Diabetes cure 'in sight'

A cure for diabetes may be in sight, according to a new study. In what is being hailed as the biggest step
forward in the development of a treatment for the condition, which affects 1.4million Britons, experts
have found a way to reverse it using a form of gene therapy.

Although experiments have so far been carried out successfully only on animals, scientists say the
breakthrough paves the way for trials in humans.The Korean and Canadian experts cured rats and mice
of diabetes by replacing malfunctioning genes which stop diabetics producing insulin, the hormone that
regulates blood sugar levels.They genetically altered an aden-ovirus - a type of germ which causes chest
infections - so that it could carry a gene that releases insulin directly to the liver and pancreas.

The scientists, whose research is published today in the scientific journal Nature, hoped the gene would
replace the malfunctioning one that caused diabetes.They were amazed when a simple injection meant
the animals, which were all suffering from the more serious type 1 diabetes, went into remission
without any noticeable side effects.

They continued to produce insulin for another eight months after the injection, the scientists from
Yonsei University in Seoul and Calgary University report.Though they stressed it was too early to say if
the therapy would work in humans, they hailed it as a significant step forward.'This gene therapy may
have potential therapeutic value for the cure of auto-immune diabetes in humans,' they said.

Dr Jerrold Olefsky, a diabetes expert at California University, said, 'This represents a definite step
forward and offers a good example of how fundamental research can be applied to problems of human
health.'

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Genetic test aims to improve diabetes diagnosis

Radiographer Paul Martin was wrongly diagnosed with type 2 diabetes in April 2013. After
months of taking two medications that failed to improve his condition, Martin visited a
consultant who subsequently diagnosed him correctly with type 1.

"They put me on tablets - metformin and glycoside - and then I was able to just continue taking
those for months until I saw a consultant who then said that my diabetes had got worse. So I
was actually diagnosed as type 1 then and introduced to insulin," he explained.

Martin is one of a number of patients diagnosed with the wrong type of diabetes, which differ
markedly in causation and treatment. Type 1 diabetes, which accounts for less than ten percent
of patients, occurs when the body's immune system destroys the cells that release insulin.
Without insulin, patients' bodies cannot absorb sugar. Most type 1 diabetics are diagnosed
young.

Type 2 diabetes is often linked with obesity and can be developed at any age. In those cases
patients' bodies are unable to use insulin correctly and can suffer damage to their pancreas,
although the condition can sometimes be managed through improved diet and weight loss.

Correctly diagnosing which type a patient has is crucial, and in a small minority of cases the
wrong diagnosis can be fatal. But in an age of growing obesity in the western world, diagnosis is
becoming increasingly difficult for doctors.

According to diabetes expert Dr Richard Oram, from the University of Exeter Medical School,
clinical diagnosis is currently based almost entirely on age at diagnosis and whether a patient is
obese.

So Oram has come up with a new, relatively inexpensive, genetic test for the disease, which he
thinks will help doctors.

"This is a genetic test which essentially means that it measures genetic risk factors for type 1
diabetes and it measures very simply and cheaply in a way that's easy to do, and it means that
when a patient presents with diabetes we could measure that genetic risk and if the genetic risk
is higher for type 1 diabetes it means they're very likely to have autoimmune type-1 diabetes,
and if the genetic risk is low for type 1 diabetes then they're much more likely to have type 2
diabetes, the kind of diabetes associated with obesity," he told Reuters.

Oram's team devised a test which measures 30 genetic variants in DNA and combines all the
risks associated with them in a single score, acting as a summary of genetic risk for type 1
diabetes. If a person's score is high they are likely to have type 1 diabetes. If the score is low
they may have type 2. A further commonly used test which measures anti-bodies would then
be undertaken to complete individual diagnosis.

Oram says early diagnosis is crucial. "If you get this wrong, if you label someone who actually
has type 2 diabetes as type 1 they'll be left on insulin for the rest of their life when they don't
need it. Even worse, if someone with type 1 diabetes is mislabelled as having type 2 diabetes
then they may not be treated with the insulin they need and they may suffer life threatening
complications," he said.

A National Institute for Health Research Clinical Lecturer and specialist in Diabetes and
Nephrology, Oram says his test will also benefit patients' understanding and attitude towards
their condition.

In the short term the University of Exeter Medical School, a leading centre in genome-wide
association studies, could test genetic samples sent by patients from hospitals across the UK.
Oram's team is also working to develop a bench-side test that any clinical laboratory could run
cheaply and quickly.

