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This is a new section which we will be leaving free for that last minute report on the discovery of the cure. :-) At the time of press it had not come through so we had these stories on stand-by to fill it up. |
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The idea of jabbing and pricking and everything involved in treating diabetes is to have our work like they would if we had perfectly functioning pancreases, right? In “normal” people – the way scientists like to describe people without something like diabetes! – the pancreas delivers insulin into the “hepatic portal vein” - a major vein near the liver. As we know, almost all people with diabetes inject or pump themselves with insulin “subcutaneously” – just under the skin. With this method, it is impossible to achieve absolute “normoglycaemia” – blood glucose levels always within the range of a “normal” person. A key difference between a person with diabetes treating themselves with insulin, even those with very good control, and a person without diabetes, is that the liver is relatively underinsulinised, the rest of the body is subject to relatively large doses of insulin and whole-body insulin resistance is present. Attempts to deliver insulin in a manner closer to “normal” include implantable insulin pumps, pancreatic transplants and islet cell transplants – all of which have significant drawbacks for the vast majority of people with Type 1 Diabetes. Scientists have recently conducted “normal” human trials of a new type of insulin which has a greater effect on the liver than the rest of the body, even when delivered subcutaneously, something they believe will able to assist with achieving improved glycaemic control. The insulin was well tolerated, well absorbed, has a long duration of action and appeared to act on the liver more than regular insulin. |
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A new type of glucose sensor which is implanted under the skin has been trialled in dogs and proven to be able to work reliably for as long as 5 months. A reading takes 10 minutes. The sensors have a radio transmitter to communicate the results. A future model is anticipated to include an alarm function to alert users to hypos. The sensor itself is the size of a jellybean, could possibly be implanted under local anaesthesia in an outpatients’ clinic and the readout device will be the size of a beeper or wristwatch. <www.diabetesinterview.com> |
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The GlucoWatch Biographer developed by Cygnus Inc in California, is a device that sits on top of a disposable gel disc. Instead of testing the blood directly, the watch draws glucose from the body into the disc using a tiny electric current flowing between two terminals beneath the watch body. As the current passes through the skin, charged molecules migrate towards the electrodes. Glucose molecules, although uncharged, get swept up by this ion flow and are dragged across the skin to the gel disc by the cathode. After putting on the GlucoWatch you have to wait for three hours while a new gel pad hydrates and reaches equilibrium with the skin. After this “warm-up” period, you calibrate the device using a glucose level taken from a standard finger-prick test. After that, the watch measures glucose up to every 20 minutes for a 12-hour period. If levels go too low or too high it sounds a warning beep. It is not intended that this technology will replace regular blood glucose monitoring, in fact users are advised to perform a traditional finger-prick test before injecting insulin, but it can provide some very useful information about what our blood glucose levels do throughout the day, which four tests a day cannot. Steven Edelman, a diabetes specialist in SanDiego who also has diabetes, has trialled the GlucoWatch several times and said that he learnt a tremendous amount about his blood levels including that they were falling dangerously low at night while he slept. The GlucoWatch has received certification for it to be sold in the European Union. In the US, Cygnus is still awaiting FDA approval. From <www.newscientist.com>
More <www.cygnus.com>
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At a campaign stop in Portland, Oregon on August 30, Vice President Al Gore was confronted by American Diabetes Association national youth advocate Clare Rosenfeld on whether he will press Congress to support the Diabetes Research Working Group (DRWG)’s recommendations for the government’s diabetes research budget. Last year the DRWG called for an immediate increase of the budget from the $442 million it received in 1999, to $827 million in 2000 with a gradual increase in the amount to $1.6 billion by 2004. Gore introduced Clare, who thanked him for his support of diabetes. Before Gore could take back the microphone , however, Rosenfeld asked Gore “Will you support the recommendation of the DRWG?” “Yes,” Gore responded, “I will call on the Republican Congress to fully fund diabetes research at NIH this year.” Go girl! <www.diabetesinterview.com> Gore headquarters <townhall@algore2000.com> |
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Following the success of the Edmonton islet cell transplants (as reported in Yada Issue 10) there are currently 10 research centres in the US and Europe attempting to repeat the procedure. From http://diabetes.medscape.com/24489.rhtml The Insulin Free World Foundation
is a fabulous source of up-to-date info and even provides an opportunity
to register your interest for participating in an islet trial. Got
to their site at www.InsulinFree.org
