By targeting the autoimmune response that attacks beta cells in type 1 diabetes, researchers aimed to improve beta cell function in people with the disease and enable them to resume insulin production.

The study used a system developed by the research group called a “stem cell educator” which contained layers of cord blood stem cells. People with type 1 diabetes had their immune cells isolated from their blood and circulated through the stem cell educator for three hours before returning the blood to the participant. The stem cells acted like a teacher in re-educating the immune cells in an attempt to stop the autoimmune attack.

Results from the trial have indicated that after a single treatment, beta cell function improved in people with type 1 diabetes, with participants producing their own insulin. This improvement was sustained throughout the 40 week trial period, with participants needing significantly reduced daily insulin doses.

Head of Research Development at JDRF Australia, Dr Dorota Pawlak PhD says “Targeting the autoimmune attack against beta cells is an essential component of an eventual cure for type 1 diabetes. Importantly, this small clinical trial shows that ‘re-educating’ the immune cells can lead to the recovery of beta cell function and reduction of insulin dose in a selected group of individuals with type 1 diabetes.”

Researchers are keen to take this research to the next step with the aim of eventually developing a viable therapy for people with type 1 diabetes.

BMC Medicine 2012, 10:3 doi:10.1186/1741-7015-10-3

Researchers from the Australian National University have identified heparan sulfate (HS) as being essential for beta cell survival. Whilst this compound is known to be involved in a number of other biological activities, this is the first time it has been implicated in the development of type 1 diabetes.

The study suggests that levels of HS in insulin-producing beta cells are depleted as a result of the autoimmune attack that causes type 1 diabetes. When levels are reduced, the cells are defenceless against damage from common byproducts of metabolism and die. The study went on to demonstrate that replacing HS, or treating the beta cells to preserve HS levels, protected against development of type 1 diabetes.

These findings have not only identified HS as a potential new therapeutic target for the prevention of type 1 diabetes onset, it has also opened up the possibility of HS levels being used as a marker of disease onset and as a method of protecting islet cells that have been isolated and transplanted.

Whilst the initial research was conducted in mice, JDRF has provided further funding to provide proof of concept in humans.

J Clin Invest. 2012;122(1):132–141. doi:10.1172/JCI46177.

The trial is looking for more volunteers to reach their goal of 12,000! To participate in the initial screening test, you will need to be aged between 4 – 30 years with a relative with type 1 diabetes. This first step will be a free blood test for antibodies that may indicate a future risk of getting type 1 diabetes.

For more information about participating in this trial and to help research towards a type 1 diabetes vaccine, please visit the newly relaunched website: www.stopdiabetes.com.au.

The new website features profiles of some of the trial participants, and explains how their regular participation contributes towards the search for type 1 prevention. You can also connect with the trial on Facebook and Twitter.

JDRF is committed to improving the lives of those living with type 1 diabetes, and ultimately curing the disease. We encourage our community to support this trial and register your interest!

For the first time ever in parallel experiments in both France and Italy, two participants with type 1 diabetes were able to control their diabetes using an artificial pancreas system in a real-life setting. Participants spent a night at a hotel and eating at a restaurant while using the device, and attained near-normal glucose levels. The research team used approved insulin pumps and continuous glucose monitors, which were controlled by a hand-held device and monitored by the investigators to ensure safety.

These were the first outpatient trials using an approach developed by the JDRF-supported International Artificial Pancreas Study Group, an international research group. Previous trials have all been conducted in an in-patient setting. Eight more patients enrolled in the trial will begin outpatient testing in coming weeks.

The advancement of an artificial pancreas is a priority for the t1d community. People with t1d constantly have to determine the right amount of insulin to dose at the right time, multiple times a day. Yet even with diligent monitoring, a portion of the day can still be spent with high or low blood sugar, placing them at risk.

Low Glucose Suspend Technology approved in United States

In-home trials of low glucose suspend technology have been approved for the first time in the U.S. An LGS system is a version of an insulin pump which suspends insulin delivery when a monitor indicates a person with diabetes has or is projected to have low glucose levels.

