JDRF News Blog

Thirty Years Wiser: How the DCCT trial continues to nurture the landscape of type 1 diabetes science

Tara Wilcox-Ghanoonparvar — Mon, 01 Apr 2013 16:08:46 GMT

In 1983, a trial began that would forever alter the standard of management of type 1 diabetes (T1D) and serve as a stepping stone to future research advances—and as we mark the 30th anniversary of the trial’s inception, we are still learning from the study.

The Diabetes Control and Complications Trial (DCCT), a 10-year multicenter clinical trial, studied 1,441 people with T1D for an average of 6.5 years each, to examine whether intensive versus conventional methods of blood-glucose control could affect one’s development of dangerous diabetes complications. In 1993, staggering results from the trial proved that intensive therapy—where participants kept their HbA1c levels as close to normal as possible through frequent monitoring and insulin injections—reduces the risk of complications such as diabetic kidney, eye, and nerve disease by 35-76 percent, compared with what was then considered conventional treatment of one or two insulin injections daily and one urine or blood glucose test per day.

The DCCT is credited for spurring a change in the way diabetes is managed. But its effects did not end there. Most of the participants of the DCCT volunteered for the follow-up study beginning in 1994, called the Epidemiology of Diabetes Interventions and Complications (EDIC) study. This subsequent research has continued to uncover insights that could impact people with T1D today.

In 2002-2003, EDIC researchers determined that the period of intensive glucose control during the DCCT continued to reduce the risk of microvascular complications 7-8 years later, despite comparable glucose control between the two groups of participants after the initial study. Coined “metabolic memory,” this phenomenon suggests that implementing intensive glucose control as early as possible could help reduce the risk of complications down the line.

In 2005, EDIC researchers reported another interesting statistic: DCCT participants who had undergone intensive treatment during the study had fewer than half the number of cardiovascular complications compared with those treated conventionally, throughout an average of 17 years since their enrollment in the DCCT. For the first time, research showed that intensive glucose control could have long-term benefits for reducing heart attacks, strokes, and cardiovascular-related death in people with T1D.

New insights into hypoglycemia and the genetics of diabetes complications are also forming from the base of data that the DCCT study provided 30 years ago. These studies and future ones highlight the importance of a strong investment in long-term research—an investment that has been made possible through funding from organizations like JDRF, and with governmental support through the Special Diabetes Program (SDP), which makes up roughly one-third of U.S. government support for T1D research.

As advocates of T1D research, we can help protect and increase critical funding through JDRF and the SDP, so that long-term studies have the resources needed to continue revealing information that could improve and save lives. In addition to advocacy, people with T1D and their families can help research advance by participating in clinical trials. For more information, visit the JDRF Clinical Trials Connection website: https://trials.jdrf.org/patient/.

JDRF Convenes Forum on the Psychosocial Burdens of Type 1 Diabetes

Gary Feit — Fri, 15 Mar 2013 20:13:03 GMT

JDRF recently brought together a group of 20 leading experts in the behavioral and mental health fields to discuss the range of psychological and social issues experienced by people with type 1 diabetes (T1D) and their families. Forums like this enable JDRF to stay up-to-date with the full spectrum of issues faced by people with T1D so we can better represent their needs in everything we do and improve JDRF-developed materials and resources and practical information about living with T1D. JDRF is indebted to Chip Halverson, JDRF board of chancellors’ member and parent of a daughter with T1D, who championed this effort and provided the financial support for the event. JDRF board member Nicole Johnson who has T1D and is an international diabetes consultant, advocate, and researcher of the psychosocial aspects of diabetes provided valuable guidance during the organization of the meeting. Both Chip and Nicole participated in the meeting sharing their personal insights with the other attendees.

It’s not news to anyone with T1D or with a family member who has T1D that this disease presents a number of unique challenges unlike those seen with other chronic diseases. Many of the unique challenges of T1D result in important outcomes that go beyond blood glucose control – they extend to a variety of psychosocial and quality-of-life issues affecting individuals and their families. Some of the factors that make T1D management unique among chronic diseases include: an intensive 24/7 regimen of blood-glucose management, the often non-private nature of testing and injections and using devices, the required attention to meal planning, food-related issues, and body weight, and the imprecise connection between blood-glucose management actions and the desired level of control. Because of these unique challenges, studies have shown that among chronic diseases, T1D has one of the lowest rates of individuals complying with their disease management plans. One study reported that 88% of HIV patients stay on their disease management plan – a high among chronic diseases – and that T1D patients were among the lowest at only 67% staying on plan.

The experts discussed how the unique aspects of T1D management result in a number of well-documented psychosocial burdens and quality-of-life issues. These issues affect everyone living with the disease, especially children with T1D and their parents, and adolescents and young adults. Reports of psychosocial issues range from mild symptoms to diagnosed psychiatric disorders. These may include; stress and distress, feelings of helplessness, anger, exhaustion, or embarrassment, disruptive behaviors, family conflict, eating disorders, substance abuse, anxiety, and depression. Milder symptoms are not as well-documented, but healthcare providers reported in a survey that 10-30% of children and adolescents with T1D experienced mild psychosocial symptoms. Multiple studies provide documentation of psychiatric disorders in people with T1D. Of particular concern, one study found that two-thirds of adolescents with poor T1D management also experienced psychosocial issues, providing evidence of the critical negative impact these issues can have on an individual’s management of the disease.

