Could gene therapy one day cure type 1 diabetes?

For years, scientists have been interested in whether alpha cells might be able to be reprogrammed to do the work of insulin-producing beta cells in type 1 diabetes.

A new study published in the journal Cell Stem Cell demonstrates an early look how one day gene therapy might be used to permanently restore normal blood glucose levels in people with type 1 diabetes.

The work, which reprogrammed the glucagon-producing alpha cells to produce insulin, restored normal blood glucose levels in the diabetic mice for about four months.

Using what’s known as an adeno-associated virus, researchers at the University of Pittsburgh School of Medicine and the Children’s Hospital of Pittsburgh delivered two proteins, Pdx1 and MafA, to the mouse pancreas that could reprogram alpha cells into beta cells.

In people, this could be done endoscopically, delivering a protein-containing liquid to the pancreas via a tube that connects it to the intestine.

In the diabetic mice, it required surgery. At least initially, it worked. The alpha cells began producing insulin and restored normal blood glucose levels in the diabetic mice for about four months.

Though the concept has so far only been tested in mice, it demonstrates what could be an important new area of exploration in searching for a diabetes cure.

Alan Attie, whose University of Wisconsin lab studies the genetic and biochemical processes underlying genetics, called it «beautiful and elegant work.»

But it raised some questions that scientists are still to answer: Why didn’t the mouse immune system immediately attack the engineered beta cells? What is the effect of transforming pancreatic alpha cells in the long term? And of course, how would all this work in people?

Eric Topol, a Scripps Research Institute geneticist, said that while the work was «interesting and creative» the fact that after four months the immune system started attacking those beta cells suggested that this is unlikely to be a one-time cure, and raises questions of how long those four months would translate to in humans.

Study summary

Successful strategies for treating type 1 diabetes need to restore the function of pancreatic beta cells that are destroyed by the immune system and overcome further destruction of insulin-producing cells. Here, we infused adeno-associated virus carrying Pdx1 and MafA expression cassettes through the pancreatic duct to reprogram alpha cells into functional beta cells and normalized blood glucose in both beta cell-toxin-induced diabetic mice and in autoimmune non-obese diabetic (NOD) mice. The euglycemia in toxin-induced diabetic mice and new insulin+ cells persisted in the autoimmune NOD mice for 4 months prior to reestablishment of autoimmune diabetes. This gene therapy strategy also induced alpha to beta cell conversion in toxin-treated human islets, which restored blood glucose levels in NOD/SCID mice upon transplantation. Hence, this strategy could represent a new therapeutic approach, perhaps complemented by immunosuppression, to bolster endogenous insulin production. Our study thus provides a potential basis for further investigation in human type 1 diabetes.

Diet for gestational diabetes

5-Day Apple Diet For Weight Loss

I have gestational diabetes. Do I have to watch what I eat?
Yes. Eating well helps all women stay healthy during pregnancy. But if you have gestational diabetes, choosing the right food to eat is even more important. That’s because many women with gestational diabetes can manage their condition by following a healthy eating plan, monitoring their blood sugar, and exercising regularly.

Keeping your blood sugar stable by eating healthy food and exercising makes it less likely that you’ll need medication to control your condition. You and your baby are also less likely to have any complications from your condition.

Watching what you eat also helps you gain a healthy amount of weight during pregnancy. If you were overweight before becoming pregnant, your healthcare provider may recommend limiting calories so you don’t gain too much as your baby grows.

Do I need to monitor carbohydrates?
Yes. The amount and type of carbohydrates (natural starches and sugars) in food affects your blood sugar levels. And with gestational diabetes, you’ll need to track your carbohydrate intake in particular.

Setting a limit on the amount of carbohydrates you eat at each meal is the first step to managing your blood sugar. Your provider is likely to recommend reducing the total amount of carbohydrates to about 40 percent of your daily calories.

Try to eat carbohydrates that are high in fiber. Fibrous foods are harder to digest.

Whole grains are high in fiber, so choosing brown rice and whole grain bread instead of refined versions (white bread and rice) means that they take longer to digest and release sugar more slowly into your bloodstream. Vegetables, beans, lentils, and chickpeas are also high in fiber and release sugar into your blood slowly.

