Is an Artificial Pancreas on the Horizon?

Written by Bonnie Sanders Polin PhD

The First Step Toward an Artificial Pancreas
Good news for those with type 1 diabetes. The Juvenile Diabetes Research Foundation (JDRF) has chosen the Johnson & Johnson company Animas to develop a system that automatically dispenses insulin to help people with type 1 diabetes better manage their disease. This is the first step toward the development of an artificial pancreas for the JDRF's Artificial Pancreas Project.

Animas currently manufactures insulin pumps, and they will work with the JDRF to develop a wireless system combining continuous glucose monitoring with insulin pumps and sophisticated software. This technology will free people with type 1 diabetes from checking blood glucose levels and manually injecting insulin.

Although it may mean wearing two devices, the benefits seem to outweigh the drawbacks. An artificial pancreas would mean people with type 1 diabetes would not have to worry about controlling insulin when blood glucose levels fall or rise. They also wouldn't have to correct for hypoglycemia or hyperglycemia with glucagon or carbohydrates.

The JDRF has been working for years to develop an artificial pancreas. The organization will spend $8 million over the next 3 years with hopes that a first generation system will be ready for regulatory review within 4 years.

To read more about this partnership, click here.

Can Diabetes Cause Frozen Shoulder?
On January 4, 2010, The New York Times published an article titled "The Claim: Diabetes Can Lead to 'Frozen Shoulder'" that highlights the latest research connecting frozen shoulder to diabetes.

Frozen shoulder comes in three stages. The first stage is weeks of inexplicable pain. Within a few days, getting dressed may seem like an obstacle course. The second stage is marked by "frozen" stiffness. The final stage is the "melting" phase.

The condition, also known as adhesive capsulitis, afflicts 2%-5% of the general population and at least 20% of those with type 1 or type 2 diabetes. The risk of developing frozen shoulder increases with age. Researchers hypothesize that excess glucose building up in the shoulder may be a cause of frozen shoulder in people with diabetes. This extra glucose essentially "glues" collagen fibers together, which restricts movement.

Treatment for frozen shoulder includes controlling blood glucose levels, using heating pads, and taking anti-inflammatories for the initial pain. Sometimes doctors suggest cortisone injections, but for those of us with diabetes, we know that these may raise blood glucose levels. When nothing else works, you may consider an arthroscopic shoulder procedure that removes scar tissue and frees ligaments.

To read The New York Times article, click here.

Metabolic Syndrome and Socioeconomic Status
January's issue of Diabetes Care has an article titled "Metabolic Syndrome Over 10 years and Cognitive Functioning in Late Midlife" by Tasnine N. Akbaraly, PhD. The article is about how metabolic syndrome may be a consequence of socioeconomic status.

Metabolic syndrome is the term used to describe a group of symptoms that increase your risk for developing heart disease and diabetes. These symptoms include high blood glucose levels, high blood pressure, abdominal obesity, and high cholesterol.

The researchers studied 4,150 Caucasian participants, and these subjects were assessed three times over the 10-year period (1991-2001).

After taking into account each participant's location, health behaviors, and health status, the researchers found that the participants with persistent metabolic syndrome (when it was present at least at 2 of the 3 screenings) over the 10-year follow-up had lower cognitive performance than participants who never had metabolic syndrome. No significant differences in cognitive function were observed between participants with non-persistent metabolic syndrome (1 of the 3 screenings) and those who never had metabolic syndrome during the 10-year period.

The researchers concluded that only persistent metabolic syndrome was associated with lower cognitive performance in late midlife. Occupation, but not education, had a substantial impact on this association. These results highlight the importance of adult socioeconomic circumstances in identifying and targeting risk factors for cognitive aging.

To read an abstract of this study, click here.

Study Reveals Diabetes Hormone-Gene Link in Mice
An article titled "Antidiabetic Effects of IGFBP2, a Leptin-Regulated Gene" by Kristina Hedbacker et al in January's issue of Cell Metabolism found that a fat hormone called leptin may control a gene linked to diabetes. This is good news, but this study was performed on mice, so we have a long time before it impacts humans.

Here is the information to file away, and we will continue to follow the updates. Earlier research found that leptin hormone treatment helps regulate blood sugar and insulin levels in both mice and humans that don't have enough leptin in their bodies. This new study found that leptin works at low levels by affecting the gene known as IGFBP2. Leptin was found to be potent in treating diabetes in mice.

The research team found that the treated animals responded 3 times better to insulin with the leptin. Future studies will focus on mice that don't have the IGFBP2 gene to determine if the gene is responsible for leptin's ability to fight diabetes.

To learn more about this study, click here.

Important Cholesterol Information for People with Type 2 Diabetes
In January's issue of Circulation, an article titled "Endothelial-Vasoprotective Effects of High-Density Lipoprotein Are Impaired in Patients With Type 2 Diabetes Mellitus but Are Improved After Extended-Release Niacin Therapy" by researchers at University Hospital in Zurich concluded that good cholesterol—known as HDL—is less protective in people with type 2 diabetes than in the general population.

The study compared HDL samples from 10 healthy adults to that of 33 patients with type 2 diabetes. All of the diabetic subjects took statins to lower their bad cholesterol.

The researchers found that the protective benefits on blood vessels were "substantially impaired" in HDL taken from patients with diabetes compared to healthy patients.

The research team then randomly divided up the diabetic patients and gave half of the group a placebo and the other half extended-release niacin—a B vitamin that raises HDL levels in the blood.

After 3 months, patients who received the niacin had increased HDL levels and markedly improved protective functions of HDL in laboratory testing, as well as improved vascular functioning.

This was a very small study, so more research must be conducted to determine if people with diabetes will benefit from extended niacin treatment.

To read an abstract of this study, click here.