Numerous insights were shared about the reasons why psychosocial, mental health, and quality-of-life issues often receive limited attention during the routine care visits of people with T1D. The most fundamental reason noted was the limited coverage for behavioral and mental health care in the United States. Interventions to address the psychosocial burdens experienced by people with T1D add time to a healthcare provider visit and require resources that are not routinely reimbursed without a clinical diagnosis by a specialist. The experts also noted a lack of enough trained healthcare professionals to diagnosis and manage the psychosocial issues associated with T1D. This includes primary care physicians and endocrinologists who provide the routine care of people with T1D—and are most likely to observe such issues. The experts identified multiple interventions for psychosocial issues in T1D that are known to provide positive outcomes but are just not widely available due to the limited resources in the healthcare system to support their implementation.

Beginning a dialogue on this important, but little discussed, aspect of T1D is a first step for JDRF. These insights will help JDRF evaluate where we can use this information to better support all the needs of everyone with T1D and those affected by the disease.

Pediatric Diabetes Registry Reveals T1D Increase

Shana — Mon, 11 Feb 2013 20:46:48 GMT

In order to prevent and ultimately achieve a world without type 1 diabetes (T1D), we must first learn more about the disease. One trend that has revealed itself in recent years is an accelerating rate of T1D, especially among younger children. Last year, the SEARCH for Diabetes in Youth study reported that the prevalence of T1D in people under age 20 in the U.S. rose by 23 percent between 2001 and 2009. Other studies have shown that in European children one to five years of age, the incidence of T1D is increasing at a rate of 5.4 percent annually.

This increase in T1D creates additional urgency for research to understand and ultimately prevent and cure the disease. It also speaks to the need for more studies to gather data about T1D incidence rates and how they’re changing over time.

With that in mind, new research from the Philadelphia Pediatric Diabetes Registry revealed the incidence of type 1 diabetes among children in Philadelphia under age 5 increased by 70 percent in the past two decades. Furthermore, the study found overall T1D incidence in the city’s children up to age 14, increased by 29 percent from 1985 to 2004 (the average yearly rate of increase was 1.5 percent). The research, led by Dr. Terri H. Lipman of the University of Pennsylvania School of Nursing, draws upon data from the only active U.S. diabetes registry, which Dr. Lipman has maintained since 1985.

While Dr. Lipman’s findings published in the recent issue of Diabetes Care, shed insight on the rising rate of diabetes in children in Philadelphia, they also highlight the importance of diabetes data centers in the U.S. and throughout the world. According to Dr. Lipman, improving and continuing research and data collection will help clarify the origins and epidemiology of these upward trends in pediatric diabetes. This knowledge will lead to a better understanding of T1D and will inform work to prevent and cure the disease.

Although JDRF did not fund this particular study, part of JDRF’s strategy is to drive research aimed at slowing and preventing the progression of T1D. As part of the program’s top priority areas, JDRF supports research studies following people over time who have, or are at risk of developing T1D to better characterize the disease process. JDRF’s recent News Blog entry, T1D Rise Among Youth Highlights the Importance of Renewed Research Funding shares an overview on such JDRF-funded prevention studies, including:

An Artificial Pancreas System in Action

Liz Cuebas — Wed, 23 Jan 2013 16:53:00 GMT

When JDRF started the Artificial Pancreas Project in 2006, the project was long on theoretical concepts but short on hard data. Scientists believed there should be a way to improve daily T1D management by connecting the reading from a continuous glucose sensor to control the operations of an insulin pump in a closed loop system – but the tools to do these experiments were limited and the path was unclear.

A few short years later, this area of T1D research, which aims to remove some of the impact of T1D from people’s lives by reducing dangerous high and low blood sugar levels and the complications that may result, has gone from a theory to a reality in widespread clinical testing. Not only are researchers continuing to refine this developing technology with the goal of eventually making it available to all people with T1D, but dozens of people with T1D have had the opportunity to test an artificial pancreas system by participating in human clinical trials.

The earliest artificial pancreas system trials focused on testing devices in a closely monitored setting to ensure patient safety. These trial participants stayed in a hospital for the trial duration and were followed closely by a medical team. The first rounds of trials showed promising results, but because the trials took place in hospitals, it was too early to conclude that an artificial pancreas system would be helpful with blood sugar management in a "real-world" setting, where people with T1D may face unpredictable circumstances and choices that can impact their glucose levels.

Last summer, JDRF announced a significant step forward in the development of artificial pancreas systems – ongoing clinical trials showed that artificial pancreas technology was proving successful in outpatient, more "real-world" settings. Study results released at the 72nd American Diabetes Association (ADA) Scientific Sessions revealed that participants in ongoing trials at international sites in France and Italy were able to use an artificial pancreas system for 18 hours outside of a hospital setting, while keeping good control of their blood sugar levels.

