A New Approach to Treating Type I Diabetes? Columbia Scientists Transform Gut Cells into Insulin Factories
The insulin made by the gut cells also was released into the bloodstream, worked as well as normal insulin, and was made in sufficient quantity to nearly normalize blood glucose levels in otherwise diabetic mice.
“All these findings make us think that coaxing a patient’s gut to make insulin-producing cells would be a better way to treat diabetes than therapies based on embryonic or iPS stem cells,” Dr. Accili says. The location of the cells in the gut may also prevent the diabetes from destroying the new insulin-producing cells, since the gastrointestinal tract is partly protected from attack by the immune system.
The key to turning the finding into a viable therapy, Dr. Accili says, will be to find a drug that has the same effect on the gastrointestinal progenitor cells in people as knocking out the Foxo1 gene does in mice. That should be possible, he says, since the researchers found that they could also create insulin-producing cells from progenitor cells by inhibiting Foxo1 with a chemical.
Data from the 2011 National Diabetes Fact Sheet (released Jan. 26, 2011)
Total prevalence of diabetes
Total: 25.8 million children and adults in the United States - 8.3% of the population- have diabetes.
Diagnosed: 18.8 million people
Undiagnosed: 7.0 million people
Prediabetes: 79 million people*
New Cases: 1.9 million new cases of diabetes are diagnosed in people aged 20 years and older in 2010.
* In contrast to the 2007 National Diabetes Fact Sheet, which used fasting glucose data to estimate undiagnosed diabetes and prediabetes, the 2011 National Diabetes Fact Sheet uses both fasting glucose and A1C levels to derive estimates for undiagnosed diabetes and prediabetes. These tests were chosen because they are most frequently used in clinical practice.
Under 20 years of age
215,000, or 0.26% of all people in this age group have diabetes
About 1 in every 400 children and adolescents has diabetes
Age 20 years or older
25.6 million, or 11.3% of all people in this age group have diabetes
Age 65 years or older
10.9 million, or 26.9% of all people in this age group have diabetes
Men
13.0 million, or 11.8% of all men aged 20 years or older have diabetes
Women
12.6 million, or 10.8% of all women aged 20 years or older have diabetes
“It’s important to realize that a new treatment for type I diabetes needs to be just as safe as, and more effective than, insulin,” Dr. Accili says. “We can’t test treatments that are risky just to remove the burden of daily injections. Insulin is not simple or perfect, but it works and it is safe.”
The research was supported by the NIH (DK58282, DK64819, DK63608), the New York Stem Cell Foundation, and the Russell Berrie Foundation.
Race and ethnic differences in prevalence of diagnosed diabetes
After adjusting for population age differences, 2007-2009 national survey data for people diagnosed with diabetes, aged 20 years or older include the following prevalence by race/ethnicity:
- 7.1% of non-Hispanic whites
- 8.4% of Asian Americans
- 12.6% of non-Hispanic blacks
- 11.8% of Hispanics
Among Hispanics rates were:
- 7.6% for Cubans
- 13.3% for Mexican Americans
- 13.8% for Puerto Ricans.
The authors report no financial or other conflict of interest.
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Upon its official opening in October 1998, the Naomi Berrie Diabetes Center at Columbia University Medical Center established a new standard of care for the 1.6 million people with diabetes in the New York area - combining world-class diabetes research and education programs with unprecedented family-oriented patient care. Named for the mother of the late Russell Berrie, founder of RUSS™ Toys, the center is today recognized as the most comprehensive diabetes research and treatment center in the tri-state region and has been designated a national “Diabetes Center of Excellence” – one of only three in the state of New York. Approximately one hundred faculty and students, affiliated with the Center, conduct basic and clinical research related to the pathogenesis and treatment of all forms of diabetes and its complications.
Columbia University Medical Center provides international leadership in basic, pre-clinical and clinical research, in medical and health sciences education, and in patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Established in 1767, Columbia’s College of Physicians and Surgeons was the first institution in the country to grant the M.D. degree and is among the most selective medical schools in the country. Columbia University Medical Center is home to the largest medical research enterprise in New York City and state and one of the largest in the United States.
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Source: Columbia University Medical Center
References:
1 Type 1 Diabetes, 2010; Prime Group for JDRF, Mar. 2011
2 NIDDK
3 Type 1 Diabetes, 2010; Prime Group for JDRF, Mar. 2011