Category: Diabetes 101

A study recently performed by Israeli researchers and presented in Haaretz, an Israeli daily newspaper, has shown that a 20-minute swim in the Dead Sea could aid diabetics in lowering their blood sugar levels.

The research team was composed of scientists from Ben Gurion University and Soroka Medical Centre of Beersheva. Both are located in the Negev desert in Israel, according to Haaretz.

The study analyzed 14 people who had been diagnosed with Type 2 diabetes, ranging in age from 18 to 65. Results showed that, after sitting in a pool of water taken from the Dead Sea for a full 20 minutes, the patients showed a significant decrease in their blood sugar levels.

Their blood glucose dropped 13.5 percent on average, from 163 milligrams per deciliter to 151mg/dl. Being submerged in the water for an hour caused a further reduction in glucose levels, to 141.3 mg/dl.

Researchers noted that the salty soak did not seem to have any negative side effects on other important characteristics of blood, including insulin levels, c-peptide or levels of cortisone hormones.

The researchers used a control group of six healthy participants, who did not show any changes in their blood glucose levels when exposed to the Dead Sea water for the same amount of time.

Professor Shaul Sukenik led the research team at Ben Gurion University. He said that the results were promising. “In the event that the findings are confirmed in further studies, a drop in blood glucose levels will allow diabetics who bathe in the Dead Sea to use less medication,” said Sukenik in an interview with Haaretz. “We cannot determine this on the basis of the current study, but the findings do suggest this,” he said.

Now that the team has established a possible link between a bath in the Dead Sea and lowered blood glucose levels, they are attempting to secure funding to conduct additional testing and determine whether a daily soak across a three week period would have an even greater effect.

Dr. Sukenik’s research team will publish its findings in HaRefua, the journal of the Israel Medical Association. It is unlikely that a swim in the Dead Sea, even if conducted daily over a period of several weeks, could replace insulin injections or frequent monitoring of blood glucose levels. However, any treatment method that can ease the burden on Type 2 diabetics is worth researching.

Swimming in the Dead Sea is a tradition in Israel, where locals and tourists alike flock to enjoy a relaxing soak. The high salt content of the water — much higher than that of the ocean — means that it’s hard to actually swim, and “floating” is a more accurate description. Many believe that the waters are rich in nutrients and minerals and thus offer healing properties. Additionally, the low pollen and allergen content of the area, along with high atmospheric pressure and reduced ultraviolet component of the sun’s rays have made it a popular spot for treatment of many conditions.

Some of the therapies used at the Dead Sea include thalassotherapy (bathing in seawater for healthful benefits), heliotherapy (using the sun’s rays as a type of treatment), and climatotherapy (using the climatic characteristics of an area, such as barometric pressure, temperature, and humidity as treatment). Some other conditions that are frequently treated at the Dead Sea include cystic fibrosis, psoriasis, osteoarthritis, and rhinosinusitis.

When it comes to texting, teenagers out-type every other age group by a long shot, with some sending thousands of text messages every month. But what if this activity could be used to help teens lose weight? One study aimed to find out whether text messages could be used to promote positive weight management activities in overweight teens, discovering that such at-risk teenagers felt reassured by positive messages but disliked deeper questions.

Overweight and obese teenagers are a difficult demographic to reach. Weight loss interventions typically have trouble making a difference in their lives as the teens have difficulty adapting to healthier habits in diet and exercise. A research team at the University of Michigan believed that using text messages might be helpful in encouraging overweight and obese teens to make healthier choices. Text messages have previously been used to help individuals overcome other bad habits.

The research team, which published its results in the journal Obesity, conducted its study with four focus groups of 24 teens, both male and female, who were participants in weight management programs. The research team tested six types of text messages for effectiveness, including messages tailored to the individual, healthy eating ideas, targeted tips, testimonials, feedback questions and questions that encouraged introspection on the part of the teens.

The teens were interested in the messages overall, but less excited about certain aspects: they enjoyed the meal and recipe ideas as well as the testimonials, but only when those messages were coming from other teenagers.