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A recent study by a group of doctors from Harvard, California and Newcastle found that half of media stories about new pharmaceutical products spoke about benefits in a way that was likely to over-state or exaggerate the truth. An extraordinary 53% of media stories didn’t even bother to mention the issue of any side effects and 70% failed to mention the costs of the drugs. In many cases they discovered that the experts cited had links with the drug manufacturer and that link was not revealed. Dr Robert Steinbrook former medical writer for the LA Times who is currently on the other side of the fence as editor of “The Journal” has commented that “only a small minority of research findings – no matter how dramatic they may seem – have immediate implications for patient care.” Steinbrook says “Skepticism is important. When a medical breakthrough is announced, fame for investigators and institutions, future research grants, and corporate profits are all usually at stake.” |
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www.abc.net.au/rn/talks/8.30/helthrpt/stories/s136600.htm New England Journal of Medicine
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As of August 2000 both Minimed and Disetronic pumps are covered by regular private hospital insurance provided you meet your health fund’s prerequisite conditions (such as a 12 month waiting period). You need to be admitted to hospital for one day of education and training to qualify. There have not been any new insulin pump attachments added to the NDSS for quite some time. A small range is available at subsidised NDSS prices but they are quite old and definitely not as comfortable – some pump trainers recommend you compromise between affordability and comfort by alternating between the expensive attachments and the NDSS ones. The problem is that the pump companies and the federal government are yet to agree on a price for the companies to be paid for the supplies. Get on the blower and make these people get their butts into gear so that insulin pumps become a real affordable alternative for us …. Diabetes Australia, ph 1800 640 862, email croberts@diabetesaustralia.com.au Minimed, ph 02 8448 2043, email minimed@executivecentres.com.au Background on pumps: www.realitycheck.org.au/pumping.htm
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I've just finished reading 'Yada Yada' and enjoyed all the articles in it apart from the one about the cure. We're all hanging out for some hope here but the article was very discouraging. At the moment I have on my desk an application form from the University of Miami who are wanting people to take part in trial islet transplants similar to the Canadian trial. They offer to pay accommodation and airfares too. Their are a few criteria, like not being hugely overweight, having diabetes more than 5 years (which rules me out unfortunately), and not having certain diseases. It sounds like you have to be on call for when a transplant becomes available. This IS good news and even if its not going to happen tomorrow, it is hope and what I need to hear for people like me. Their are exciting developments happening and their is hope of a cure in my lifetime, something that I am very aware, and it humbles me to think, has not been available for many before me. Lynette Wamsteker <awamstek@bigpond.net.au>
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Dr Margo Honeyman of the Walter & Eliza Hall Institute in Melbourne has observed that some parts of a type of gastro virus called a “rotavirus” are very similar to the proteins on the surface of pancreas cells. Because of this similarity, if someone contracts this rotavirus, the body’s immune system could attack both the invading virus and the body’s own pancreatic tissues and cause Type 1 diabetes. There is currently much scientific interest in identifying the environmental factors which may trigger a whole range of auto-immune diseases among them Lupus, Multiple Sclerosis and Type 1 Diabetes. From www.abc.net.au <www.abc.net.au/science/news/health/HealthRepublish_163026.htm
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Up until now studies have shown that when insulin powder is inhaled only 8% is absorbed so that very large amounts are required. Scientists in Dusseldorf have developed an absorption enhance so that allows insulin to work similarly to when it is injected, with just a slight variance in that it peaks faster. The first use of this technology is anticipated to be with Type 2 Diabetes who are very reluctant to go onto insulin injections. < http://diabetes.medscape.com/reuters/prof/2000/10/10.09/20001006clin012.html
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With donated human organs being so scarce, scientists are working to see if pig organs and cells could be transplanted into humans. This process is called xenotransplantation. Most recent news on this front is a concern about pig viruses being transmitted to humans. Dr Ian McKenzie from the Austin Research Institute, which is recognised as one of the top three laboratories in the world in xenotransplantation, spoke to us about this on Diabetes Station recently: “The viruses are called Pig Endogenous Retro Viruses (PERVS). All species, including humans, have bits of virus in them. The worry is that a bit of pig virus, a bit of human virus might join together and make a new virus which could be nasty. The facts are:
Despite conflicting evidence, the National Health and Medical Research Council announced in August that it would block a trial at Sydney’s Prince of Wales Hospital and the University of NSW as “the safety issues are still not totally clear.” More: < http://www.diabetesstation.com/archive_index.asp
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A recent study at the National Institute of Diabetes and Digestive and Kidney Diseases in Maryland USA (these guys are big time!) looked at postmenopausal women, both with and without diabetes, and discovered that those who were currently on Hormone Replacement Therapy (HRT) had lower HbA1cs. Diabetic women on HRT averaged 7.36% compared with 7.80% for those who had never used HRT or had used it in the past. Women without diabetes average HbA1cs were 5.34% for current HRT users, 5.56% for past users and 5.58% for never users. < http://diabetes.medscape.com/29412.rhtml?srcmp=endo-110300
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