Diabetes mellitus type 1
|
Diabetes mellitus type 1 Microchapters |
|
Differentiating Diabetes mellitus type 1 from other Diseases |
|
Diagnosis |
|
Treatment |
|
Cardiovascular Disease and Risk Management |
|
Case Studies |
|
Diabetes mellitus Main page |
|
Patient Information |
|---|
For patient information click here.
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3]
Overview
Historical Perspective
Pathophysiology
Risk Factors
Screening
Epidemiology and demographics
Natural history, Complications, and Prognosis
Classification
Causes
Differentiating Type page name here from other Disorders
Diagnosis
History and Symptoms | Physical Examination | Laboratory Tests | Electrocardiogram | Chest X Ray | MRI | CT | Echocardiography | Other Imaging Findings | Other Diagnostic Studies
Treatment
Medical: Medical Therapy
Surgical: Surgery
Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies|Social issues
See also
References
Data from the Report of the Expert Committee on the diagnosis and classification of diabetes mellitus
External links
- American Diabetes Association
- Diabetes
- Diabetes Australia-NSW
- Canadian Diabetes Association
- Diet, Nutrition and the prevention of chronic diseases (including diabetes) by a Joint WHO/FAO Expert consultation (2003)
- Centers for Disease Control Diabetes Section
- Diabetes UK
- Diabetes Health Institute
- Diabetes Institute for Immunology and Transplantion
- The Immunology of Diabetes Society
- International Diabetes Federation
- Juvenile Diabetes Research Foundation
- MedlinePlus Diabetes from the U.S. National Library of Medicine
- National Diabetes Education Program
- National Diabetes Information Clearinghouse
- Primary Care Diabetes Europe
- World Health Organization fact sheet on diabetes
- World Health Organization—The Diabetes Programme
- Diabetic Medical ID Tag
References
Overview
Prevention
"Immunization" approach
If a biochemical mechanism can be found that prevents the immune system from attacking beta cells, it may be administered to prevent commencement of diabetes type 1. The way several groups are trying to achieve this is by causing the activation state of the immune system to change from Th1 state (“attack” by killer T Cells) to Th2 state (development of new antibodies). This Th1-Th2 shift occurs via a change in the type of cytokine signaling molecules being released by regulatory T-cells. Instead of pro-inflammatory cytokines, the regulatory T-cells begin to release cytokines that inhibit inflammation.[4] This phenomenon is commonly known as "acquired immune tolerance".
DiaPep277
A substance designed to cause lymphocyte cells to cease attacking beta cells, DiaPep277 is a peptide fragment of a larger protein called HSP60. Given as a subcutaneous injection, its mechanism of action involves a Th1-Th2 shift. Clinical success has been demonstrated in prolonging the "honeymoon" period for people who already have type 1 diabetes [5]. The product is currently being tested in people with latent autoimmune diabetes of adults (LADA). Ownership of the drug has changed hands several times over the last decade. In 2007, Clal Biotechnology Industries (CBI) Ltd., an Israeli investment group in the field of life sciences, announced that Andromeda Biotech Ltd., a wholly owned subsidiary of CBI, signed a Term Sheet with Teva Pharmaceutical Industries Ltd. to develop and commercialize DiaPep277[6].
Intra-nasal insulin
There is pre-clinical evidence that a Th1-Th2 shift can be induced by administration of insulin directly onto the immune tissue in the nasal cavity. This observation has led to a clinical trial, called INIT II, which began in late 2006, based in Australia and New Zealand.
Denise Faustman research
Tumor necrosis factor-alpha, or TNF-a, is part of the immune system. It helps the immune system discern between self and non-self. Type one diabetics are deficient in this substance. Dr. Faustman discovered that giving BCG, an inexpensive drug, to diabetic mice, stimulates TNF-a production. TNF-a kills the white blood cells responsible for destroying beta cells, and thus prevents, or reverses diabetes[1]. She has reversed diabetes in laboratory mice with this techniqe, but was only able to receive funding for subsequent research from Lee Iaccoca. Human trials began in 2007, and are still underway.
Entities involved in research
This section is a complete list of mainly commercial companies but also other entities, namely governmental institutions and individual persons, actively involved in research towards finding a cure to diabetes type 1.
It does not list research funds, hospitals in which research is undertaken, etc., but only the industrious, actual developers of such products.
Entities are listed along with their status of research in that field, so that also entities which ceased research into finding a cure to diabetes type 1 may be listed.
Entities are alphabetically listed.
- Cerco Medical [7] – Present status: Unknown
- Denise Faustman [8] – Present status: Working on immune modification
- DeveloGen [9] – Present status: Developing DiaPep 277
- Diamyd Medical [10] – Present status: Developing GAD65-based vaccine (phase III application submitted to the FDA)
- Encelle [11] – Present status: On hold; awaiting decision on whether to move forward into encapsulated beta cell transplantation.
Further reading
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) - Diabetes in America Textbook (PDFs)
References
- ↑ Shinichiro Ryu, Shohta Kodama, Kazuko Ryu, David A. Schoenfeld & Denise L. Faustman. 2001. Reversal of established autoimmune diabetes by restoration of endogenous β cell function. J. Clin. Invest. 108(1): 63-72.