The participants favored positive messages with some uses of texting trends such as emoticons. However, certain colloquialisms, such as “LOL,” failed to make a good impression. In addition, any mention of unhealthy foods was not looked upon favorably, even if they were mentioned in the context of discussing healthier choices; even the suggestion of those unhealthy foods might have caused cravings for those foods.

Researchers experimented with broad questions that encouraged self-reflection and introspection, but they did not garner a positive response. Some texts featured several such questions in a row, such as “What does being healthy mean for you? How does screen time fit in with your goals? How could cutting back on it help improve your health?” The teens felt that there were too many questions and weren’t sure which ones they should answer first. When the teens discussed the questions with researchers, they said that they simply wanted to have healthy habits outlined for them instead of having to devise their own diet and exercise systems.

The teens’ reluctance to develop their own plans surprised the researchers, since some studies have shown that people who make their own behavior modifications are more likely to stick with them than if they’re simply being told what to do. However, the researchers noted that the length limitations of text messages may have hindered the progress that those types of questions could make.

According to the research team, their next goal is to conduct additional research to determine if the messages could actually contribute to positive changes in diet and exercise habits along with actual weight loss in overweight and obese teenagers.

Child and teen obesity began a dramatic increase in the 1990s and has climbed to frightening levels. Over 30 states in the United States have child and teen obesity rates above 30%.

Diabetics who receive their prescription medication through the mail have higher rates of adherence to oral diabetes medications, according to a study published in the Journal of Medical Economics.

“This is the first study to show that mail service can help Medicare Part D members achieve better adherence with their diabetes medications,” said Jacqueline Kosecoff, PhD, CEO of OptumRx, in a press release. “Improving adherence has been shown to prevent the worsening of disease outcomes, decrease the use of health resources and control escalating health care costs.”

Adherence is defined as “the extent to which a person’s behavior [in] taking medication corresponds with agreed recommendations from a health care provider,” according to the World Health Organization.

The study, conducted by Prescription Solutions by OptumRx, was a retrospective cohort study that analyzed medication adherence in Medicare Part D beneficiaries who had been diagnosed with diabetes. The team at Prescription Solutions used the data to determine if there is an association between increased medication adherence and the delivery of medication to the patients’ homes through mail-order pharmacy.

Researchers used Prescription Solutions data on pharmacy claims for 22,546 patients; 89% of the patients were 65 or older. The team excluded patients who treated with insulin or exenatide (Byetta and Amylin), those who received low-income subsidies, and those who were taking anti-depressant or anti-dementia drugs during the research period. The group was then divided into two cohorts — one composed of patients who only filled prescriptions at retail pharmacies and the other composed of patients who only received their medications by mail from Prescription Solutions.

The press release from OptumRx states that adherence to antidiabetes medications, including metformin, thioglitazones, and sulfonylureas, was measured by the proportion of days covered throughout the year 2009. Among the diabetic patients in the study, 41.6% achieved good adherence, with the average proportion of days covered being 0.60. When the researchers compared the patients who received medication through the mail versus those who filled prescriptions at a pharmacy, the mail-order patients showed a significantly higher number of days covered at 0.68 versus 0.57. The patients who used mail-order pharmacies achieved a higher adherence percentage at 49.7% versus the 42.8% of retail pharmacy users who achieved good adherence.

“Medication adherence is a multi-faceted problem that requires a multi-faceted approach,” said Brian K. Solow, MD, chief medical officer of OptumRx. “Our study provides convincing evidence that mail-order pharmacy would be one way to help improve adherence for patients with chronic diseases.”

Failure to achieve medication adherence can put patients at greater risk of developing complications associated with their conditions, especially those suffering from chronic conditions. Poor adherence can result in worsening of the condition, death, and increases in the cost of health care. Of the medication-hospitalizations that occur in the United States, approximately 33% to 69% of them occur because of nonadherence to a prescription plan. Unfortunately, it can be difficult for physicians to detect such nonadherence.

