Type 1 Diabetes: Molecule Identified to Regenerate Insulin-Producing Cells

A neurotransmitter by the name of GABA, known to reduce brain activity, could induce the regeneration of insulin-producing cells, researchers in France have found. The breakthrough, confirmed in mice and partially validated in humans, brings new hope to patients suffering from type 1 diabetes, explains the French National Institute of Health and Medical Research, INSERM (Institut national de la santé et de la recherce médicale).



This latest research, published in the journal Cell, could hold particular significance for patients suffering from type 1 diabetes.

This form of the disease accounts for 5% to 10% of all diabetes cases. Although with no symptoms for a relatively long time, the disease often manifests during childhood or adolescence, when 80% to 90% of insulin-producing cells in the pancreas (beta cells) have already been destroyed due to an autoimmune reaction.

The main aim of the research was to regenerate these cells, "as current treatments are not always sufficient in preventing (serious) complications," explains INSERM.

The team of researchers discovered that this effect could be induced "with no genetic modification, using GABA, a neurotransmitter that is naturally present in the body and also available as a dietary supplement."

Previously, only a genetic modification of cells that resemble the beta cells, called glucagon-secreting alpha cells, was able to increase the number of insulin-producing cells.

GABA is the main inhibitory neurotransmitter of the central nervous system. Unlike dopamine or adrenaline, it doesn"t have a stimulating effect. In the body, GABA is synthesized from an amino acid called glutamic acid. Dietary sources of glutamic acid include cod, soybeans, almonds, cheese (Parmesan, Gouda, Edam, Gruyère) and veal.

The role of GABA was first observed in mice.

"In mice, GABA induces the continuous, yet controlled, regeneration of pancreatic alpha cells and their transformation into insulin-producing beta cells. The regenerated cells are functional and can cure chemically-induced diabetes multiple times," said the researchers.

In humans, the scientists found that the number of glucagon-producing alpha cells was reduced by 37% and the number of insulin-producing cells increased by 24% in pancreatic islets treated with GABA.

"These results are truly encouraging for a putative application in humans. Accordingly, a pilot clinical trial will soon be initiated to determine whether GABA may effectively help patients with type 1 diabetes," the researchers conclude.

Click Here to Find Out 3 Proven Steps to Reverse Type-2 Diabetes Watch The Video Now

Diabetes Tops List of Costliest Diseases in US

Diabetes leads a list of just 20 diseases and conditions that account for more than half of all spending on healthcare in the United States, according to a new comprehensive financial analysis.

U.S. spending on diabetes diagnosis and treatment totaled $101 billion in 2013, and has grown 36 times faster than spending on heart disease, the country"s No. 1 cause of death, researchers reported.



"After adjusting for inflation, we see that every year the U.S. is spending 6 percent more than we spent the year before on diabetes," said lead researcher Joseph Dieleman, assistant professor at the University of Washington Institute for Health Metrics and Evaluation.

"That"s really a remarkable growth rate, notably faster than the economy is growing or health care spending as a whole," he said.

The annual rate of growth in healthcare spending between 1996 and 2013 has been 3.5 percent on average, Dieleman noted.

"Spending on diabetes grew twice as fast as all conditions combined" during that 18-year period, he said.

The study findings were published in the Dec. 27 issue of the Journal of the American Medical Association.

Americans spent $2.1 trillion in 2013 on diagnosis and treatment of health problems, which amounts to more than 17 percent of the total U.S. economy, the researchers concluded from their analysis of federal data.

"That is a staggering, almost unimaginable amount," Dr. Ezekiel Emanuel wrote in an editorial accompanying the new study. Emanuel is chair of medical ethics and health policy at the University of Pennsylvania.

"Indeed, this level of spending makes the U.S. health care system the fifth largest economy in the world, behind only the U.S., Chinese, Japanese and German national economies," Emanuel pointed out.

Dieleman and his colleagues broke down the $2.1 trillion spent in 2013 across 155 different health conditions, to see which diseases were drawing in the most dollars.

The top 10 most costly health expenses in 2013, according to the analysis, were:

• Diabetes -- $101.4 billion.


• Ischemic heart disease -- $88.1 billion.


• Low back and neck pain -- $87.6 billion.


• High blood pressure -- $83.9 billion.


• Injuries from falls -- $76.3 billion.


• Depression -- $71.1 billion.


• Dental care -- $66.4 billion.


• Vision and hearing problems -- $59 billion.


• Skin-related problems -- $55.7 billion.


• Pregnancy and postpartum care -- $55.6 billion.

