers. This effort will give us critical information on donor characteristics, organ procurement, islet processing, and other key variables that influence the success of islet transplantation,” said Dr. Camillo Ricordi of the Diabetes Research Institute at the University of Miami, who serves on the CITR’s scientific advisory committee.
The CITR is supported by a special funding program for type 1 diabetes research, which provides a total of $1.14 billion from fiscal year 1998 through fiscal year 2008 to supplement other funds for type 1 diabetes research made available through the regular NIH appropriations process.
Because only about 6,000 donor pancreata become available each year, and many are used for whole organ transplantation, the scarcity of islets poses a major obstacle to wider testing of islet transplantation as a treatment for type 1 diabetes. To improve the potential of cell replacement therapy for type 1 diabetes, NIH-funded research is focusing on understanding the beta cell and its regeneration and on efforts to develop alternative sources of beta cells. Researchers are also working on ways to coax the immune system into accepting donated cells or tissues without suppressing the whole immune system.
Saturday, September 04, 2004
JDRF/Harvard launch new research partnership
August 23, 2004
BOSTON-The Juvenile Diabetes Research Foundation (JDRF) and Harvard Medical School today announced the opening of the JDRF Center for Immunological Tolerance in Type 1 Diabetes at Harvard Medical School, Generously Supported by Marshalls Ten Year Partnership with JDRF.
The Center was developed because advances in the immune tolerance area are critical for finding better treatments, and eventually a cure, for type 1 diabetes. The primary goals of the JDRF Center for Immunological Tolerance at Harvard Medical School are:
* understanding how immunological tolerance breaks down to provoke type 1 diabetes
* learning how to re-establish tolerance in order to prevent or cure type 1 diabetes, in particular via islet transplantation
* providing a framework for integrating basic research and clinical endeavors focused on islet transplantation
* serving as a magnet for research on immunological tolerance in type 1 diabetes at Harvard Medical School and its affiliated hospitals, and in the Boston area more generally
* becoming a reservoir for new technologies and resources to service the worldwide community of type 1 diabetes researchers.
The new Center will be supported by JDRF with a three-year grant of approximately $5 million.
"We are excited about tackling the critical and very complicated area of immune tolerance," says Raphael Dolin, M.D., Dean for Academic and Clinical Programs at Harvard Medical School. "The Center's scientists are dedicated to learning more about immune tolerance and are acutely aware of its potential impact on islet transplantation, which is a very promising strategy for treating and potentially curing diabetes. We are honored to be working with JDRF to help find a cure for type 1 diabetes."
Type 1 diabetes is caused by a breakdown in immunological tolerance. Specifically, type 1 diabetes results when the body attacks its own insulin-producing beta cells. As such, understanding immunological tolerance is a critical objective for type 1 diabetes researchers.
Co-directors Dr. Diane Mathis and Dr. Christophe O. Benoist are heading the JDRF Center for Immunological Tolerance in Type 1 Diabetes at Harvard Medical School and they will oversee a group of ten laboratories from Harvard and its affiliated institutions.
With the development of this Center they are bringing together complementary expertise in immunology, molecular biology and experimental transplantation. Essentially, the Center is a confederation of eight research projects and three supporting cores, constituting a broad-based basic research program on immunological tolerance in type 1 diabetes.
According to Dr. Mathis, "Christophe and I are delighted to have pulled together such an 'All Star' team for this Center. With our team in place we are confident that, in due time, we will elicit an impressive amount of new information about how the immune system breaks down and provokes the onset of type 1 diabetes. Armed with this new knowledge, we will be that much closer to finding ways to prevent and ultimately cure the disease."
Peter Van Etten, President and CEO of JDRF, further emphasized the power of the new Center when he said, "We are confident that the brilliant scientists affiliated with the new JDRF Center for Immunological Tolerance in Type 1 Diabetes at Harvard Medical School will produce very promising results. We always strive to work with the best the science world has to offer, and I¹m confident that these people are at the very top of their field."