Some ways that physicians can monitor medication adherence include determining the rate of prescription refill, measuring physiological markers such as the levels of a metabolite in the blood, counting pills, directly observing the patient taking the medication, and asking the patients to keep track of their dosages, such as with a medication diary. Data has shown that adherence rates are inversely proportional to the frequency of dosing; in patients taking medication that required four doses daily, adherence rates fell to about 50%.

Type 2 diabetics don’t always receive advanced warning that they are about to lose consciousness from a drop in blood glucose levels. Common symptoms of passing out include sweating, tingling or numbness in the face, a feeling of intense hunger and heart palpitations. But in patients who have lived with diabetes for a long period of time, the symptoms aren’t always present before an episode. Performing a finger prick test is still the most reliable way to determine if blood sugar levels are dropping too low.

However, that may change within a few years. Research has shown that a diabetic’s sweat pattern undergoes changes when blood glucose levels drop too low. Now a sweat meter developed jointly at the University of Olso in Norway and the National Hospital may be able to monitor sweat patterns to determine irregularities in blood glucose levels and send an alert via text message before the patient suffers an attack.

Better yet, the sweat meter could supercede finger pricking as the primary mechanism for quickly testing blood glucose levels in diabetics. “The advantage of the sweat meter is that the patient doesn’t have to prick themselves,” said Professor Ørjan G. Martinsen with the Department of Physics at the University of Oslo. “All you need to do is paste an electrode on your skin.”

“We envisage that the device will be able to measure sweat activity continuously, providing an indication of whether the patient is about to experience low blood sugar,” said Christian Tronstad, a medical technology researcher at the Oslo University Hospital. “It can communicate directly or via a smartphone. The warning system will then not be very bothersome for the patient.”

The project is being supported by the Norwegian Diabetes Association. Researchers are now conducting studies to determine if changes in sweat patterns can be viable indicators of dangerous blood glucose levels. “In the study we will compare the continuous measurements of sweat activity and blood sugar in patients to see if we can get a good enough warning of a low sugar level in the blood,” said Tronstad.

Kåre Birkeland, head of the medical council of the Norwegian Diabetes Association, believes that the sweat meter holds exciting possibilities in streamlining blood glucose testing and providing advance warning of attacks from low blood sugar for diabetics. “It can be developed into a practical, usable device that can help those who have a hypo when their blood sugar gets too low. The patient can then take the necessary precautions,” said Birkeland.

The sweat meter was actually developed to diagnose hyperhidrosis, or a condition that causes excessive sweating. It sends a small electrical current through the outermost layers of skin, which moves into the sweat glands and then returns to the surface of the skin. When the skin has sweat on it, the electrical current reacts to its salt content and notifies the meter that sweat is present on the skin.

Professor Martinsen leads a team that is at the forefront of research dealing with the electrical properties of the skin. Martinsen has worked for over 20 years with Sverre Grimnes, professor emeritus of medical technology at the University of Oslo, on researching and studying bioimpedance, or the electrical resistance properties of biological tissues. The research team calls itself the Bioimpedance Group; they have started a scientific journal to present their findings.

A new study conducted by Durham University in the United Kingdom has produced findings that may result in finger prick tests for diabetes being performed along with other unrelated exams, such as eye examinations. The researchers found that diabetes testing in unconventional settings, such as with opticians, dentists, and chiropodists could help to diagnose millions of individuals who are living with Type 2 diabetes but are unaware of their condition for various reasons, such as a lack of visits to their general practitioner physicians.

According to the researchers, earlier diagnosis of diabetes could help patients to manage the disease better; diabetes is the leading cause of blindness among the population at working age. The early detection of diabetes through this kind of testing could lower diabetes treatment costs for the U.K.’s National Health Service.

The number of diabetics worldwide is estimated to be about 150 million, but up to 50% of diabetics are thought to be undiagnosed, which could lead to more severe complications when actual diagnosis does occur.

Previous research has shown that health care professionals who do not normally conduct diabetes testing such as pharmacists and chiropodists can conduct simple blood tests that identify whether the patient has Type 2 diabetes. According to the researchers, even dentists have the capacity to perform such simple tests while patients are already in the office, eliminating the need for a separate doctor visit just to test for diabetes.

