Margaret Harrigan, a teacher from Adelaide, is producing her own insulin for the first time since being diagnosed with type 1 diabetes 36 years ago after receiving an islet transplant in January.

Margaret had spent years living with hypoglycemia unawareness – severe and uncontrollable blood glucose fluctuations that made day-to-day living almost impossible. Four weeks after the transplant, Margaret has almost halved her insulin requirement and is free of dangerous low blood sugar attacks.

This is an exciting milestone for the Australian Islet Transplantation Program with each of the three centres in NSW, VIC and SA now having the expertise and facilities to isolate islets from donors and transplant into recipients.

Whilst the procedure was undertaken in SA, it was a truly national effort with Victorian researchers isolating the islets from the donor pancreas and the NSW team providing expert assistance.

Fourteen Australians have benefited from the Islet Transplantation Program to date with three patients now completely free of insulin injections. Find out more about this program at http://itp.jdrf.org.au.

The Type 1 Diabetes Prevention Trial is an exciting study being run across Australia and New Zealand by the Diabetes Vaccine Development Centre (DVDC). Investigators are using an insulin nasal spray vaccine to try to protect people who are genetically at risk of type 1 diabetes.

If successful, it will prevent or postpone the onset of type 1 diabetes. At the very least, participation in this non-invasive trial will provide researchers with valuable information about the processes involved in the development of type 1 diabetes.

To find out about the eligibility criteria to participate call 1300 138 712 or go to www.stopdiabetes.com.au for more information.

In Australia, and many other countries around the world, stem cell therapy is only approved to treat blood disorders such as leukemia. Whilst research is moving rapidly and showing great promise, the use of any type of stem cell as a therapy for diseases like type 1 diabetes is still firmly classed as experimental. This doesn’t mean these therapies won’t work, just that scientists and clinicians have deemed there isn’t enough data available to demonstrate patient safety as well as a long term benefit.

Not all countries have such strict protocols for demonstrating the safety and worth of a medical treatment, and a number of stem cell “clinics” have taken advantage of this lack of regulation. Often advertising via the media or internet, the treatments offered at these privately run centres are often extremely expensive and have little to no scientific rationale. Worryingly, the International Society for Stem Cell Research has also shown that a large number of these programs have little regard for patient health and safety, and in many cases, are highly unlikely to provide any benefit whatsoever.

There are places where you can find out more. If you are considering any kind of overseas medical therapy, your first port of call should always be your medical specialist or health care provider. They will be able to give you a run down of what is, and what may soon be, available to you. The government-funded Australian Stem Cell Centre has also published a handbook for people considering stem cell therapy. As well as providing lots of information about how stem cells work, it aims to provide the information required to make an informed decision.

You can go to the Australian Stem Cell Centre website for more information, www.stemcellcentre.edu.au, and to obtain a copy of the patient handbook.

Questions to ask when considering stem cell treatment

Is the treatment offered within a mainstream medical environment?

In Australia, proven stem cell treatments are available through the public health system. All experimental treatments and clinical trials must be undertaken at an institution that has been accredited by a relevant Federal Government agency (usually the NHMRC). Not all countries place such a focus on patient safety so understand what regulations do exist and make an informed decision of the potential risks versus the advertised benefits.

Does the provider charge for the treatment?

In Australia, any accepted mainstream stem cell treatment will receive some level of reimbursement from either Medicare or a private health fund. Experimental treatment received as part of a clinical trial should not incur any charges at all, and this is the case in many other countries as well.

What evidence do they use when promoting the therapy?

The best way to assess if a therapy is effective is to check if it has been written up in the scientific literature and been assessed by government sanctioned clinical trials. Don’t be shy to ask for copies of their research publications, results of previous clinical trials and copies of relevant government approvals – they will gladly give them to you if the therapy is proven and accredited.

Patient testimonials and media coverage are NOT evidence that a therapy is safe and effective. Remember it is possible to make all kinds of unproven claims, particularly on the internet, so contact a local health agency or disease advocacy group to establish their credentials.

Where do the stem cells come from?

Whilst we talk about stem cells as a single entity, there are in fact a number of different sources of cells that can act in very different ways. If the proposed treatment involves stem cells from an external source (for example donor tissue, cord blood or embryonic cells) it is highly likely that your body will reject the foreign cells unless immune-suppression therapy is also given. If the stem cells have been taken from animal tissue there is a risk of infection from animal viruses. Embryonic stem cells, if introduced in an undifferentiated state, may become cancerous cells.