"There are things on that list that, when we think of healthcare, they"re not necessarily the things the average American would think of," Dieleman said.

The first five conditions alone comprised 18 percent of all personal health care spending and totaled $437 billion in 2013, the researchers noted.

Cancer did not make the list because the researchers split the category into all different types of cancers, such as breast cancer and colon cancer, Dieleman said. All combined, cancer care cost about $115 billion, the study found.

However, Dieleman added that this study only looked at total dollars spent on health care, and not whether the dollars were spent wisely. A follow-up report coming out in a few months will connect the money to risk factors that cause illness.

"I think of this study as providing a landscape," he said. "It tells you where to start digging deeper. For example, it tells you we"re spending notably more on diabetes, and now we can think about why that is."

Of the money spent on diabetes care in 2013, more than 57 percent went to medications and 23.5 percent went to outpatient care, the study authors reported.

"We know in diabetes most of the growth was in pharmaceuticals," Dieleman said.

But that doesn"t necessarily mean money for medications is ill-spent, he added.

"I think people are quick to point at pharma, but if medications are preventing trips to the clinic, that"s not necessarily a bad thing," Dieleman said. "Spending on treatment of high cholesterol is almost exclusively pharma, and that"s probably a good thing."

On the other hand, billions are being spent on low back and neck pain, and 70 percent of that spending is for working-age people younger than 65, Dieleman said.

"When I talk with medical doctors about this, there"s some cynicism about the effectiveness of the spending on low back and neck pain," he said. "Low back and neck pain is certainly one of those places where we"re spending a lot, and it encourages us to look closer and evaluate what we are getting out of that spending."

Emanuel agreed in his editorial.

"Rates of pain-associated health problems are actually increasing, rather than decreasing, and few people would rate the U.S. performance on these conditions as exemplary," he wrote.

"Patients who want pain relief often undergo surgery, even when rest, physical therapy and nonsurgical interventions would be equally effective," Emanuel said.

Click Here to Find Out 3 Proven Steps to Reverse Type-2 Diabetes Watch The Video Now

Metformin Still Best Drug for Type 2 Diabetes

Newly updated guidelines reaffirm that metformin is the first-line drug for people with type 2 diabetes, and that several other medications -- including newer ones -- can be added if needed.



The recommendations come from the American College of Physicians (ACP). The American Academy of Family Physicians endorsed the new guidelines. The ACP updated the guidelines because of new research into diabetes drugs, and the U.S. Food and Drug Administration approval of new diabetes drugs.

"Metformin, unless contraindicated, is an effective treatment strategy because it has better effectiveness, is associated with fewer adverse effects, and is cheaper than most other oral medications," ACP president Dr. Nitin Damle said in a college news release.

"The escalating rates of obesity in the U.S. are increasing the incidence and prevalence of diabetes substantially. Metformin has the added benefit of being associated with weight loss," Damle said.

The ACP recommends that if a patient needs to take a second drug by mouth to lower blood sugar levels, physicians should look at adding a sulfonylurea, thiazolidinedione, SGLT-2 inhibitor, or a DPP-4 inhibitor.

Examples of sulfonylurea drugs include glyburide (Diabeta, Glucovance, Micronase), glimepiride, glipizide (Glucotrol) and tolbutamide. Thiazolidinedione drugs include pioglitazone (Actos) and rosiglitazone (Avandia).

SGLT-2 inhibitors include canagliflozin (Invokana), empagliflozin (Jardiance) and dapagliflozin (Farxiga). DPP-4 inhibitors include sitagliptin (Janumet, Januvia) or linagliptin (Jentadueto, Tradjenta). Brand names for metformin include Glumetza, Glucophage, and Fortamet.

"Adding a second medication to metformin may provide additional benefits," Damle said.

"However, the increased cost may not always support the added benefit, particularly for the more expensive, newer medications. ACP recommends that clinicians and patients discuss the benefits, adverse effects, and costs of additional medications," he added.

An estimated 29 million people in the United States have diabetes, according to the U.S. Centers for Disease Control and Prevention.

Click Here to Find Out 3 Proven Steps to Reverse Type-2 Diabetes Watch The Video Now

Diabetes it affects Almost 10 Years From Lifespan

Type 2 diabetes reduces lifespan by almost a decade, says a new study published in JAMA. The study, which included more than 512,000 Chinese adults, found that those who were diagnosed with the metabolic disease in middle age lost, on average, nine years of life when compared to people who didn"t have the disease.



Participants were recruited between 2004 and 2008 and were followed until 2014. Of the group, 6 percent had diabetes (4 percent lived in rural areas while 8 percent lived in urban areas).