The study was conducted by Durham University and the James cook University Hospital in Middlesbrough; it was published in the British Journal of General Practice. Though the study examined the possibility of conducting diabetic testing at various doctors’ offices, it focused primarily on the possibility of conducting them at optometrists’ offices.

The researchers analyzed 1,000 participants who were visiting their opticians for eye tests. Of the patients who had risk factors for diabetes, such as a high body mass index (BMI) or an age over 40, about 32% of them were referred to their general practitioner physicians to be checked for diabetes after simple blood tests were conducted at the optician’s office.

Since most diabetes screening is conducted in medical settings by general practitioners, and many individuals do not see their GPs regularly enough to engage in effective preventative care, the inclusion of blood glucose testing as a part of non-medical checkups may aid in detecting diabetes in these patients.

“Charities’ campaigns have managed to reduce the proportion of people with undiagnosed diabetes but there is still a ‘hard-to-reach’ group who remain undiagnosed,” said Dr. Jenny Howse, a former optician with the Durham University School of Medicine and Health and lead author of the study. “Opticians could provide routine, non-emergency care and the simple screening can be done outside usual medical settings, such as GP surgeries.”

The finger prick tests conducted in the study were random capillary blood glucose (rCBG) tests. They were conducted on patients who had one or more risk factors for diabetes. If the patient’s blood glucose level was elevated, he or she was advised to visit a GP for further testing.

“The screening test is less invasive and time consuming than fasting blood glucose and oral glucose tolerance tests,” said Howse. “Already pharmacists and chiropodists have shown it is feasible to offer screening in their practices, here in the UK as well as in Australia and Switzerland. In the US, 60 per cent of adults visit dentists at least once a year for standard check-ups and those practices could be suitable locations to screen for diabetes.”

A prespecified analysis presented at the 2011 Congress of the European Society of Cardiology (ESC) suggests that treatment with eplerenone drastically reduces the likelihood of cardiovascular mortality or hospitalization from heart failure in patients who have risk factors such as renal compromise and diabetes.

The trial treated patients who had suffered NYHA class 2 systolic heart failure with eplerenone, an aldosterone blocker. A control group was treated with a placebo in addition to standard medication prescribed for heart failure. The rates of mortality fell sharply in the patients treated with eplerenone.

“So, overwhelmingly the data are positive,” said co-principal investigator Dr Bertram Pitt, with the University of Michigan School of Medicine in Ann Arbor. Dr. Pitt presented the findings of the study.

“The diabetics, those with renal disease, the elderly, and the low ejection fraction and low blood-pressure [subgroups] all showed the same efficacy, more or less, and the same safety,” said Pitt. “We saw an excess of hyperkalemia [potassium >5.5 mmol/L] . . . and less hypokalemia, but there was less serious hyperkalemia [potassium >6.0 mmol/L], no significant excess of hospitalization for hyperkalemia or renal disease, and not a single patient that we know about died due to hyperkalemia on eplerenone. So to us, the data are pretty straightforward and pretty compelling for the use of eplerenone in patients with NYHA class 2 heart failure.”

The primary results of the trial were presented at the American Heart Association 2010 Scientific Sessions. It was conducted on 2737 randomized patients who had experienced mild heart failure and had an LVEF (left ventricular ejection fraction) of greater than 30 percent. The trial had not even run its projected course when it was halted because it became clear that eplerenone imparted a significant benefit in the health of the patients. At that point, patients who had been receiving eplerenone had shown a 24 percent reduction in cardiovascular death and a 42 percent reduction in heart failure hospitalization compared to the control group that was receiving placebo.

Hospitalization is a very important factor in those who have been hospitalized for mild heart failure. Future hospitalizations are a strong indicator of the progression of the condition and the health of the patient.

“…For patients with mild heart failure, hospitalization really matters — really matters for survival, for the progression of the disease, and for quality of life,” said Dr Piotr Ponikowski of the Medical University, Clinical Military Hospital in Wroclaw, Poland. Ponikowski served as the discussant after Dr. Pitt’s presentation of the trial’s findings.