What does the therapy involve?

Whilst the type of stem cell used is important, so is the process by which it is administered. Whilst the basic hygiene of the medical centre is obviously important, the standards of any associated laboratory procedures are also critical to prevent contamination and infection. Many therapies involve quite serious medical interventions such as lumbar punctures. These procedures themselves can be risky and really should only be conducted when absolutely necessary. Finally, make sure you identify if follow-up medical care is provided.

Supported by a crowd of family members, total numbers at Kids in the House will hit 300. They are visiting Canberra as representatives of the 140,000 children and adults in Australia with type 1 diabetes, and the tens of thousands more who care for them.

The Youth Ambassadors will personally meet with nearly 100 MPs to explain why they desperately need government funding for a Clinical Trials Network, which would improve Australian patients’ access to the latest science and speed up the process of curing the serious disease they will otherwise have for life.

JDRF CEO Mike Wilson said it was critical for MPs to understand the serious health implications of type 1 diabetes and the need for continued support of Australian research.

“Australian patients deserve access to the best science, and we should take every opportunity to be the ‘clever country’.”

“The Clinical Trials Network will turn the best science into benefits for patients, by helping to translate the best of Australian research into improved clinical outcomes and attracting international trials and investment to Australia.”

“Investment in the Clinical Trials Network would be a continuation of existing research support, and JDRF will leverage this funding with help from local philanthropists.”

“We know that public investment in research delivers returns, so support of the Clinical Trials Network is a step toward reducing one of the heaviest burdens on Australia’s health system – diabetes.”

“On top of this, the human impact of a cure is incalculable.”

“Australia has one of the highest rates of type 1 diabetes in the world and the rate of new cases in children in this country is rising by 3% every year. This situation is urgent.”

Sign Our Petition

Show your support for The Clinical Trials Network by signing our petition below. We will give the signatures to the Prime Minister at the Kids in the House event. Send this page to your friends, family and collegues now as it will be given to the Prime Minister on Thursday 17th March.

Cooper is a bright, active, “beautiful” seven year old boy who has had type 1 diabetes since he was three. Back then, while visiting a sick brother in hospital, Cooper picked up a virus. Leah says he never really recovered.

After a high temperature, Cooper started wetting the bed and consuming litres of water every night. He was quickly diagnosed with type 1 diabetes and spent a week in hospital on the general ward, while he recovered and his parents learnt about their new life of needles, fingerpricks and hypos.

The hypos are a worryingly frequent event in little Cooper’s life. Leah says sadly that his control is not very good. “Cooper is very sensitive to insulin. He’ll run really high and the doctor will increase his dose by just one unit to bring it down, but then we run into a spiral of hypos. There is no happy medium.”

As a result of the challenges with his insulin sensitivity, Cooper is currently having two or three hypos every day. Leah counts herself lucky that he has only ever had two overnight hypos, but luck has had little to do with it. She is vigilant at night with her son.

“I check him every three hours through the night because I’m so worried about hypos. I managed to combine it with feeding the baby so I was able to squeeze in a little bit of sleep!”

Cooper’s life with type 1 diabetes is about to change dramatically. The Australian Government has announced a big increase in the subsidy available for insulin pumps, which will make the technology much more affordable for families like Cooper’s.

The Type 1 Diabetes Insulin Pump Program was launched in 2008 and provides a means-tested subsidy towards the purchase of an insulin pump for children under 18. In Australia insulin pumps can cost up to $8,000, making it a medically desirable but unaffordable option for many without private health insurance.

Children under 18 with type 1 diabetes will now be eligible, on the recommendation of a health professional, for a significantly increased subsidy of up to 80% of the cost of an insulin pump, up to a maximum of $6,400. The subsidy will be means-tested and based on a sliding scale reflecting family income.

Research shows that insulin pumps can help in the management of type 1 diabetes by minimising the dangerous fluctuations in blood glucose levels that lead to complications.

Insulin pumps also alleviate the intrusive daily regime of management and injections.

Cooper’s need for supervision of his diabetes is ’round the clock’, so it is clear that an insulin pump is going to change the family’s life.

Leah has always made excuses for him to avoid birthday parties, and Cooper has never stayed overnight with grandparents or friends. Leah says “It is understandable that most other people don’t feel comfortable giving him needles and it’s a big responsibility to hand over.”

Cooper will still have type 1 diabetes after he gets an insulin pump and he may still experience hypos. But his diabetes management will get a lot easier. Insulin adjustments on pumps can be made in 0.05 unit increments.