This past fall, JDRF had the unique opportunity to film the experiences of an artificial pancreas clinical trial participant at the University of Virginia. Tom Brobson, JDRF’s National Director of Research Investment Opportunities, was diagnosed with type 1 diabetes in 2004 and joined JDRF as a staff member shortly after that.

According to Tom, "Being diagnosed with T1D at age 44 felt like part of my life was being taken away - becoming involved with JDRF was like getting it all back."

Participating in clinical trials was another way that Tom could make a difference and help to advance T1D research. In 2007, he began participating in artificial pancreas clinical trials and returned in 2009 and again in 2012.

"I participate in clinical trials because I want to see a whole progression of advances leave the laboratory and become life-changing therapies for those of us with T1D."

Tom's third experience being connected to a functioning artificial pancreas system was quite different than the two previous times.

"In 2007," Tom explains, "I was in a hospital bed with wires running all over the place. We had to have two laptops running the software, my doctor had to check every single step the system wanted to make, and I couldn’t leave the room. By 2009, things had progressed, everything sort of fit into a fanny pack, there were still wires, but fewer of them, and I could walk around the hospital a bit – I even got on an exercise bike. The laptops were still running things but they were out of sight in a different room connecting via a wireless signal. All of this was needed because in these first attempts safety was paramount. It still is, of course, but in 2012, the laptops were gone and the system was running on a smartphone! This time, we left the hospital and went into the real world for three days."

As part of the 2012 trial, Tom was able to walk around town and eat out at restaurants to test how the device would function in situations that people with T1D face on a daily basis.

In the video below, you’ll see Tom’s portable smartphone artificial pancreas system in action and learn more about how JDRF has managed to efficiently accelerate this groundbreaking technology in just a few years.

(Please visit the site to view this video)

If you are interested in participating in a clinical trial, please visit JDRF’s Type 1 Diabetes Clinical Trials Connection at http://trials.jdrf.org. This is a service that provides information and matches people with T1D clinical trials for which they may be an appropriate participant. You can also find more information on artificial pancreas trials through the website of the JDRF Artificial Pancreas Consortium: http://jdrfconsortium.jaeb.org.

People with T1D Inspiring Others

Andrew Bell — Fri, 11 Jan 2013 19:13:35 GMT

Living with type 1 diabetes (T1D), to say the least, is no cake walk. Let’s be honest, it’s downright tiring and absolutely challenging sometimes. Despite this truth, and in the face of nearly impossible obstacles, people with T1D still do amazing things. And their accomplishments inspire everyone connected to JDRF to no end!

For example, Yahoo sports recently posted a story on Chicago Bears quarterback Jay Cutler. Jay, after being diagnosed with T1D over four years ago and in the midst of his NFL career, has taken it upon himself to raise money for T1D and also work directly with children living with the disease – all while still playing! Another recent news story focused on a woman in New Zealand, Winsome Johnston, who has lived with T1D for 78 years. Other people living with T1D who also have significant years of diabetes management under their belt know just how incredible an achievement this is. And speaking of milestones in a person’s life and others who are inspiring, 13-year-old Matthew Sherr recently raised more than $90,000 for JDRF by donating gifts from his bar mitzvah. Great job, Matthew, and congratulations on proving that it’s possible for a person with T1D to make a big difference at any age!

On a personal note, I’m quite proud of some of my recent accomplishments as a person living with T1D for over 19 years, including a hard-earned belt promotion in Brazilian Jiu Jitsu and graduating from a 500 hour yoga teacher training course.

So, if you’re reading this, and you are someone living with T1D, or you care greatly for someone living with it, JDRF has a number of forums where you can share your story and what you’ve accomplished while living with this unique challenge.

Tell us Who’s your #1? This page on the JDRF website gives you an opportunity to talk about those with T1D you're most passionate about.
Sign up for TypeOneNation, JDRF’s online community for people touched by T1D.
Tweet to JDRF and share on Facebook.
Connect with others through your local Chapter of JDRF.

Finally, continue to spread awareness, support T1D research, and keep trying to do good things while dealing with this difficult hand that’s been dealt. Your story, like Jay Cutler’s, Winsome Johnston’s and Matthew Sherr’s, helps inspire others and keeps this sometimes seemingly impossible course ahead navigable.

JDRF Completes First Stage of the Glucose Responsive Insulin Grand Challenge

Michael — Wed, 19 Dec 2012 18:21:00 GMT

In September, JDRF wrapped up the first stage of its first-ever crowdsourcing challenge to garner ideas for developing a glucose responsive insulin (GRI) drug. The Agnes Varis GRI Grand Challenge Prize, the first stage of which was called the “Theoretical Phase,” resulted in the selection of three winning ideas, presented by five “solvers.” The winning teams each received $35,000 for their ideas, which are being further assessed by JDRF for their potential to work in a laboratory setting.

GRI is an engineered insulin that ideally would remain in a person’s body and regulate blood glucose levels for extended periods, such as a once-a-day treatment or longer (up to a week). Such a breakthrough, when achieved, would effectively end the need for frequent blood sugar checks and multiple daily insulin injections or infusion pumps.