These systems are the first step toward an artificial pancreas, a device that could transform the lives of individuals with t1d. By automating detection of blood sugar levels and delivery of insulin in response to those levels, an artificial pancreas has the potential to transform the lives of people with type 1 diabetes.

JDRF Australia CEO Mike Wilson says these steps towards using an artificial pancreas in a real-life setting are encouraging.

“This technology has great potential to improve the lives of the t1d community, but it will only be successful if it can be used as people go about their daily lives. These two developments are a big step forward in achieving that goal”.

The study out of the Department of Endocrinology and Diabetes at the Princess Margaret Hospital in Perth, found that rates of severe hypoglycaemia in children with Type 1 diabetes declined two thirds between 2000 and 2009.

The study also showed that glycaemic control stayed the same in that time, with the link between glycaemia and risk of hypos growing weaker. There was also no longer an increased risk of severe hypoglycaemia in children under six years old.

The study authors said that the reduction “may have resulted from changes in clinical practice”, including recent developments in new insulin regimes and improved monitoring and management.

JDRF CEO Mike Wilson says “This study demonstrates real results of JDRF’s constant promotion of improved monitoring regimes, and reminds us how important good management is”.

Diabetes Care 2011; doi: 10.2337/dc11-0748

InnoCentive finds new ways to solve technological and scientific problems using crowdsourcing and open innovation. The idea is to use the web to build connections between R&D problems or ‘Challenges’ and ‘Solvers’, who are creative people that might work or study in different industries or fields, or perhaps in other countries.

The goal of the JDRF InnoCentive Challenge is a glucose responsive insulin drug that would release insulin in response to changes in blood glucose levels. This type of drug would revolutionise the management of type 1 diabetes, releasing kids and adults from their daily regime of multiple injections and fingerpricks.

JDRF Australia CEO Mike Wilson said he hoped this initiative would energise the search for new treatments for people with type 1 diabetes.

“Huge strides have been made in recent years in diabetes research but we need to be daring and embrace interesting new approaches if we’re serious about delivering a better life for people with type 1 diabetes.”

“JDRF has been part of every major research breakthrough achieved so far in the field of type 1 diabetes research and our hope is that this Challenge could prompt more breakthroughs.”

“Entry is open to thinkers from across the world and across different industries. Creative Australians, I urge you to step up.”

President and CEO of InnoCentive Dwayne Spradlin said JDRF is an organisation that recognises the importance of innovation in the healthcare industry. “We are happy to be included in the process of finding a new way to enhance the quality of life for patients while helping them better manage their disease.”

Other organisations that have partnered with InnoCentive include Eli Lilly, Life Technologies, NASA, nature.com, Popular Science, Procter & Gamble, Roche, Rockefeller Foundation, and The Economist. For more information, visit www.innocentive.com.

The study looked at 27 teens and their parents, and analyzed their internalizing behaviours, or anxiety and depression, as well as externalizing behaviours, which relate to conduct problems and hyperactivity.

The study suggested that ‘greater lifestyle freedom and flexibility … may impact positively on children and adolescents,’ which echoes what many people in the type 1 diabetes community are saying about insulin pumps.

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

The study was supported in part by a restricted research grant and provision of equipment from Medtronic Australasia. Medtronic had no involvement in study design, conduct, data analysis or preparation and submission of the manuscript.

 Diabetic Medicine 2011; doi: 10.1111/j.1464-5491.2011.03322.x

1. Joslin 50-year Medallist study uncovers protective factors against diabetes complications
2. Clinical trials of an overnight artificial pancreas system improve glycemic control
3. Transplantation of encapsulated stem cells reduces glucose levels in diabetic mice

Joslin 50-year Medallist study uncovers protective factors against diabetes complications

A JDRF-funded study has characterised a subgroup of people who have had diabetes for 50 years or more, who remain free from complications. This population is likely enriched for protective factors against complications, and uncovering any protective mechanisms against complications might prove useful to the general population with diabetes.

The study of 351 Joslin Medallists (who have survived 50 years or more of type 1 diabetes) assessed retinopathy, nephropathy, neuropathy, and cardiovascular disease in relation to a range of risk factors. It was found that a high proportion of Joslin Medallists remained free of diabetes complications and that, in this group, glycaemic control was unrelated to the development of complications. Specific Advanced Glycation Endproducts (AGE) combinations were strongly associated with complications, indicating a link between AGE formation or processing with the development of complications.