Researchers found that those with diabetes had twice the risk of dying during the follow-up period, and the increase was higher in rural areas than in urban areas.

Diabetes was associated with increased mortality from ischemic heart disease, stroke, chronic kidney disease, chronic liver disease, infection, and cancer of the liver, pancreas and breast.

The risk of dying from complications of diabetes (diabetic ketoacidosis or coma) was much greater in rural areas than in urban areas, and was much higher than in high-income countries.

The University of Oxford researchers estimated that the 25-year probability of death would be 69 percent among those diagnosed with diabetes at age 50 years compared with 38 percent among otherwise similar individuals without diabetes. The loss of life equaled about nine years of life —10 years in rural areas and eight years in urban areas.

More than 29 million Americans have diabetes, and it"s the seventh leading cause of death, according to the American Diabetes Association. More than a quarter of Americans age 65 and older have diabetes.

Numerous studies have shown that losing weight and following a healthy diet will reduce the risk of developing Type 2 diabetes. A March 2016 study from Britain"s Newcastle University found that losing 10 percent of body weight slashed the risk of Type 2 diabetes by up to 90 percent.

The study, which was published in Diabetes Care, found that undergoing a crash diet (800 calories) for eight weeks stopped diabetes in its tracks. If patients maintained their weight loss, they remained free of the condition. Even patients who had been diagnosed with diabetes for 10 years were able to reverse the disease.

Click Here to Find Out 3 Proven Steps to Reverse Type-2 Diabetes Watch The Video Now

Diabetes During Pregnancy Hikes Depression Risk

Gestational diabetes and a previous bout of depression can increase a first-time mother"s risk of postpartum depression, a new study suggests.



The analysis of data from more than 700,000 women in Sweden showed that gestational diabetes (developing diabetes during pregnancy) alone raised the risk for postpartum depression.

However, that risk rose even more if a woman had previously been diagnosed with depression.

"Most practitioners think of these as two isolated and very different conditions, but we now understand gestational diabetes and postpartum depression should be considered together," said study lead author Michael Silverman. He"s an assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai in New York City.

"While having diabetes increases [postpartum depression] risk for all women, for those women who have had a past depressive episode, having diabetes during pregnancy makes it 70 percent more likely that they will develop [postpartum depression]," Silverman said in a school news release.

The researchers said they also identified other risk factors for postpartum depression.

Among women with a history of depression, diabetes before pregnancy and giving birth prematurely at 32 to 36 weeks (full-term delivery is 39 to 40 weeks) increased the risk, the researchers said.

Also, among women with no history of depression, giving birth at a young age, having an instrument-assisted or cesarean delivery, and giving birth before 32 weeks increased the risk.

The study was published online Jan. 18 in the journal Depression and Anxiety.

"The reason a doctor asks if you smoke is because they know you are 20 times more likely to get cancer if you do. We believe ob-gyns should now do the same for depression history," Silverman said. "With this information, we can now intervene early, before the mother gives birth."

Click Here to Find Out 3 Proven Steps to Reverse Type-2 Diabetes Watch The Video Now

Language Barriers Cited in Poorer Diabetes Care

Hispanic-American Type 2 diabetes patients who lack proficiency in English may end up with poorer care, a new study finds.

Specifically, these patients were found to be much less likely than non-Hispanic patients to take newly prescribed diabetes medications as directed, the researchers said.



The study "suggests that more needs to be done to improve adherence to newly prescribed medications among Latino patients at all levels of English proficiency," wrote a team led by Dr. Alicia Fernandez, of the University of California, San Francisco.

 A diabetes specialist who reviewed the study wasn"t surprised by the results.The research "further validates what many clinicians already know: Patients who do not understand English tend to do worse with management of chronic disease," said Dr. Maria Pena. She is an endocrinologist who directs the Center for Weight Management at Lenox Hill Hospital in New York City.

According to background information in the study, more than 3.1 million Hispanics in the United States have diabetes and must take medication every day.

For the research, Fernandez"s team tracked data from nearly 31,000 insured patients in California.

The study found that more than 60 percent of Spanish-speaking Hispanic patients did not take newly prescribed diabetes drugs as directed. That"s compared to about 52 percent of English-speaking Hispanics, and 37.5 percent of white patients, the researchers said.

"Our study among insured patients suggests that more needs to be done to improve adherence to newly prescribed medications among Latino patients at all levels of English proficiency," Fernandez and her co-authors wrote.

The study was published Jan. 23 in JAMA Internal Medicine.