"The other half of this impressive story of discovery and strides for a cure belongs to our partners in fundraising," continued Van Etten. "Today I would especially like to recognize Marshalls as an exceptional corporate partner. This new center is generously supported by Marshalls ten year partnership with JDRF, a partnership which began in 1994 when they raised $22,000 for the Walk. Just three years later in 1997, Marshalls was raising $500,000 a year, and by 2000, their annual donations exceeded $1 million. Now, more than 650 stores participate in 42 states and Puerto Rico, selling JDRF paper sneakers and forming Walk teams. Last year, Marshalls raised a phenomenal $1,275,000, and over the past 10 years, their cumulative contributions have exceeded $7.4 million. So, it¹s safe to say that this Center has been blessed with two 'Dream Teams!'"
Harvard Medical School
Harvard Medical School has more than 5,000 full-time faculty working in eight academic departments based at the School's Boston quadrangle or in one of 47 academic departments at 18 Harvard teaching hospitals and research institutes. Those Harvard hospitals and research institutions include Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Cambridge Hospital, The CBR Institute for Biomedical Research, Children's Hospital Boston, Dana-Farber Cancer Institute, Forsyth Institute, Harvard Pilgrim Health Care, Joslin Diabetes Center, Judge Baker Children's Center, Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital, Massachusetts Mental Health Center, McLean Hospital, Mount Auburn Hospital, Schepens Eye Research Institute, Spaulding Rehabilitation Hospital, VA Boston Healthcare System.
About JDRF
JDRF was founded in 1970 by the parents of children with juvenile diabetes -- a disease that strikes children suddenly, makes them insulin dependent for life, and carries the constant threat of devastating complications. Since inception, JDRF has provided more than $800 million to diabetes research worldwide. More than 80 percent of JDRF's expenditures directly support research and education about research. JDRF's mission is constant: to find a cure for diabetes and its complications through the support of research.
BOSTON-The Juvenile Diabetes Research Foundation (JDRF) and Harvard Medical School today announced the opening of the JDRF Center for Immunological Tolerance in Type 1 Diabetes at Harvard Medical School, Generously Supported by Marshalls Ten Year Partnership with JDRF.
The Center was developed because advances in the immune tolerance area are critical for finding better treatments, and eventually a cure, for type 1 diabetes. The primary goals of the JDRF Center for Immunological Tolerance at Harvard Medical School are:
* understanding how immunological tolerance breaks down to provoke type 1 diabetes
* learning how to re-establish tolerance in order to prevent or cure type 1 diabetes, in particular via islet transplantation
* providing a framework for integrating basic research and clinical endeavors focused on islet transplantation
* serving as a magnet for research on immunological tolerance in type 1 diabetes at Harvard Medical School and its affiliated hospitals, and in the Boston area more generally
* becoming a reservoir for new technologies and resources to service the worldwide community of type 1 diabetes researchers.
The new Center will be supported by JDRF with a three-year grant of approximately $5 million.
"We are excited about tackling the critical and very complicated area of immune tolerance," says Raphael Dolin, M.D., Dean for Academic and Clinical Programs at Harvard Medical School. "The Center's scientists are dedicated to learning more about immune tolerance and are acutely aware of its potential impact on islet transplantation, which is a very promising strategy for treating and potentially curing diabetes. We are honored to be working with JDRF to help find a cure for type 1 diabetes."
Type 1 diabetes is caused by a breakdown in immunological tolerance. Specifically, type 1 diabetes results when the body attacks its own insulin-producing beta cells. As such, understanding immunological tolerance is a critical objective for type 1 diabetes researchers.
Co-directors Dr. Diane Mathis and Dr. Christophe O. Benoist are heading the JDRF Center for Immunological Tolerance in Type 1 Diabetes at Harvard Medical School and they will oversee a group of ten laboratories from Harvard and its affiliated institutions.
With the development of this Center they are bringing together complementary expertise in immunology, molecular biology and experimental transplantation. Essentially, the Center is a confederation of eight research projects and three supporting cores, constituting a broad-based basic research program on immunological tolerance in type 1 diabetes.
According to Dr. Mathis, "Christophe and I are delighted to have pulled together such an 'All Star' team for this Center. With our team in place we are confident that, in due time, we will elicit an impressive amount of new information about how the immune system breaks down and provokes the onset of type 1 diabetes. Armed with this new knowledge, we will be that much closer to finding ways to prevent and ultimately cure the disease."