"If someone could have a blood sample taken it would be sent to our lab here and have the
genetic risk score tested," Oram said. "What we think is better for people with diabetes both in
the UK and around the rest of the world is if their local hospital could do this test on a bench-
side machine."

The research was supported by the UK's National Institute for Health Research (NIHR) and the
Wellcome Trust, an independent, global charitable foundation dedicated to improving health.
It's also been backed by research charity Diabetes UK.

The latter's regional manager Claire Gordon called the research "excellent." She added:
"They're looking at making it a very cheap process, so people can literally have a phone app
that will help them determine whether it's type 1 or type 2, and it will be cheap enough that
you can do it universally, so one of the problems with lots of research is that things cost a lot of
money. This is really great because it identifies what the risk of type 1 and type 2 are and
means you're much more likely to get the right diagnosis quickly."

Paul Martin agrees, and says his health has improved markedly since his correct diagnosis two
years ago. "Basically my blood sugars have come right down. I don't seem to be as tired as I
used to be," he said.

Oram's team published its research in peer-reviewed journal Diabetes Care last November.
Diabetes (diabetes mellitus)

Diabetes is a disease characterized by excessive urination. Diabetes mellitus is caused by

insufficient insulin production or lack of responsiveness to insulin, resulting in hyperglycemia
(high blood glucose levels). There are 2 primary types of diabetes mellitus, type I (insulin-
dependent or juvenile-onset), which may be caused by an autoimmune response, and type II
(non-insulin-dependent or adult-onset). Diabetes insipidus is typically due to hormonal
dysregulation.

Diabetes mellitus (DM) is a chronic metabolic disorder caused by an absolute or relative

deficiency of insulin, an anabolic hormone. Insulin is produced in the pancreas by the beta cells
of the islets of Langerhans. Absence, destruction, or loss of these cells causes an absolute
deficiency of insulin, leading to type 1 diabetes (insulin-dependent diabetes mellitus [IDDM]).
Most children with diabetes have IDDM and a lifetime dependence on exogenous insulin.

Type 2 diabetes (noninsulin-dependent diabetes mellitus [NIDDM]) is a heterogeneous

disorder. Patients with NIDDM have insulin resistance, and their beta cells lack the ability to
overcome this resistance. Although this form of diabetes previously was uncommon in children,
20% or more of new patients with diabetes in childhood and adolescence now have NIDDM, a
change associated with increased rates of obesity.

Insulin is essential to process carbohydrate, fat, and protein. Insulin reduces blood
glucose levels by allowing glucose to enter muscle cells and fat cells and by stimulating the
conversion of glucose to glycogen as a carbohydrate store. Insulin also inhibits the release of
stored glucose from liver glycogen and slows the breakdown of fat to triglycerides, free fatty
acids, and ketones. Additionally, insulin slows the breakdown of protein for glucose production.

Hyperglycemia results when insulin deficiency leads to uninhibited gluconeogenesis and

prevents the use and storage of circulating glucose. The kidneys cannot reabsorb the excess
glucose load, causing glycosuria, osmotic diuresis, thirst, and dehydration. Increased fat and
protein breakdown leads to ketone production and weight loss. Without insulin, a child with
IDDM wastes away and eventually dies from diabetic ketoacidosis.

Information on mortality rates is difficult to ascertain without complete national registers

of childhood diabetes, although age-specific mortality probably is double that of the general
population. Particularly at risk are children aged 1-4 years who may die with DKA at the time of
diagnosis. Adolescents also are a high-risk group. Most deaths result from delayed diagnosis or
neglected treatment and subsequent cerebral edema during treatment for DKA, although
untreated hypoglycemia also causes some deaths.

IDDM complications are comprised of 3 major categories: acute complications, long-term

complications, and complications caused by associated autoimmune diseases. Acute
complications reflect the difficulties of maintaining a balance between insulin therapy, dietary
intake, and exercise. Acute complications include hypoglycemia, hyperglycemia, and DKA.
Long-term complications arise from the damaging effects of prolonged hyperglycemia and other
metabolic consequences of insulin deficiency on various tissues. While long-term complications
are rare in childhood, maintaining good control of diabetes is important to prevent complications
from developing in later life. The likelihood of developing complications appears to depend on
the interaction of factors such as metabolic control, genetic susceptibility, lifestyle, pubertal
status, and gender. Most cases of IDDM are the result of environmental factors interacting with
a genetically susceptible person. This interaction leads to the development of autoimmune
disease directed at the insulin-producing cells of the pancreatic islets of Langerhans. These
cells are progressively destroyed, with insulin deficiency usually developing after the destruction
of 90% of islet cells.