Avoid food and drinks that are high in added sugars, such as candy, cakes, and sodas. If you’re craving something sweet, artificial sweeteners such as aspartame (NutraSweet and Equal) and sucralose (Splenda) are fine in moderation.

Lean proteins should make up about 20 percent of what you eat each day. Fish, lean meat, and low-fat milk and dairy products are healthy protein choices.

The remainder of your calories should come from healthy (unsaturated) fats, such as olive oil. That’s about 40 percent of your daily calories.

Avoid unhealthy (saturated) fats, such as butter, and trans (hydrogenated) fats, like those found in processed foods. Foods like all-natural peanut butter are high in healthy fat and a good source of protein, but check labels because peanut butter can have trans fat.

If all this seems overwhelming, know that you don’t have to make these changes on your own. Your provider will give you plenty of information to guide you when making food choices. She can also refer you to a registered dietitian to help with meal planning.

How can I keep my blood sugar stable?
When you’re trying to control gestational diabetes, what you eat isn’t the only factor to consider. How and when you eat is important too.

The goal is to keep your blood sugar even and avoid the spikes that lead to blood sugar going up. This is even more critical if you do need to take medications to control your diabetes.

Having some protein at each meal can help balance blood sugar. For example, eating a small portion of whole grain cooked cereal (like oatmeal) with an egg or yogurt at breakfast can balance your meal and prevent blood sugar spikes. All-natural peanut butter on whole wheat toast is another good option.

Have three small meals, plus two to four healthy snacks, every day to keep your blood sugar level stable. Try to space these out evenly so you eat something every two to three hours. Having a snack before bedtime is especially important to keep your blood sugar levels from falling overnight.

Repeated blood sugar spikes mean gestational diabetes is uncontrolled, which can lead to health problems for you and your baby.

What are low glycemic index foods?
The glycemic index (GI) ranks foods that contain carbohydrates based on how quickly they release energy, in the form of glucose, into your blood.

Foods with a low glycemic index give a sustained release of energy. Because they take time to digest and turn to glucose gradually, foods low on the glycemic index are less likely to cause spikes in blood sugar and can help to control blood sugar levels.

On the other hand, foods high on the glycemic index are digested rapidly and turn to glucose more quickly. This can make your blood sugar rise soon after meals.

Knowing about the GI of some foods can help you plan meals when you’re pregnant. But the GI of foods can be affected by many things, such as manufacturing process, combination of ingredients, ripeness, or how much it’s cooked.

Generally speaking, foods that are highly processed or cooked are more likely to have a higher GI, and foods that are raw or high in fiber have a lower GI. Highly processed foods are the biggest concern because they tend to be loaded with starches and added sugar.

GI plans can be complicated to follow, and not everyone agrees that they are helpful if you have gestational diabetes. But if you’re interested in learning more, ask your provider for advice.

Low GI foods include:

most fruits, especially apples, oranges, pears, peaches, and mangoes
vegetables, such as broccoli, green beans, peas, yams, lettuce, cabbage, and carrots
legumes, such as beans, chickpeas, and lentils
brown rice
whole oats, and whole-oat-based cereals, such as porridge, oat bran, muesli, and granola
multigrain and pumpernickel bread
High GI foods include:

fruit juice
ready-to-eat cereal
white bread
short grain white rice
russet potatoes
instant oats
macaroni cheese from mix
saltine crackers
rice cakes
I’ve been referred to a dietitian. What can I expect?
You’ll get medical nutrition therapy (MNT), which is a personalized eating plan you’ll work out with your dietitian. This will take into account your weight and how many calories you need each day. A dietitian will talk to you about:

how to count carbohydrates
how many carbohydrates to have daily
when to consume carbohydrates
timing insulin with food consumption
the impact of exercise on diet and insulin
getting the vitamins and minerals you need for a healthy pregnancy
As your pregnancy progresses, your dietitian may make changes to your MNT based on the results of blood sugar monitoring and how much weight you’ve gained. If you need to start taking insulin, you’ll still need to follow an eating plan, but a dietitian will likely make some changes to take your treatment into account.