Clinical trials of an overnight artificial pancreas system improve glycemic control

Two JDRF-funded clinical trials have been run to compare the safety and efficacy of an overnight Artificial Pancreas system with conventional insulin pump therapy. Published in the British Medical Journal, the trials tested 24 adults on an ‘eating in’ scenario (mid-sized meal) and an ‘eating out’ scenario (larger meal + alcohol). During overnight closed loop delivery, sensor measurements of glucose were fed into a computer algorithm, which advised insulin pump infusion rates at 15 minute intervals.

For the eating in scenario, overnight closed loop delivery of insulin increased the time plasma glucose levels were in target by 15%. For the eating out scenario, closed loop delivery increased the time plasma glucose levels were in target by 28%. Overall, time plasma in target range increased by 22%, and overnight time spent hypoglycemic was reduced by 3%.

Transplantation of encapsulated stem cells reduces glucose levels in diabetic mice

Insulin producing cells have been derived from stem cells and transplanted into mice with diabetes. Stem cells from human umbilical cord blood and from mouse bone marrow were differentiated into insulin producing cells, and encapsulated in an alginate membrane before being transplanted into diabetic mice.

Transplantation of these cells into mice with diabetes led to reduced blood glucose levels and increased body weight. Encapsulation protected the transplanted cells from the immune response and prevented graft rejection.

The rallies come as the government has suggested there will be funding cuts to the National Health and Medical Research Council in the next federal budget. The rumoured cuts are causing much concern – not just amongst those whose livelihood depends on medical research but all those whose lives depend on it.

JDRF CEO Mike Wilson said that ongoing support for research careers and infrastructure is vital to secure Australia’s future as a clever country. “And on a personal level, people affected by type 1 diabetes need reassurance that health and management will improve, and we know that medical research is the only path to a better life and ultimately a cure for type 1 diabetes.”

Arguing for government investment in medical research is supported by strong economic evidence, and studies have shown that the returns paid by medical research prove its worth as a good investment. Today’s Sydney Morning Herald reports on the findings of a 2008 Access Economics study, which concluded that every dollar invested in Australian health research earned a return of $2.17.

The medical research community will rally today Sydney, Melbourne, Perth, Adelaide and Canberra. Get the details here.

Sign an online petition here.

Or share your thoughts about the need for medical research with JDRF below.

It has been known for some time that glucose is a key factor in the growth of beta cells. However, it’s not as simple as increasing blood glucose to re-grow beta cells, because inducing high levels of glucose in the blood has serious health implications that can include blindness, stroke and kidney failure.

Lead researcher Yuval Dor PhD, from the Hebrew University of Jerusalem, used a combination of techniques to encourage beta cells to reproduce themselves, including the manipulation of an enzyme known as glucokinase, which senses blood glucose and tells cells how to respond.

The surprise was the beta cells response: they increased their rate of regeneration in response to the message from the enzyme glucokinase, not the actual blood glucose levels themselves.

This finding gives hope to the type 1 diabetes community because drugs that activate glucokinase are currently being developed for those with type 2 diabetes, to increase their production of insulin.

“Our work shows that as glucose is metabolised, it tells the beta cells to regenerate. It is not blood glucose per se that is the signal, but the glucose-sensing capacity of the beta cell that’s the key to regeneration,” says Dor, who is also the 2010 recipient of a JDRF Research Award.

“Beta cells, contrary to expectations, do have a regenerative capacity. It’s slow, it’s weak. It may be defective in diabetics, but it’s there,” said Dor.

JDRF Australia’s Head of Research Development, Dr Dorota Pawlak PhD, says beta cell regeneration is a key area of focus for curing type 1 diabetes.

“Beta cells are the victims of the autoimmune attack that causes type 1 diabetes. In combination with stopping that attack, re-growth or transplant of beta cells using techniques like this will be the key to restoring health and curing this disease.”

Cell Metabolism Vol 13 Issue 4, e-pub 6 April 2011: 440-449