Dr. Pitt believes that aldosterone blockers such as the eplerenone studied in the trial are underused in the West. Physicians are cautious in prescribing them to heart failure patients who also have renal disease.

“Paradoxically, heart-failure patients with renal disease are among the highest risk, so physicians are overly cautious, and they get the worst treatment,” said Pitt. “You have people at very high risk.” Pitt believes that aldosterone blockers will soon become more commonly recommended in heart failure patients and diabetics since it does not have as many side effects as spironalactone:

“After this, we think they should say specify that you should use eplerenone, at least in the diabetic subset, because there’s good data now that spironolactone in diabetes makes endothelial function worse–it raises hemoglobin A1c, raises cortisol, and reduces adiponectin–whereas eplerenone does not.”

Insulin glargine is an analog for human insulin, meaning that it is an altered form of insulin not produced by the human body, but still able to be used by the human body in a way similar to actual insulin. In the United States, insulin glargine is marketed by Sanofi-Aventus under the name Lantus. When used to supplement human insulin production, it is released in small concentrations over a 24 hour period into the blood, which means that it can be taken once a day for long-lasting insulin management

Insulin glargine functions over time because it contains a modified domain that prolongs its interaction with the insulin-like growth factor-I receptor, or IGF-IR. However, many types of cancer patients show an overactivity of IGF-IR, leading some to believe that use of insulin glargine may be associated with the development cancer if it is continually interfacing with IGF-IR. But is there any truth to that hypothesis?

Researchers conducted 11 in vitro studies on human and mice cells to determine whether insulin glargine might cause the mitogenesis, or cell growth, of cancerous cells. The results showed that the insulin glargine promoted mitosis in 5 malignant cell cultures as well as one nonmalignant culture. Insulin glargine, overall, had a 10 percent to 60 percent greater mitogenic effect than regular human insulin.

Five more studies were conducted to investigate the risk that insulin glargine may have in causing cancer in humans. One study showed that treatment with insulin glargine alone was associated with a slightly higher risk of cancer in patients who had been diagnosed with Type 2 diabetes, with those receiving greater doses being more at-risk.  However, a later analysis of the results that was adjusted for age and sex to ensure the objectivity of the results actually showed that insulin glargine had a protective effect on the study participants. The results were controversial and were heavily debated; however, three more studies were conducted which did not appear to show any increased risk of cancer from regular insulin glargine treatment.

The fifth and final study did find that female patients treated with insulin glargine alone appeared to show an increased risk for breast cancer compared to patients who had been treated with both insulin glargine and human insulin. Again, the findings of this study were the subject of debate as the authors did not take into consideration other risk factors for breast cancer, so the apparent increased risk of breast cancer may have simply been the result of random fluctuations in frequency. The authors came to the conclusion that the data did not provide a strong enough link to prove a causal relationship between insulin glargine use and the development of cancer compared to other types of insulin-based therapies.

The Food and Drug Administration released a new safety announcement in January 2011 regarding their review of insulin glargine and any possible links to cancer. The FDA determined that the evidence so far has been inconclusive since the studies and their methodology were questionable. However, the FDA continues to work with the medication‘s manufacturer as well as the Department of Veterans Affairs to determine whether there is a risk of developing cancer associated with the use of insulin glargine.

The American Diabetes Association, The American Association of Clinical Endocrinologists, the European Association for the Study of Diabetes, and the European Medicines Agency have all stated that there is currently no need for any change in the use of insulin glargine treatment.

A study led by an Indian-origin researcher and published in the journal Nature Genetics has discovered six new genes that may cause the early onset of Type 2 diabetes in South Asians — those of Indian, Pakistani, Sri Lankan and Bangladeshi origin.

The study’s findings may provide new leads for scientists as they try to discover new diagnostic tools that will help them prevent and treat Type 2 diabetes.

Those of South Asian descent may be at up to four times the risk of developing Type 2 diabetes as opposed to those of European ancestry. The disease leads to other severe complications such as stroke and heart disease.