Diabetes is a disease that can be deadly if not treated correctly. Most people with
diabetes have one of the two types and can be treated with pills or insulin shots. My mother has
type II diabetes, and helping her cope with her disease gives me a wider outlook on it. I see her
give herself shots every day to monitor her blood sugar levels; and I also see her taking
medicine to help control the amount of glucose to be present in her system. Hopefully one day
there will be a cure for this disease so that many people ,along with my mother, can live lives
without pain and be healthy.

Resources:

Diabetes Mellitus: William H Lamb, MD, FRCP, FRCPCH

Hypoglycemia for Dummies by Cheryl Chow

American diabetes association complete guide to diabetes by American Diabetes Association,

American Dietetic Association

Websites:

www.diabets.org

www.diabetes.diabetesjournals.org

www.diabetes.com
Diabetes mellitus
Diabetes mellitus has a long historical record dating back to second century AD. The
word "diabetes" was first used by the Greek physician Aretaeus. The word diabetes
means "siphon". It was first used to describe patients with excessive thirst and urination.
In the 17th century, the word mellitus, meaning "like honey", was added when diabetes
patients' urine was noticed to be sweet. However, the disease is not directly related to
urine, but instead to the pancreas. Today many other symptons and complications of
the disease are known. Although, the disease has many complications there are also
simple treatments to follow to avoid serious problems. Diabetes is a familiar health
problem that affects millions of people world wide.

Diabetes results from the failure of the pancreas to produce a sufficient amount
of insulin. Insulin is the hormone that regulates the body's use of glucose. Therefore, the
excess gluce remains in the bloodstream and passes out the body in urine. In some
cases, the pancreas produces a sufficient amount of insulin, but the insulin is blocked
from the body's cells and cannot be used. This causes diabetes patients to have
abnormally high amounts of sugar in their blood and urine. Diagnosing a patient with
diabetes is more complicated than measuring the glucose level of urine only one time.
Instead the diagnosis involves several hours of glucose-tolerance tests. These tests
measure the rate in which sugar is removed from the bloodstream. After the test are
complete, a high glucose level indicates insufficient insulin and the patient is diagnosed
with diabetes.

There are several symptoms and complications involved with diabetes mellitus.
The symptoms are excessive thirst and urination, unusual hunger, a lot of weight loss,
and fatigue. The complications are heart attack and stroke, chronic kidney disease,
lower-extremity amputations, blindness, and death. Arteriosclerosis is a condition
caused by prolonged high levels of blood sugar that causes the walls of small blood
vessels to thicken. This condition results in heart disease and stroke. Kidney failure may
be caused by inadequate blood circulation. Poor circulation in the legs leads to
gangrene which may require amputation of the toes or the legs. New cases of blindness
in adults between the ages of 20 and 74 are caused by diabetic retinopathy. This
condition causes hemorrhages in the capillaries of the eye's retina resulting in a loss of
vision. Pain or a loss of feeling in the arms or the legs is caused by neurophathy which
damages the nerves. Women infected with diabetes may also experience complications
with pregnancy. Diabetes is the seventh leading cause of death; and therefore, a
serious health problem.
 Although diabetes is not a curable disease, there are several treatments that
contribute to keeping the disease stable and its side effects to a minimum. A healthy
diet is important and can control the disease. Fifty percent of all diabetics rely on a
healthy diet to keep their disease under control. Calorie intake must be consisten and
fats, carbohydrates, and proteins must be evenly distributed into three main meals
throughout the day. On the other hand, other patients require insulin injections to control
the disease. These injections are used to fulfill the required amount of insulin the blood
is not receiving from the pancreas. It is very important that diabetes patients follow
these treatments to decrease their risk of future complications.

Diabetes is a widespread disease that affects millions of people. Approximately

ten million people are affected with diabetes; which is 5.9% of the entire population.
There are several risk factors involved with diabetes including old age, obesity, gender,
ethnicity, a family history of diabetes, and lack of physical activity. Diabetes mellitus is
more likely to develop in people over the age of forty. Of all the people in the United
States over sixty-five years old, 18.4% of them have diabetes. Between sixty and ninety
percent of diabetes patients are overweight. The disease is more common in women
than in men with a 27 to 25 ratio. The ethnic groups that are at high risk of developing
the disease are Pacific Islanders, African Americans, Hispanic/Latino Americans,
American Indians, and Asian Americans.

In conclusion, diabetes mellitus results from a failure of the pancreas to produce

a sufficient amount of insulin. There are several symptoms and complications of the
disease. Although, the disease has many complications there are also treatments to
follow to avoid serious problems. Diabetes is a familiar health problem that affects
millions of people world wide.