However, the true potential of such a discovery remains unknown. The closest example is a product called SmartInsulin, which is currently being developed by Merck & Co. SmartInsulin was developed by SmartCells, Inc. with support from JDRF. That drug is currently in preclinical development. Because the path to drug approval is long and provides no guarantees in early stages, JDRF decided to pursue other avenues toward this important goal through the Grand Challenge.

In this video, Sanjoy Dutta, Ph.D. discusses in greater detail what GRI is and how JDRF envisions the Grand Challenge bringing such a drug to reality. If you have any questions about GRI, or the Grand Challenge, visit www.jdrf.org.

(Please visit the site to view this video)

Eggnog Etiquette

William Sorensen — Fri, 14 Dec 2012 17:42:00 GMT

During the holidays, you eat and drink with everyone from your second cousin’s hair stylist to the soccer coach for your college roommate’s kid. If you have T1D, as I do, be ready for well-meaning people to ask you some of the same questions you’ve heard since the day you were diagnosed. Here’re eight comments I hear most often, followed by suggestions on how to respond:

Are you going to eat that? People are horrified when they see you eating anything other than a stalk of celery. Respond by saying, “Yes, those of us with T1D can eat anything as long as we deliver ourselves enough insulin to account for how many carbs we’re consuming.” You know the drill. Yes, it’s tedious, but remain calm. You might feel better if you remind yourself you’re helping to enlighten the world about a common health misunderstanding.
Are you sure? A lot of well-intentioned people think they understand your disease better than you do. If necessary, pull medical science into the conversation. “Yes, I’m sure I can eat this. My treatment plan was designed specifically for me, by an endocrinologist. I appreciate your concern.”
Well, I know you can’t eat this so I won’t offer you any. More than a few hosts passing around a plate have said this to me. It’s usually uttered by someone moving fast—someone offering frosted snowman cookies or ladling out cups of rum-laced eggnog—so I don’t usually bother slowing their pace by correcting them. But if it’s impossible for you to let misinformation glide by, you only need five words: “I can. But no thanks.” Or, “Yes, I can. Thank you.”
How can you have diabetes? You’re not shaped like Santa Claus. Suggested answer: “I’ve been asked that before because many people don’t realize there are two types of diabetes.” Then go on to explain what the differences are—if you have the time and patience. Otherwise, tell them to visit the JDRF website.
Did you eat too many candy canes when you were little? This is a variation on the notion that only obese people have diabetes. “You know, I’m glad you asked that question. Quite a few people aren’t aware that type 1 diabetes has no connection with lifestyle, eating habits, or physical activity.” Again, if you’re eager to move on, mention the JDRF website.
Do you really stick needles into yourself? Your impulse might be to say, martyr-like, “People do crazy things to stay alive.” But breathe deeply and slowly explain that it’s part of your daily routine. I like to quote the hospital nurse who taught me how to plunge syringes into myself. “After a week of this, it’ll be as easy as brushing your teeth.”
Does it hurt? I never mind this question. The simple answer is, “No.” Many years ago I realized I didn’t have the option of allowing injections to hurt, so 99 percent of the time they don’t. On the rare occasion when one does hurt, I don’t scowl or wince because my mind is occupied with wondering, what made it hurt? First things first.
You must hate the holidays. Why? Because there are more opportunities to eat? Does that make you hate the holidays?” Your delivery matters with this answer. Don’t sound defensive or angry.

For people living with T1D, that’s a piece of advice to use throughout the year, and throughout life: Don't be defensive or angry. More than likely, anyone with assumptions, questions, or comments about your life with diabetes has your best interests at heart.

Nanoparticle Research Shows Promise for T1D and Other Autoimmune Diseases

Gary Feit — Mon, 03 Dec 2012 19:25:12 GMT

One of the toughest challenges in halting or reversing the autoimmune process that destroys beta cells and causes type 1 diabetes is doing so in a way that does not compromise a person’s entire immune system. Antigen-specific immune therapy research, which targets only a specific part of the immune system, is a key part of JDRF’s strategy to cure T1D. Results from a recent study involving an animal model of multiple sclerosis have confirmed that using nanoparticles may represent an exciting and relatively new approach to antigen-specific immune therapies that could help stop the autoimmune process for people with various autoimmune diseases, including T1D.

The research by Dr. Stephen Miller and his colleagues at Northwestern University involves the use of a nanoparticle-based immune therapy as a treatment for the autoimmune disease multiple sclerosis (MS). In this research, the investigators used biodegradable nanoparticles containing MS-related antigen components to reset the immune system balance and create immune tolerance in an animal model of MS. JDRF provided partial support for this work because of its relevance to T1D immune therapies.

The use of nanoparticles– very small packages as a way to deliver components that trigger the immune system – appears to have the ability to effectively mimic the natural immune system tolerance processes. Such nanoparticles allow the delivery of multiple important triggers of immune tolerance, should minimize side effects by being more specific to T1D, and allow better control of the production of the particles to specifically modify the immune response. While this research has so far only been conducted in mice, if successfully applied to humans, it could provide a potential pathway to controlling the autoimmunity that underlies T1D.