Another study in the same issue of the journal was led by Melissa Parker of Kaiser Permanente in Oakland, Calif. Her team found that blood sugar control could improve for Hispanic type 2 diabetes patients with limited English skills -- but only when they switched from a primary care doctor who only spoke English to a doctor who primarily spoke Spanish to his or her patients.

Pena called diabetes treatment a "complex" issue that requires clear understanding between doctor and patient, if it is to succeed.

She said that "in some cases, treatment may require frequent checking of finger sticks to monitor sugar levels, injecting medications such as insulin, and knowing how to calculate the amount of insulin necessary based on the amount of carbs consumed."

And while the new studies focused on Spanish-speaking patients with type 2 diabetes, Pena believes the results probably hold true for "any disease that requires long-term monitoring and follow-up."

Click Here to Find Out 3 Proven Steps to Reverse Type-2 Diabetes Watch The Video Now

High-Tech Sugar Monitors Boost Diabetes Care

A continuous glucose monitor helps people with Type 1 diabetes who need insulin shots every day manage their blood sugar levels safely, two new studies suggest.

Also known as a CGM, the device constantly measures and reports a person"s blood sugar levels. It does this via a thin wire sensor that"s inserted underneath the skin, a transmitter worn on top of the skin, and a receiver (or smartphone) to gather the information.



"Few treatment options exist in the type 1 diabetes field. CGM is a treatment option that [people] should test if they have the option," said Dr. Marcus Lind, lead researcher on one of the studies. He"s the chief physician of diabetology at Uddevalla Hospital in Sweden.

People with Type 1 diabetes don"t make enough insulin -- a hormone the body needs to use the carbohydrates in food for fuel. Because of this, people with Type 1 rely on insulin injections or insulin delivered through a tiny catheter inserted under the skin and then attached to an insulin pump worn outside the body. People with Type 1 diabetes using shots may need five or six insulin injections daily.

In people with Type 2 diabetes, the body is no longer able to use insulin properly. Most (95 percent) of diabetes cases involve the type 2 form of the disease. Sometimes, people with type 2 diabetes also need to use insulin injections.

However, using insulin is a difficult balancing act -- too much or too little can cause problems, even life-threatening ones.

Aaron Kowalski is vice president of research for JDRF (formerly the Juvenile Diabetes Research Foundation). He noted, "Insulin is a dangerous but necessary drug for people with Type 1 diabetes. These studies provide additional support for CGMs, which have been getting better and better. There"s no doubt that someone on insulin will benefit from these devices."

When blood sugar levels go out of range -- either too high or too low -- a CGM"s receiver sends an alarm, alerting the person with diabetes (or a parent for babies and children with diabetes) to the problem.

This is important because when blood sugar levels drop too low, people with diabetes can become disoriented, and if levels drop even further, they may pass out. Blood sugar levels that are too high and left untreated over time can cause complications such as kidney troubles, eye problems and heart disease.

Both studies used the Dexcom G4 CGM, and were funded by the manufacturer, Dexcom Inc. All participants used insulin shots to manage their Type 1 diabetes.

The study led by Lind included 161 people with Type 1 diabetes at 15 diabetes clinics in Sweden. Their average age was 44. The patients were randomly assigned to one of two groups.

The first group was given CGM for 26 weeks, and then conventional therapy for 26 weeks, with a period of no monitoring for 17 weeks in between. The other group did this in reverse and started with conventional therapy. Conventional therapy is self-monitoring of blood sugar levels.

The second study was led by Dr. Roy Beck, executive director of the Jaeb Center for Health Research in Tampa, Fla. This study included 158 patients. Their average age was 48. They were treated at 24 endocrinology practices across the country.

These volunteers were randomly given 24 weeks of CGM therapy or conventional therapy.

In both studies, blood sugar levels improved in both groups of patients. HbA1C levels dropped for those using CGMs. HbA1C is often called A1C for short. This test measures an average blood sugar level over the past two to three months. The results are expressed as a percentage. The American Diabetes Association goal for adults with diabetes is to get below 7 percent.

In Beck"s study, there was a mean drop of 0.6 percent more in A1C for the CGM group versus the control group. In Lind"s research, the decrease was about 0.4 percent more in those on CGMs than the control group. Both study authors said these drops were meaningful for patients.

Lind"s group also saw a drop in severe low blood sugar (hypoglycemia) in people on a CGM.

"The satisfaction in our study was extremely high. CGMs have gotten smaller and more accurate. The benefits are greater and the hassles are less. It"s worth it to carry around another device," Beck said.

Click Here to Find Out 3 Proven Steps to Reverse Type-2 Diabetes Watch The Video Now