Cooper is excited but nervous. Currently he has all his needles in his bottom, because he is very small and with no fat on his tummy, it quickly gets lumpy when he has injections there. The doctor has reassured him that he can have his pump site on his bottom too, minimising the pain of the site change.

For the next few weeks, he will watch Leah’s friend who has type 1 diabetes do a bolus dose on her insulin pump for her coffee and cake, and imagine all the things he will be able to do for the first time when his insulin pump arrives.

The program was first launched in 2008 and provides a means-tested subsidy towards the purchase of an insulin pump for children under 18 who do not have access to private health insurance.

In Australia insulin pumps can cost up to $8,000, making them a medically desirable but unaffordable option for many without private health rebates.

Children under 18 with type 1 diabetes will now be eligible, on the recommendation of a health professional, for a subsidy of up to 80% of the cost of an insulin pump, to a maximum of $6,400 and a minimum of $500.

The subsidy will be means-tested and based on a sliding scale reflecting gross family income.

This program will potentially impact around 500 Australian children with type 1 diabetes who would benefit from moving from multiple daily insulin injections of insulin pump therapy.

JDRF CEO Mike Wilson said increased access to insulin pumps had the potential to dramatically change many hundreds of lives.

“Children with type 1 diabetes face a huge strain juggling the management diabetes with the demands of daily life. We know that insulin pumps can make this daily and lifesaving management much easier.”

“More importantly, pumps are the best way for many patients to improve their chances of a healthy future, making this subsidy a win-win for people with type 1 diabetes and Australia’s health system.”

The Type 1 Diabetes Insulin Pump Program is a collaboration between the Juvenile Diabetes Research Foundation and the Department of Health and Ageing.

For more information for patients about the Type 1 Diabetes Insulin Pump Program, please contact Chanelle Stowers on 02 9966 0400 ext 223 or cstowers@jdrf.org.au.

Alternatively, visit our website for more information and the online subsidy estimator.

Show your support for the insulin pump subsidy

Send a thank you message to the Hon Nicola Roxon MP for increasing the government subsidy.

Published today in the respected journal The Lancet, JDRF-funded researchers developed and successfully tested an automated management system, which was able to predict and prevent blood sugar fluctuations. Dramatic blood sugar drops, or hypoglycemia, have immediate and often devastating consequences and have an enormous impact on both individuals and families living with type 1 diabetes.

The system being tested in this case combined a commercially available insulin pump and continuous glucose monitor with a sophisticated computer algorithm designed to calculate the appropriate amount of insulin required in different circumstances. It was fitted to participants with type 1 diabetes aged between 5-18yrs who were kept overnight at hospital for monitoring.

The results of the trial showed that the children using the system spent twice as much time in a healthy blood sugar range. A further trial showed that that this protective quality did not diminish when participants consumed a large carbohydrate meal before bed and showed an even more positive improvement when participants did strenuous exercise before bed.

According to the Chief Investigator, Dr Roman Horvorka, these results show that commercially-available devices, when coupled with the newly developed algorithm, can improve glucose control in children and significantly reduce the risk of overnight hypos. This is a significant improvement on current management practices and will ideally be moved into wider clinical testing in the home environment.

Dr Dorota Pawlak

Commenting on the research, JDRF Research Manager Dr Dorota Pawlak said “An automated diabetes management system, or artificial pancreas, is the Holy Grail for people who are living with insulin-dependant diabetes.”

“While an artificial pancreas isn’t a cure, it will help to significantly reduce serious diabetic health complications whilst also reducing the burden on individuals and families that live with the constant fear of blood sugar fluctuations.”

“This trial is the first real proof that existing management technology can be expanded to make a dramatic difference to the lives of people living with type 1 diabetes and also their carers.”

This research project is just one element of JDRF’s global Artificial Pancreas Project which is bringing together the best scientific teams across the world to progress development of the artificial pancreas system as fast as possible.  You can find out more at www.jdrf.org/artificialpancreas

This research is only possible thanks to the generosity of JDRF’s supporters.

You can help us speed up the process of bringing the Artificial Pancreas to reality by supporting the Artificial Pancreas Project . Every dollar will help bring research to reality.

These findings reinforce the potential of regeneration as a cure for diabetes and provide insights for discovering new approaches to treat people with diabetes by restoring or regenerating their ability to produce insulin.