JDRF has been at the forefront of driving research using nanoparticles to benefit people with T1D. In addition to branching out and funding Dr. Miller’s study on MS because of its relevance to T1D, JDRF has a robust portfolio of other promising research it is funding in this area. JDRF’s recent and current funding commitments to research involving nanoparticles total over $6 million.

Included in this research are other studies by Dr. Miller that specifically focus on T1D. In this research, Dr. Miller is attempting to use nanoparticles to help achieve immune tolerance for transplanted insulin-producing islet cells. Another JDRF-funded study in this area that has received attention is one conducted by Dr. Pere Santamaria at the University of Calgary, using nanoparticles to restore the balance among the T cells and stop the autoimmune process in T1D. His work involves assembling triggers of the immune system onto a nanoparticle, including specific T1D antigens. It has shown that protective T cells still exist in T1D, but just not enough of them to properly control the autoimmune process. By dosing mice with his nanoparticles, Dr. Santamaria has been able to increase the numbers of the protective T cells resulting in a rebalancing of the T cells and halting the autoimmune process.

In addition to the research led by Dr. Miller and Dr. Santamaria, JDRF’s nanoparticle portfolio includes an industry partnership with Selecta Biosciences as well as studies being conducted by Dr. Eric Bachelder at Ohio State University, Dr. Nick Giannoukakis at the University of Pittsburgh, Dr. Teresa DiLorenzo at Albert Einstein College of Medicine, Dr. Francisco Quintana at Brigham and Women’s Hospital, and others.

Implanted Encapsulated Pancreatic Islet Product Safely Demonstrates Improvement of T1D Management

Tara Wilcox-Ghanoonparvar — Fri, 16 Nov 2012 18:04:00 GMT

In September, Living Cell Technologies (LCT) revealed positive results from its JDRF-funded Phase II study of DIABECELL—a unique proprietary encapsulation technology comprised of encapsulated pancreatic islets from pigs. According to LCT’s announcement, the New Zealand-based study in 14 study participants with type 1 diabetes (T1D) demonstrated the product’s safety and ability to reduce hypoglycemia, lower HbA1c levels, and improve quality of life over a 52-week period following implantation of the product. While none of the participants in the DIABECELL trial became insulin independent, this first-generation encapsulation product is the most advanced demonstration of the potential benefit of an encapsulation product in T1D.

The objective of this research was to test the safety of the implantation of DIABECELL, and whether the implanted pig islets improve blood glucose control in people with T1D. The findings demonstrate the potential of such novel techniques to improve the management of T1D in the short term.

Led by Dr. John Baker at Middlemore Hospital in Auckland, LCT’s study used islets from specially bred pigs, and encapsulated them before implantation in the hopes of protecting them from any harmful immune response—thereby eliminating the need for immunosuppressant drugs. The protected islets were implanted into the abdomens of study participants through a laparoscopic procedure.

Encapsulation is one of JDRF’s priority areas of research toward curing T1D. Its promise lies in its potential to address two main hurdles to widespread beta cell transplantation as a cure for T1D: the limited supply of transplantable cells available, and the need for life-long immunosuppression therapy to prevent the rejection of those transplanted cells. Over the past five years, JDRF has provided more than $26 million toward research into encapsulation and xenotransplantation (transplanting insulin-producing islets from animals into humans) through direct funding and collaborations with other organizations—including $4.6 million in FY2011—to address these obstacles.

In addition to LCT’s research, JDRF is funding significant projects that are also developing alternative beta cell and islet encapsulation product concepts. One example is a collaboration with the biotechnology company ViaCyte to develop a first-of-its-kind encapsulated stem cell-based replacement therapy. At Emory University, JDRF-funded researchers are exploring ways to improve alginate microcapsules for pig islet transplantation. A grant to Harvard University—partially funded by The Leona M. & Harry B. Helmsley Charitable Trust (HCT)—has made possible another prominent study at the Massachusetts Institute of Technology, researching biomaterials and delivery systems for islet encapsulation. Furthermore, in August, JDRF announced a major collaboration with the HCT to fund advanced encapsulation research at the Diabetes Research Institute at the University of Miami.

It is too soon to know when DIABECELL might be commercially available; trials in Argentina are also taking place, and Phase III trials are needed to test the product on a larger number of participants, identify any adverse reactions, and explore long-term benefits of use. Still, LCT’s innovative product concept in the field of beta cell replacement could lead to exciting advancements in T1D research.

JDRF Discusses New Treatment for Diabetic Eye Disease

Liz Cuebas — Fri, 12 Oct 2012 01:07:48 GMT

Eye disease is one of the most common complications of type 1 diabetes.

Eye disease in people with diabetes, also known as diabetic retinopathy, is caused by chronic high blood sugar levels, which can damage the blood vessels in the retina of the eye and cause excess blood vessel growth. Retinopathy can range from extremely mild to vision-threatening. One of the most common complications of retinopathy is diabetic macular edema, which results when fluid and protein build up on the retina and cause swelling and fluid leakage. Diabetic retinopathy, including diabetic macular edema, is the leading cause of adult-onset blindness.