Peter Van Etten, President and CEO of JDRF, further emphasized the power of the new Center when he said, "We are confident that the brilliant scientists affiliated with the new JDRF Center for Immunological Tolerance in Type 1 Diabetes at Harvard Medical School will produce very promising results. We always strive to work with the best the science world has to offer, and I¹m confident that these people are at the very top of their field."
"The other half of this impressive story of discovery and strides for a cure belongs to our partners in fundraising," continued Van Etten. "Today I would especially like to recognize Marshalls as an exceptional corporate partner. This new center is generously supported by Marshalls ten year partnership with JDRF, a partnership which began in 1994 when they raised $22,000 for the Walk. Just three years later in 1997, Marshalls was raising $500,000 a year, and by 2000, their annual donations exceeded $1 million. Now, more than 650 stores participate in 42 states and Puerto Rico, selling JDRF paper sneakers and forming Walk teams. Last year, Marshalls raised a phenomenal $1,275,000, and over the past 10 years, their cumulative contributions have exceeded $7.4 million. So, it¹s safe to say that this Center has been blessed with two 'Dream Teams!'"
Harvard Medical School
Harvard Medical School has more than 5,000 full-time faculty working in eight academic departments based at the School's Boston quadrangle or in one of 47 academic departments at 18 Harvard teaching hospitals and research institutes. Those Harvard hospitals and research institutions include Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, Cambridge Hospital, The CBR Institute for Biomedical Research, Children's Hospital Boston, Dana-Farber Cancer Institute, Forsyth Institute, Harvard Pilgrim Health Care, Joslin Diabetes Center, Judge Baker Children's Center, Massachusetts Eye and Ear Infirmary, Massachusetts General Hospital, Massachusetts Mental Health Center, McLean Hospital, Mount Auburn Hospital, Schepens Eye Research Institute, Spaulding Rehabilitation Hospital, VA Boston Healthcare System.
About JDRF
JDRF was founded in 1970 by the parents of children with juvenile diabetes -- a disease that strikes children suddenly, makes them insulin dependent for life, and carries the constant threat of devastating complications. Since inception, JDRF has provided more than $800 million to diabetes research worldwide. More than 80 percent of JDRF's expenditures directly support research and education about research. JDRF's mission is constant: to find a cure for diabetes and its complications through the support of research.
New technology detects early signs of diabetes
From the Joslin Diabetes Center:
BOSTON – By the time overt symptoms of type 1 diabetes appear in an individual, destruction of the insulin-producing beta cells of the pancreas has already progressed significantly. However, findings by researchers at Joslin Diabetes Center and Massachusetts General Hospital, published in the Aug. 24 issue of Proceedings of the National Academy of Sciences, show that a powerful new imaging technology gives scientists a glimpse into the earliest stages of the inflammatory process leading to type 1 diabetes in laboratory animals. The new findings one day may be useful for predicting whether and when diabetes will develop in humans.
Type 1 diabetes is an autoimmune disease in which the body’s immune system mistakenly launches an attack on the insulin-producing beta cells of the pancreatic islets. This process may eventually destroy the beta cells, preventing them from producing sufficient insulin, so that high blood-glucose levels—and full-blown diabetes—develop. Early in this process, white blood cells called T-cells invade the islets (an inflammatory condition known as “insulitis”). A very early marker of this inflammation is increased permeability (leaking) of the tiny blood vessels surrounding and within the islets.
Until recently, the only way to track type 1 diabetes in its earliest stages was to measure blood levels of autoantibodies (the immune system’s “guided missiles”) directed against pancreatic islet proteins. Yet, these tests are only an indirect indication of the disease process, and don’t allow researchers to directly follow the progression of disease.
This gap may someday be filled by a new technology that exploits magnetic resonance imaging, commonly known as MRI, to monitor miniscule magnetic nanoparticles leaking from the blood vessels of the pancreas, according to researchers at the Joslin Diabetes Center and Massachusetts General Hospital.
How the technology works
The new imaging technology uses tiny probes called long-circulating magnetofluorescent nanoparticles (CMFN). These particles contain magnetic nanocrystals of iron oxide, which are very easily detected by MRI. After being injected intravenously, CMFN travels throughout the body, including through the tiny blood vessels of the pancreas. If these vessels have started to become permeable as a result of islet inflammation, more CMFN tends to leak out and collect in the surrounding tissue, as can be seen on the MRI. This technique allows researchers to observe this early inflammatory process over time. “Thus, we have the means to non-invasively monitor the initiation and progression of insulitis in mouse models of type 1 diabetes in vivo and in real time,” said Diane Mathis, Ph.D., of Joslin Diabetes Center.