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15 remedies to treat diabetes at home

India is said to be the diabetes capital of the world. With nearly 50 million people in India suffering from diabetes, the country has a big challenge to face. First, let’s know what is diabetes. The elevated sugar in the blood is called diabetes. There are two primary reasons behind diabetes – one is when our body stops producing insulin and second is when the body does not respond to insulin that is produced by the body. Insulin is broken down by the body and used as energy, which is transported to the cells. There are two types of diabetes – Type I diabetes and Type II diabetes. Let’s know about them in a little detail:
Type I diabetes
Type I diabetes usually occurs in people who are below the age 20 and that is why it is also called as juvenile diabetes. In this type, the body becomes partially or completely unable to produce insulin. Type I diabetes is an autoimmune disease. In this, your immune system attacks the pancreas from where the insulin is produced, thereby making the pancreas inefficient or unable to produce insulin. Type I diabetes cannot be prevented, it can only be controlled with healthy lifestyle changes.
Type II diabetes
Type II diabetes is more common than Type I diabetes in India. Type II diabetes usually happens to people who are above the age of 40. This type of diabetes is caused due to insulin resistance. In this case, the pancreas produces insulin but the body is not able to respond to it properly. There can be many reasons behind type II diabetes. Some of the reasons can be being overweight, high blood pressure, having a poor diet, taking too much stress, hormone imbalance, certain medications and leading a sedentary lifestyle. Though type II diabetes can be reversed.
Let’s us know some natural ways by which we can treat diabetes at home:
What not to eat:
There are some foods which can negatively impact your diabetes. So, the first thing you need to do is to remove these foods from your diet.
1. Refined sugar – We all know that sugar, until it is in its most natural form, is bad for people suffering from diabetes. When consumed, refined sugar spikes the blood sugar rapidly. Sometimes even the natural form like honey can cause a sudden spike in the blood sugar levels. So, it’s better to avoid refined sugar by all means if you are a diabetic.
2. Whole grains – Grains that have gluten in them should be avoided. Gluten is associated with diabetes as its intake can cause leaky gut leading to inflammation which in turn can lead to auto immune diseases.
3. Alcohol – Alcohol consumption is directly related to diabetes. Alcohol not only damages your liver but also attacks the pancreas that produces insulin. Diabetes is linked with consumption of heavy alcohol which is two to three glasses a day. Beer should especially be avoided as it has a lot of carbohydrates.
4. Cow’s milk – Just like whole grains, cow milk can trigger the immune system which can lead to inflammation. Milk coming from sheep and goat is not harmful in fact it helps to maintain the blood sugar level. But the conventional cow milk can be dangerous for you if you are suffering from diabetes.
5. GMO foods – GMO foods have the capability to promote diabetes along with causing liver and kidney diseases. Go for products which are labeled as GMO-free.
What to eat and do

Cinnamon contains a bioactive compound that can help to fight and prevent diabetes. Cinnamon is known to stimulate the insulin activity and thus regulate the blood sugar level. As excess of anything is bad, likewise cinnamon if taken in excess can increase the risk of liver damage due to a compound called coumarin present in it. The true cinnamon, not the one buy from shops (Cassia cinnamon) is safer to have.
How to consume cinnamon
– Mix half or one teaspoon of grounded cinnamon with warm water and have it once daily.
– Boil raw cinnamon in 2 glasses of water. Let it cool for 30 minutes and have it daily.
Aloe vera
Aloe vera is easily found in Indian households. Though it’s bitter in taste, but combing it with buttermilk makes it taste better. Usually, aloe vera is used for beauty purposes but as it has anti-inflammatory properties it can heal the wounds. Due to its anti-inflammatory properties, it is said to control the blood sugar levels.
Jamun and its leaves have proven to be helpful in lowering the blood sugar levels. Consuming approximately 100 grams of Jamun every day is said to show tremendous improvement in your blood sugar levels.

Vitamin C
Vitamin C is not only good for skin but also for diabetes. Recent studies have shown that consuming approximately 600 mg of Vitamin C daily can improve the blood sugar level significantly. People who have chronic diabetes should consume foods rich in Vitamin C every day. Some foods rich in Vitamin C are amla, orange, tomato and blueberry.
One of the main reasons behind type II diabetes is being overweight. Any kind of physical activity, be it yoga, Zumba, aerobics, gymming, playing sports can significantly improve blood sugar level by maintaining your weight. Not only this, walking every day can help to reduce the blood sugar level tremendously.

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