JDRF- funded researchers at the Salk Institute for Biological Studies in California showed that the stress hormone CRF (corticotropin-releasing factor) could increase the rate at which insulin-producing cells in the pancreas expand in animal models. 

Dr Wylie Vale, Ph.D., Professor and Head of the Clayton Laboratories for Peptide Biology said that being able to stimulate beta cells to divide faster “may be part of a solution that may ultimately, hopefully, allow management of type 1 diabetes.”

“But because type 1 diabetes is an autoimmune condition, making the cells divide won’t be enough. That is why researchers are working hard to solve the problem of destruction of beta cells.”

See JDRF International for more information.

In just 5 years the Ride to Cure Diabetes has seen more than $5 million invested into Australian research in type 1 diabetes, with a  spectacular $1.1 million raised this year.

Former Adelaide Crows star Nathan Bassett participated in the Ride to Cure Diabetes for the fifth time. Nathan has type 1 diabetes himself, making this a very personal cause.

“Type 1 diabetes is increasing more and more in Western society, so we really need to find the reasons why, and do something about it.”

JDRF CEO Mike Wilson was thrilled that hundreds of Riders participated. “Australia has one of the highest rates of type 1 diabetes in the world and the rate of new cases in children in this country is rising by 3% every year. This situation is urgent.”

You can still donate to the Ride to Cure Diabetes. Visit the website for more information.

The Juvenile Diabetes Research Foundation has today announced an innovative partnership to develop an automated system to help people with type 1 diabetes better control their disease – the first step on the path to what would be among the most revolutionary advancements in treating type 1 diabetes: the development of an artificial pancreas, a fully automated system to dispense insulin to patients based on real-time changes in blood sugar levels.

JDRF has formed a partnership with Animas, a Johnson & Johnson company and a leading manufacturer and distributor of insulin delivery and glucose management systems.

The objectives of the partnership, a major industry initiative within the JDRF Artificial Pancreas Project, are to not only produce the automated system but to conduct extensive clinical trials for safety and efficacy and submit the product to the regulatory authorities for approval and subsidy.

“If successful, the development of this first-generation system would begin the process of automating how people with diabetes manage their blood sugar,” said Mike Wilson Chief Executive Officer of JDRF Australia.

“Ultimately, an artificial pancreas will deliver insulin as needed, minute-by-minute, throughout the day to maintain blood sugars within a target range.  But even this early system could bring dramatic changes in the quality of life for the 140,000 Australians living with type 1 diabetes, beginning to free kids and adults from testing, calculating and treating themselves throughout the day.”

Dr. Alan Lewis, CEO and President of JDRF International noted that “JDRF will provide $US8 million in funding over the next three years for this project, with a target of having a first-generation system ready within four years.”

Currently, type 1 diabetes is managed with insulin injected from a needle or an insulin pump and regular fingerprick blood tests. Unfortunately, blood glucose levels can change rapidly in response to hundreds of different triggers making it extremely difficult to accurately predict the amount of insulin required.

This first-generation system will be partially automated, utilising an insulin pump connected wirelessly with a continuous glucose monitor (CGM). The CGM continuously reads glucose levels through a sensor with a hair-thin sensor wire inserted just below the skin, typically on the abdomen.  The sensor would transmit those readings to the insulin pump, which delivers insulin through a small tube or patch on the body.  The pump would house a sophisticated computer program that will address safety concerns during the day and night, by helping prevent hypoglycemia and extreme hyperglycemia.  It would slow or stop insulin delivery if it detected blood sugar was going too low and would increase insulin delivery if blood sugar was too high.

For example, the system would automatically discontinue insulin delivery to help prevent hypoglycemia, and then automatically resume insulin delivery based on a specific time interval (i.e., 2 hours) and/or glucose concentration.  It will also automatically increase insulin delivery to reduce the amount of time spent in the hyperglycemic range and return to a pre-set basal rate once glucose concentrations have returned to acceptable levels.

In this early version of an automated diabetes management system, the patient would still need to manually instruct the pump to deliver insulin at times, (i.e. around meals).  But this “hypoglycemia-hyperglycemia minimiser” system would represent a significant step forward in diabetes management, and could provide immediate benefits in terms of blood sugar control, by minimising dangerous highs and lows.

The Artificial Pancreas Project was established by JDRF in 2005. You can find out more at www.jdrf.org/artificialpancreas.

You can help speed up the process of bringing the Artificial Pancreas to reality. Support the Artificial Pancreas Project by giving to JDRF. Every dollar will help bring research to reality.