Developing effective treatments for diabetic retinopathy is a key part of JDRF’s research goals. Until recently, the only treatment for diabetic macular edema was with lasers that often halted the worsening of the condition but did not improve a person’s eyesight. Now, however, a promising new treatment has emerged in the form of a drug called Lucentis (known generically as ranibizumab).

Lucentis, which is already approved for treatment of other eye disorders, has the potential to actually restore eyesight in people suffering from certain diabetic-related vision loss. It works by suppressing the growth of new blood vessels that cause swelling and leakage in the retina. Lucentis is administered through injections to the eye. In August, the FDA announced that it would approve Lucentis for use in treating diabetic macular edema.

In the video below, JDRF’s Dr. Helen Nickerson discusses this promising development and JDRF’s key role in funding the basic research that ultimately led to the discovery and development of Lucentis preceding its approval by the FDA.

(Please visit the site to view this video)

To learn more about JDRF’s research strategy and understand how JDRF’s programs are making progress toward our goal of curing, better treating, and preventing T1D, please visit JDRF’s website; subscribe to our online publication Countdown; and visit our newsroom, all of which are updated with new stories frequently.

For other recent updates on diabetic retinopathy research, please see the following recent Key Advances on the JDRF website:

Novel Pathway May Lead to Proliferative Diabetic Retinopathy Treatment

Early Detection of Diabetic Retinopathy

Novel Pathway Reduces Diabetic Eye Disease in an Animal Model

Novel Tests Detect Early Changes in the Retina in Some Adolescents with Diabetes

Recap of Recent JDRF Cure Research Studies

Shana — Mon, 01 Oct 2012 18:04:00 GMT

In our efforts to cure T1D, JDRF actively supports research aimed at restoring a person's insulin-producing capability and halting or reversing the body's misguided immune attack on the pancreas. A cure for T1D remains JDRF’s key priority and in the past month or so, a couple of JDRF cure research studies have reported notable results:

- The scientific journal Diabetes recently reported on a clinical trial using two drugs to reverse the autoimmune attack in newly diagnosed T1D patients. The trial was led by Dr. Carla Greenbaum, at Benaroya Research Institute at Virginia Mason and sponsored by the Immune Tolerance Network (ITN), a clinical trial network funded by JDRF and the National Institutes of Health (NIH). The study’s researchers administered the combination of two drugs, Proleukin (IL-2) and Rapamune (sirolimus), to see whether they would halt the autoimmune destruction of the remaining beta cells in trial participants. Although the therapy had the intended effect of increasing Treg cells in people, other immune system cells were affected in an unexpected way resulting in an overall negative effect on beta cell function. The study’s findings further indicate the challenges of translating therapies that work in animal models into human successes – they can guide us, but aren’t a perfect predictor of what happens in people. Although this novel approach did not meet its intended goals, the study’s findings will help guide other trials using a combination therapy approach since it did boost Treg cells, an approach still expected to help rebalance the immune system.

- The scientific journal PLoS One published results of a JDRF-supported islet transplantation study that employed a new approach to encapsulation. To promote the survival of transplanted insulin-producing cells, researchers created pancreatic tissue, surrounded by a three-dimensional network of blood vessels. The study, conducted in mice, was led by Professor Shulamit Levenberg of the Technion-Israel Institute of Technology. According to the published report, the engineered tissue has compelling benefits vs. traditional pancreatic tissue and may lead to improved islet replacement techniques for people with T1D:

The transplanted insulin-producing cells survive longer in the engineered tissue, and produce more insulin and other essential hormones.
When researchers transplanted the tissue into diabetic mice, the cells began functioning well enough to lower blood sugar levels in the mice.
The 3-D model demonstrated in the study will have important clinical implications if the same results can be replicated with human cells.
The model system also provides a good platform to study the details and mechanisms that underlie successful transplantation and implanting of encapsulated cells.

To learn more about JDRF’s research strategy and understand how these and other studies are helping us make progress toward our goal of curing T1D, please visit JDRF’s website; subscribe to our online publication Countdown; and visit our newsroom, all of which are updated with new stories frequently. For other recent updates on cure-related research, please see the following recent JDRF News Blog entries:

- JDRF collaborates to fill gaps in encapsulation research for type 1 diabetes

- New Industry Partnership Paves the Way for Drug Development for Beta Cell Regeneration

- Novel technology may help new beta cells survive

JDRF collaborates to fill gaps in encapsulation research for type 1 diabetes

Michael — Thu, 30 Aug 2012 18:17:00 GMT

Recently, JDRF announced that it is jointly funding research at the Diabetes Research Institute (DRI) with The Leona M. and Harry B. Helmsley Charitable Trust. The grant will support the efforts of Dr. Camillo Ricordi and his team as they work to advance the field of islet cell implantation and encapsulation.

For JDRF, funding type 1 diabetes (T1D) research at DRI is not new. In fact, over the past 10 years, JDRF alone has funded roughly $12 million in research at Dr. Ricordi’s lab. In addition to having top scientists, such as Dr. Ricordi, the institute combines both the basic science and clinical resources needed to approach problems from multiple disciplinary perspectives, allowing for the potential of more complete solutions.