The researchers say that this new imaging process may prove an invaluable aid in helping researchers and clinicians to spot early insulitis and to monitor how it changes, during the development of disease and after experimental or therapeutic interventions aimed at stopping its progression. Further, they point out that the technique already has been used safely and effectively by the MGH group in human clinical trials to detect the spread of prostate cancer to the lymph nodes. “Given the known safety of magnetic nanoparticles in humans, the technology might someday be used in individuals who are genetically at risk for diabetes to detect this autoimmune process in its earliest stages,” suggests Joslin's Dr. Christophe Benoist.
This research was funded by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health.
BOSTON – By the time overt symptoms of type 1 diabetes appear in an individual, destruction of the insulin-producing beta cells of the pancreas has already progressed significantly. However, findings by researchers at Joslin Diabetes Center and Massachusetts General Hospital, published in the Aug. 24 issue of Proceedings of the National Academy of Sciences, show that a powerful new imaging technology gives scientists a glimpse into the earliest stages of the inflammatory process leading to type 1 diabetes in laboratory animals. The new findings one day may be useful for predicting whether and when diabetes will develop in humans.
Type 1 diabetes is an autoimmune disease in which the body’s immune system mistakenly launches an attack on the insulin-producing beta cells of the pancreatic islets. This process may eventually destroy the beta cells, preventing them from producing sufficient insulin, so that high blood-glucose levels—and full-blown diabetes—develop. Early in this process, white blood cells called T-cells invade the islets (an inflammatory condition known as “insulitis”). A very early marker of this inflammation is increased permeability (leaking) of the tiny blood vessels surrounding and within the islets.
Until recently, the only way to track type 1 diabetes in its earliest stages was to measure blood levels of autoantibodies (the immune system’s “guided missiles”) directed against pancreatic islet proteins. Yet, these tests are only an indirect indication of the disease process, and don’t allow researchers to directly follow the progression of disease.
This gap may someday be filled by a new technology that exploits magnetic resonance imaging, commonly known as MRI, to monitor miniscule magnetic nanoparticles leaking from the blood vessels of the pancreas, according to researchers at the Joslin Diabetes Center and Massachusetts General Hospital.
How the technology works
The new imaging technology uses tiny probes called long-circulating magnetofluorescent nanoparticles (CMFN). These particles contain magnetic nanocrystals of iron oxide, which are very easily detected by MRI. After being injected intravenously, CMFN travels throughout the body, including through the tiny blood vessels of the pancreas. If these vessels have started to become permeable as a result of islet inflammation, more CMFN tends to leak out and collect in the surrounding tissue, as can be seen on the MRI. This technique allows researchers to observe this early inflammatory process over time. “Thus, we have the means to non-invasively monitor the initiation and progression of insulitis in mouse models of type 1 diabetes in vivo and in real time,” said Diane Mathis, Ph.D., of Joslin Diabetes Center.
The researchers say that this new imaging process may prove an invaluable aid in helping researchers and clinicians to spot early insulitis and to monitor how it changes, during the development of disease and after experimental or therapeutic interventions aimed at stopping its progression. Further, they point out that the technique already has been used safely and effectively by the MGH group in human clinical trials to detect the spread of prostate cancer to the lymph nodes. “Given the known safety of magnetic nanoparticles in humans, the technology might someday be used in individuals who are genetically at risk for diabetes to detect this autoimmune process in its earliest stages,” suggests Joslin's Dr. Christophe Benoist.
This research was funded by the National Institute of Allergy and Infectious Diseases of the National Institutes of Health.
Friday, September 03, 2004
Regenerating insulin cells found in pancreas
From the University of Toronto
Researchers ID cells in mouse pancreas capable of generating beta cells
University of Toronto researchers have identified individual cells in the adult mouse pancreas capable of generating insulin-producing beta cells.
Their research, published Aug. 22 in the online edition of Nature Biotechnology, offers hope for the millions of diabetics worldwide who take insulin injections to compensate for defective pancreatic islets. Healthy islets, made up largely of beta cells, release insulin to help regulate the body's blood sugar levels.