The study was conducted jointly by researchers around the world. They analyzed the DNA of 18,731 individuals who had been diagnosed with Type 2 diabetes, along with a healthy control group of 39,856 non-diabetic individuals. The researchers analyzed the genetic makeup of the individuals to search for variations in the genetic code that appeared to be common among those who had been diagnosed with diabetes.

When the study concluded, researchers had identified six areas of the genetic code where a difference of a single letter was linked to the development of Type 2 diabetes. The findings suggest that the genes related to these variables may play a part in determining an individual’s likelihood of developing diabetes.

“This is the first genome-wide association study in South Asians, who comprise one-quarter of the globe’s population, and who carry a high burden of the disease and its complications, including heart attack and stroke,” said Professor Jaspal S. Kooner with the National Heart and Lung Institute at Imperial College London. Kooner, the lead author for the study, said: “We have shown that the genetic variants discovered here in South Asians also exist and contribute to diabetes in Europeans. Our studies in Asians and European populations highlight the importance and gain in examining the same problem in different ethnic groups.”

Dr. John Chambers with the School of Public Health at Imperial College London was the senior author of the study. “Type 2 diabetes is more common in South Asian populations than any other ethnic group, but the reason for this increased risk is unclear,” said Chambers. “Although lifestyle factors such as unhealthy diet, physical inactivity and obesity are important causes of diabetes in South Asians, these are only part of the explanation. Genetic factors have been widely considered to play a role in the increased risk of type 2 diabetes in Asians, but to date have not been systematically explored in this population.”

“Our study identifies six new genetic variants linked to type 2 diabetes in South Asians. Our findings give important new insight into the genes underlying of diabetes in this population, which in the long term might lead to new treatments to prevent diabetes,” continued Dr. Chambers.

According to a research article published in 2007 in the British Journal of Diabetes and Vascular Disease, South Asians have a one in three chance of developing Type 2 diabetes over the course of their lives. Those who develop diabetes are also diagnosed with the disease ten years earlier than Europeans, on average. Not only does diabetes incur a greater social and economic burden on South Asians, but they suffer higher fatality rates from cardiovascular and renal disease as a result of their higher rates of diabetes. About 55 million South Asians worldwide are affected by diabetes, with that number projected to rise to 80 million by 2030.

The obesity epidemic is growing daily; worse, it seems to be accelerating. With the increased numbers of overweight and obese people comes a higher risk of those people suffering health complications associated with obesity, such as Type 2 diabetes. Research teams around the world are attempting to identify body processes that could be targeted by therapeutics to reduce appetite and therefore reduce obesity. One such research team, led by Scott Waldman with the Department of Pharmacology and Experimental Therapeutics, Division of Clinical Pharmacology at Thomas Jefferson University in Philadelphia, has identified a new potential target for therapeutics in their work with analyzing the mechanisms that control appetite in mice down to the molecular level.

In studying mice, Waldman’s research team discovered that when they took in nutrients from food, the cells of the gut released a precursor to a hormone known as uroguanylin (prouroguanylin). The precursor is secreted in the blood and travels through the bloodstream to the brain where it is converted to uroguanylin in the hypothalamus, a region of the brain that has been associated with a decrease in appetite. Once the uroguanylin is active, it binds to receptor proteins called GUCY2C receptors on the outside of nerve cells. The binding begins a process that signals to the mouse to decrease its food intake.

Waldman’s team showed that disrupting GUCY2C expression in mice impaired their normal appetite cycles by reducing satiation. When the pathway was interrupted and mice no longer felt full from eating, they engaged in hyperphagia — overeating. Unsurprisingly, this caused the mice to become obese and develop associated complications such as metabolic syndrome. This uroguanylin-GUCY2C pathway had been previously unrecognized.

According to Waldman and his research team, the findings show that it may be worth developing therapeutics that target the uroguanylin-GUCY2C pathway in order to control appetite and therefore reduce obesity and all the health complications that commonly accompany it, such as Type 2 diabetes. Randy Seeley and Matthias Tscöp of the University of Cincinnati, in an accompanying commentary, agreed with Waldman’s suggestion that this pathway be targeted for reducing obesity.