In the case of beta cell transplantation, the current methods, while showing moderate success, still suffer from limitations that hamper the effectiveness of the treatment. That is why JDRF has made beta cell encapsulation one of its research priorities. However, developing the technology to encapsulate islet cells is only one part of the solution, as those cells must then be safely implanted in a way that enables them to flourish without requiring a lifetime of drug therapy.

JDRF and The Helmsley Charitable Trust turned to DRI for its expertise in the area of transplantation and its multidisciplinary approach to research, to develop a procedure that would enable the safe implantation of encapsulated cells. If successful, this procedure would create a platform technology that addresses the limitations posed by clinical islet transplantation as it is practiced today. The approach moves the cells away from the liver—widely considered an inhospitable transplant site for islets—and incorporates a bio-protective scaffold that can accommodate many other beneficial technologies to protect islets from the immune system, including cell encapsulation. As part of the grant, DRI is also working on its own solution for cell encapsulation by developing an extremely thin coating of polymer around the islets.

This grant is the latest example of how JDRF and its partner, The Helmsley Charitable Trust, are directing research through funding key programs in order to fill gaps. DRI’s comprehensive approach addresses both sides of encapsulation, developing techniques to coat and implant the cells.

JDRF Science Workshop Attempts to Unravel a Fundamental T1D Disease Mechanism

Gary Feit — Thu, 02 Aug 2012 13:56:27 GMT

JDRF scientists and their colleagues recently published the key insights from a JDRF-organized workshop with leading experts who met to discuss a potential basic disease mechanism in T1D. JDRF’s unique network of scientific collaborators enables JDRF to bring together the best minds from around the world to tackle the most challenging T1D research problems. In this case, it was to define new programs to help understand why the immune system becomes broken in T1D.

In T1D and other autoimmune diseases, the body mistakenly mounts an immune response to normal or native body components, such as insulin, as opposed to only attacking foreign substances like bacteria or viruses. Normally, a person’s immune system learns to correctly distinguish between native and foreign materials. Correctly distinguishing native components is known as immune tolerance – the normal immune system learns to “tolerate” the presence of native components like our own proteins.

The mechanisms by which immune tolerance becomes broken in T1D are complex and not very well understood. One possibility, which this workshop explored, is that alterations in the structure of native components (such as proteins) might play a role. These alterations to native proteins may happen in several ways, such as the attachment of different molecules, changes to the protein’s structure, or connecting proteins in different ways. We know that a similar process occurs in other autoimmune diseases, such as celiac disease and rheumatoid arthritis, where the immune process trigger is believed to be a result of one of these alterations. So it’s possible that a similar process might trigger T1D.

So how might these native compounds that have been modified be involved in breaking immune tolerance? One possible explanation is that, after undergoing these modifications, the altered components look different to the immune system than the unmodified or normal components. The immune system then recognizes the modified protein as foreign and mistakenly mounts an immune response to similar native components.

The recent workshop and resulting publication were a first step in exploring how this process may play a role in the development of T1D. To follow up, JDRF funded a number of proposals to prove or disprove the workshop-developed theories about these key alterations in T1D. If they are found to be important in T1D, as suspected, we may be able to use them as markers of disease progression or target them with a vaccination strategy to induce immune tolerance. We also need to explore whether people at different life stages and different stages of T1D (such as children and adults, or newly diagnosed individuals) may react to different altered native components. If so, intervening in the immune process to prevent T1D may require a number of different approaches.

T1D Rise Among Youth Highlights the Importance of Renewed Research Funding

Tara Wilcox-Ghanoonparvar — Fri, 27 Jul 2012 18:37:00 GMT

In June, the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) released results from their latest SEARCH for Diabetes in Youth study. The data revealed a 23 percent growth in type 1 diabetes (T1D) prevalence, between 2001 and 2009, in Americans under age 20. At this rate, the prevalence of T1D would double for every future generation, calling attention to the urgent need to reverse this alarming trend.

In order to do this, we need research. We must understand what factors cause T1D and why, who is at risk for the disease and why, and then discover methods for preventing the progression of the disease. The SEARCH results are the latest example of why organizations like JDRF are essential, and of why federal support of research through the Special Diabetes Program (SDP) must continue to be renewed. The SDP funds roughly one-third of all diabetes research at the NIH. Its impending expiration, if not renewed by Congress, would hinder the continuation of key research initiatives that are working toward slowing down and halting T1D.

In only a decade, SDP research has expanded the catalog of genes now believed to influence a person’s risk of developing T1D from three genes to nearly 50 genes or genetic regions today. We are also positioned to learn a great deal about the environmental factors that may trigger T1D. The SDP funds The Environmental Determinants of Diabetes in the Young (TEDDY), a multi-national consortium examining the environmental exposures of children who are at an increased genetic risk for the disease. A greater understanding of who is at risk for T1D and why will help researchers to develop possible approaches to prevention of T1D.