"People have been intensely searching for pancreatic stem cells for a while now, and so our discovery of precursor cells within the adult pancreas that are capable of making new pancreatic cells is very exciting," says Simon Smukler, a PhD candidate in U of T's Department of Medical Genetics and Microbiology, who was one of the lead researchers. He conducted the study along with U of T MD/PhD candidate Raewyn Seaberg and their supervisor, Professor Derek van der Kooy.
The scientists are now hoping to extend their research to prove that these precursor cells are truly stem cells. True stem cells must exhibit two properties: the ability to renew themselves over the entire life of the organism and some ability for the parent cell to generate varied cell types – for example islet cells and exocrine cells. Pancreatic stem cells could provide a plentiful supply of beta cells for transplant treatments.
A finding Smukler considers equally exciting is their discovery that these pancreatic cells generated both beta cells and neurons, cells associated with the workings of the brain and the nervous system.
"The existing dogma regarding how development occurs states that fairly early in development, there is a distinction made between a group of cells destined to make the brain and another group destined to make the pancreas," he says. "The idea that a single cell within the pancreas could make both beta cells and neurons is intriguing."
U of T has a proud history of both diabetes and stem-cell research. Frederick Banting and Charles Best discovered insulin here in the 1920s, while years later, Drs. Ernest McCulloch and James Till first described the stem-cell concept.
This study was supported by the Stem Cell Network and the Canadian Institutes for Health Research. Zeenat Ashgar and Michael Wheeler from the U of T's Department of Physiology, Grigori Enikolopov of New York's Cold Spring Harbor Laboratory and Stem Cell Network members Timothy Kieffer of the University of British Columbia and Gregory Korbutt of the University of Alberta also contributed to the research.
"This remarkable discovery is a case study in cross-Canada cooperation," says Dr. Ron Worton, Scientific Director of the Stem Cell Network. "The research offers considerable new hope for people living with diabetes."
Researchers ID cells in mouse pancreas capable of generating beta cells
University of Toronto researchers have identified individual cells in the adult mouse pancreas capable of generating insulin-producing beta cells.
Their research, published Aug. 22 in the online edition of Nature Biotechnology, offers hope for the millions of diabetics worldwide who take insulin injections to compensate for defective pancreatic islets. Healthy islets, made up largely of beta cells, release insulin to help regulate the body's blood sugar levels.
"People have been intensely searching for pancreatic stem cells for a while now, and so our discovery of precursor cells within the adult pancreas that are capable of making new pancreatic cells is very exciting," says Simon Smukler, a PhD candidate in U of T's Department of Medical Genetics and Microbiology, who was one of the lead researchers. He conducted the study along with U of T MD/PhD candidate Raewyn Seaberg and their supervisor, Professor Derek van der Kooy.
The scientists are now hoping to extend their research to prove that these precursor cells are truly stem cells. True stem cells must exhibit two properties: the ability to renew themselves over the entire life of the organism and some ability for the parent cell to generate varied cell types – for example islet cells and exocrine cells. Pancreatic stem cells could provide a plentiful supply of beta cells for transplant treatments.
A finding Smukler considers equally exciting is their discovery that these pancreatic cells generated both beta cells and neurons, cells associated with the workings of the brain and the nervous system.
"The existing dogma regarding how development occurs states that fairly early in development, there is a distinction made between a group of cells destined to make the brain and another group destined to make the pancreas," he says. "The idea that a single cell within the pancreas could make both beta cells and neurons is intriguing."
U of T has a proud history of both diabetes and stem-cell research. Frederick Banting and Charles Best discovered insulin here in the 1920s, while years later, Drs. Ernest McCulloch and James Till first described the stem-cell concept.
This study was supported by the Stem Cell Network and the Canadian Institutes for Health Research. Zeenat Ashgar and Michael Wheeler from the U of T's Department of Physiology, Grigori Enikolopov of New York's Cold Spring Harbor Laboratory and Stem Cell Network members Timothy Kieffer of the University of British Columbia and Gregory Korbutt of the University of Alberta also contributed to the research.
"This remarkable discovery is a case study in cross-Canada cooperation," says Dr. Ron Worton, Scientific Director of the Stem Cell Network. "The research offers considerable new hope for people living with diabetes."
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