The article that accompanies the findings states that “Intestinal enteroendocrine cells are critical to central regulation of caloric consumption, since they activate hypothalamic circuits that decrease appetite and thereby restrict meal size by secreting hormones in response to nutrients in the gut.” By targeting the hormones and processes involved in these hypothalamic circuits, the team has hopes that scientists may be able to produce therapeutics that activate the pathway and make people feel satiated by eating less food, which would work towards reducing obesity.

The team called obesity a pandemic in their paper, citing that it affects more than 300 million adults worldwide and is accompanied by an array of comorbidities including endocrine, metabolic, and oncologic diseases and decreased life expectancy. The economic burden of obesity, according to the researchers, exceeds $100 billion per year, and decoding the neural pathways that exist between the stomach and the brain may lead to treatments that control appetite and limit metabolic diseases such as diabetes.

The team’s findings are published on August 25, 2011 in the Journal of Clinical Investigation. The studies were supported by grants from the NIH and from Targeted Diagnostics and Therapeutics. Scott Waldman is the Samuel M.V. Hamilton Endowed Professor at Thomas Jefferson University.

Scientists are currently performing tests on a new drug that may lead to the end of insulin injections for Type 1 diabetics. The drug is being developed with the intention of stopping the process that causes the immune system to attack the pancreas in patients with diabetes.

Intended for use with those newly diagnosed with Type 1 diabetes, the medication will halt the progress of the disease by preventing the destruction of the insulin-producing cells of the pancreas. The creators of the drug intend to have it ready for use by patients within three years.

According to the scientists working on the drug’s development, it will help Type 1 diabetics in continuing to produce some of their own insulin. In time, the drug may help the pancreas to recover completely and produce enough of its own insulin to support the patients without insulin injections. Since the pancreas will be producing its own natural insulin, the drug will also reduce the risk of side effects that commonly appear with regular use of synthetic insulin, including kidney disease, stroke, and heart disease.

Clinical trials on the drug’s effectiveness and possible side effects are being conducted at 140 research centers in the United Kingdom. King’s College Hospital in London is one of the facilities involved in the study. The trials are also being conducted in other countries in Europe, North America, and South Africa, and in Israel.

“We have proved in earlier trials that our compound stops the immune system attacking the pancreas,” said Dr. Shlomo Dagan of Andromeda Biotech, an Israeli biotechnology firm. “There is evidence to suggest that using the drug over a period of time, maybe a couple of years, will allow the pancreas to recover enough to make more insulin. In that situation the patient could stop injecting insulin.”

“The research on this shows it may well be possible that patients could cope without the need for any insulin injections,” said Dr. Eleanor Kennedy, spokeswoman for the Juvenile Diabetes Research Foundation. “This is very exciting,” continued Kennedy.

Type 1 diabetes is caused by a malfunction in the immune system which causes it to attack the pancreas, destroying insulin-producing pancreas cells that manage blood glucose levels. If the condition is left untreated, blood glucose levels rise to dangerously high levels.

Type 1 diabetics require regular injections of insulin to supplement their own lack of insulin due to the destruction of pancreatic cells. If a Type 1 diabetic does not receive insulin, he or she will enter a coma and die. The new medication being developed, temporarily called DiaPep277, prevents the immune system from destroying the insulin-producing pancreatic cells, allowing the body to make enough of its own insulin that injections are not required. The medication is made from a protein known as a long-chain heat-shock peptide and was first developed by professor Irun Cohen at the Weizmann Institute in Israel.

Type 1 diabetes affects nearly 250,000 people in the United Kingdom; in the United States, that number rises to about three million. Type 1 diabetes differs from Type 2 diabetes in that the former is typically diagnosed in childhood and the latter is developed later in life and is typically caused by obesity. Type 1 diabetics receive injections of synthetic insulin to manage their blood glucose levels as their bodies are unable to produce insulin on their own. Both types of diabetes are very costly to the public, costing millions in treatment every year.