TrialNet, funded in part by the SDP and by JDRF, is screening relatives of individuals with T1D for the presence of beta cell-specific autoantibodies, to determine an individual’s risk of developing the disease. Individuals at high risk are being offered the opportunity to enroll in TrialNet T1D prevention trials.

With the help of TEDDY, TrialNet, and many other studies on why and how T1D progresses, scientists are now working toward possible interventions, such as T1D vaccines. Researchers are exploring therapeutic avenues that have successfully preserved residual beta cell function in recent onset T1D, in order to find ways to protect beta cells in those at risk before disease begins.

JDRF and others are committed to putting an end to T1D, and the latest SEARCH data underscores that commitment. In addition to research, we must continue to advocate for the protection of federal support for SDP. If you would like to get involved in helping to ensure continued diabetes research funding, sign up here to be a JDRF advocate or visit advocacy.jdrf.org for more information.

True Descriptions

William Sorensen — Wed, 18 Jul 2012 19:35:00 GMT

In the newly released True Believers, author Kurt Andersen’s narrator and lead character is a celebrated 64-year-old attorney named Karen Hollander. She also has T1D. Her diagnosis follows a memorable night when everything is perfect: She’s at the top of her high school class, she’s speaking at her graduation, and she’s been admitted to Radcliffe. The guy she’s been hoping to date, for years, is with her on prom night. Karen’s life seems so perfect right then that her frequent trips to the toilet are no big deal.

In the delirium of that phase-changing night, I chalked up my odd spiral of unquenchable thirst and endless urination to enchiladas and Pabsts and having my period, to overexcitement and staying up late and Mountain Dew. But it continued the next day and the next and then the next, and on Tuesday a doctor in Evanston told my mother and me that I had juvenile diabetes. For mysterious reasons, my pancreas had stopped working. I would have to inject insulin every day for the rest of my life.

Some 47 years later, Karen’s T1D has not hindered her successful legal career, and on one occasion it lands her a spot on Oprah. Karen is the dean of a prestigious law school and has been frequently mentioned as a possible nominee for the Supreme Court. She’s written several bestsellers.T1D has not kept Karen from realizing goals in her personal life, either, but it has required hourly attention. She’s a mother of two and a fit, healthy grandmother. She describes an argument with her 17-year-old granddaughter:

My peevishness with her is so intense that I wonder if I’m on a hypoglycemic downward slide. I keep glucose meters all over the place—bedroom, bathroom, kitchen, right here on the coffee table—so I prick my finger and squeeze out a drop: 117. Good. I’m just angry, not too low, for my meter tells me so.

“You okay?” Waverly asks.

“All good.” In the fifteen seconds it’s taken me to find out how many milligrams of sugar are floating in each deciliter of my blood, my love has dissolved my anger.

It’s clear that Karen has always been vigilant about her diabetes. She’s kept up with advances in medical treatment. She’s under the care of an endocrinologist and the burdensome daily requirements of T1D are routine. But, as all of us living with T1D know, constant vigilance and a blood meter in every room still doesn’t protect you from precarious life situations.

As I’ve explained, avoiding high blood sugars—what wrecks your blood vessels, your eyes, your kidneys—has its price, increasing the risk that your level drops too low, making you ”spaz out” (as Greta used to say) and become confused, scared, scary, even unconscious. In 1987, when Jack was in Europe at a music festival and I was alone in Brooklyn Heights with the kids who were twelve and three, in the middle of the night I had flailing convulsions and went into a coma. Greta awoke—I have no memory of this—after I knocked over and smashed the nightstand lamp, and called 911.

Andersen gets the descriptive details of T1D life exactly right. He gets Karen Hollander’s T1D mindset right, too. Did he do extensive research? Well, you could say he did a couple decades worth of research. He was diagnosed with T1D when he was 32. Like his heroine, he injects himself with insulin a few times every day. He does multiple finger prick blood tests and counts every carbohydrate. And like his heroine, Andersen has piled up impressive accomplishments. He’s a bestselling author and is a contributor to New York, The New Yorker, Time, and Vanity Fair. He was a co-founder of Spy and hosts the popular public radio program Studio 360.

Parents looking for positive role models for kids with T1D should know that True Believers is a book for adults. But 85 percent of people with T1D are older than age 20. They’re likely to find themselves nodding in agreement whenever Karen Hollander deals with her diabetes. At one point Karen tests her blood and gets the number 100. “The perfect number always pleases me, as if I’ve won a gold star. My brain chemistry is once again objectively normal.”

While Andersen’s main character lives with T1D and has to think about it constantly, her disease doesn’t drive the plot. It’s not a novel about living with T1D. It’s a thriller in which the reader waits for a mystery to be revealed. It involves a 64-year-old trying to accept a time in her life she regrets, when something drastic happened.

T1D figures in all 35 chapters of True Believers without being the story. That reflects an important truth about life with T1D: It’s always there, 24 hours a day and 365 days a year. While it requires more attention than anything else in your life, it doesn’t determine what will happen in your life or what your life will be about.

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William Sorensen is National Director of Media Relations for JDRF. He has lived with T1D for more than 40 years.