We R the Cure

Seeking Cures and Cheating Destiny


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Chance Chat At Work Leads to Blog Revival: Quantum Cascade Laser Tests Blood Sugar Without Finger Pricks

Happy New Year to all my Type 1 diabetes friends and #DOC community. After a long, long blogging vacation … I’m back to writing again thanks to a chance chat with a colleague at work today.

Princeton Researchers Use Lasers to Measure Blood Sugars

Members of the research team test the new laser system. Images courtesy of Frank Wojciechowski/Princeton University.

It was a completely unscripted meeting. As I was in the men’s restroom testing my blood sugar at work, Jonathan walks in, sees me and my bright red blood spot on my test strip. Then he asks: how many times a day did I ” prick my finger” for a blood drop to test my glucose. My normal answer: 8 to 10 times a day. Then I stop myself wondering if we’ve got a connection?

After a few soundbites about testing, insulin pumps, CGMs and all the standard stuff from me — Jonathan pauses and says: “Before I came here I was working in a research group at Princeton that is working to use lasers to accurately measure blood sugar without needing a finger prick,” he said.

Dramatic pause. The sound you heard is my jaw dropping and hitting the bathroom counter. First time I’d ever heard this possibility. The possibility of fewer finger pricks for blood testing is a dream for all of us T1Ds. Wave a magic wand or light beam over your finger and the BG results sync up with my soon-to-be-real Artificial Pancreas closed-loop technology!  Wow, my mind is now racing and I’m back in the blogging game. Here’s the link to the full story. Read it and let me know if you’ve heard of this research?  Together, We R the Cure for Type 1 diabetes and its serious medical complications!!

A team from Princeton University has developed the new technique, which measures blood sugar by directing an IR quantum cascade laser at a person’s palm. The laser light is partially absorbed by sugar molecules in the patient’s body; the amount of absorption is used to measure the level of blood sugar.

According to the researchers, the results indicated that the laser measurement readings produced average errors that were somewhat larger than standard blood sugar monitors, but remained within the clinical requirement for accuracy. In measuring blood glucose levels, readings must be within 20 percent of the patient’s actual blood sugar level. The new system has demonstrated 84 percent accuracy.

“We are working hard to turn engineering solutions into useful tools for people to use in their daily lives,” said Claire Gmachl, the Eugene Higgins Professor of Electrical Engineering and the project’s senior researcher. “With this work we hope to improve the lives of many diabetes sufferers who depend on frequent blood glucose monitoring.”


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Is anyone using Joslin HypoMap App? Are self-management technologies future of diabetes care?

An open question to my peers in the #DOC : I’m wondering if anyone is using the Joslin HypoMap software App?  Is any of the cost covered by healthcare insurance? What are the early results from users?

diagram of the HypoMap App developed by Glooko and Joslin Diabetes Center.

Diagram of the HypoMap App developed by Glooko and Joslin Diabetes Center.

 

The app is included in this must read update about translational technologies from the Joslin Diabetes Center :

JITT doesn’t plan to introduce any new technology to the market themselves. “We are not technology,” says Harry Mitchell, executive director of JITT. “We are the know-how. We are the clinical solutions that strive to make technology better to improve the lives of people with diabetes.”  A nationwide shortage of endocrinologists, diabetes nurse educators, and adult diabetes care centers has burdened the healthcare system and impacted timely patient care. Howard Wolpert, M.D., director of JITT, believes the future of medicine, particularly diabetes care, must begin with self-management technologies.

DiaTribe Report of HypoMap.

http://blog.joslin.org/2014/09/molding-the-future-of-diabetes-technology-with-the-joslin-institute-for-technology-translation/#more-5365


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ViaCyte begins clinical trial of diabetes treatment derived from stem cells; 40 people are needed for the trial

ViaCyte is developing a drug delivery system that enables implanted pancreatic progenitor cells to survive and differentiate into functioning insulin-producing islet cells.

Graphic showing ViaCyte encapsulated cell therapy for Type 1 diabetes clinical trials

View of ViaCyte’s encapsulated cell therapy packet. Stem cells will produce insulin and other hormones to better control blood glucose levels in persons with Type 1 diabetes.

UC San Diego said Tuesday it is hosting the Phase 1 trial in partnership with San Diego-based ViaCyte. The biotech company grows islet cells from human embryonic stem cells. The cells are placed into a semi-permeable envelope and implanted into the patient. In animals, the stem cells mature into islet cells, successfully controlling blood sugar.

The treatment could provide what the company calls a virtual cure for Type 1 diabetes, which is caused by a lack of insulin-producing “islet” cells in the pancreas. About 40 people are being sought for the trial.  The number to call for more information on the diabetes clinical trial is 858-657-7039.

I encourage you to read this article — This is why We R the Cure.  We need more public and private dollars for cutting-edge high tech research and we need more PWDs ( Persons With Diabetes) to enroll in clinical trials and encourage others to do the same.

http://www.utsandiego.com/news/2014/sep/09/viacyte-clinical-diabetes-stem-cells/

 


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JDRF Research News: Specific Protein May Help Beta Cells Survive in Type 1 Diabetes

JDRF-funded researchers find therapeutic potential of MANF protein to reduce beta cell stress in type 1 diabetes.

Image for Diabetes Advocates

I am a diabetes advocate. We R the Cure is a blog site dedicated to the persons living with Type 1 diabetes and the clincial researchers who are making positive things happen in our journey to a cure.

In the healthy pancreas of someone without type 1 diabetes (T1D), the hormone insulin (essential for turning food into energy) is produced, stored, and released in a normal “factory-like” process within pancreatic beta cells in response to glucose in the diet.

Early in the course of T1D, however, excessive or pathologic stress in beta cells compromises their ability to properly secrete insulin, triggering a cascade of events ultimately contributing to the beta cell death. Over the past several years, JDRF-funded researchers have found evidence that beta cell stress may play a role in the onset of T1D, and are exploring possible ways to stop it from occurring, thus potentially protecting beta cell health and maintaining normal beta cell function.

In April, JDRF-funded researchers in Finland released new findings in the journal CellPress that add another piece to the puzzle of beta cell stress and T1D.

Post comes from News release published at  http://www.jdrf.org.


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Mathematics, Mary Tyler Moore and Standard Deviation, Part 2: Looking for the Type 1 Auto Pilot Easy Button

One of the all-time great movie quotes, from Airplane circa 1980s, actually fits perfect for persons living with Type 1 diabetes who keep looking for a qualified pilot or Auto Pilot “Easy Button” to help them fly safe and keep their complex human body on course:

Photo of Auto Pilot Easy Button to push for diabetets control

Managing Type 1 diabetes is like flying a complex jet airplane. What we need is an Auto Pilot Easy Button to keep us flying level and safe.

“All right, Striker, you listen, and listen close. Flying a plane is no different from riding a bicycle; it’s just a lot harder to put baseball cards in the spokes.”

The more you know about your own diabetes, the less you understand. The more time you spend managing your diabetes, using the latest technology tools, aiming for a lower A1c and a lower Standard Deviation, logging in and learning from the Diabetes Online Community (DOC) — the less you actually comprehend about a chronic disease that is, actually, almost impossible to control. There is no Auto Pilot button in the T1D cockpit.

In the first four months of 2014, I’ve been hyper-focused or rededicated to my diabetes management. Thanks to my new tech partner, the Dexcom “Studio” reporting app, I’ve been monitoring my hourly, daily and weekly trends, adjusting basel and bolus rates based on pattern or trend lines,  and charting my own “success report” or flight plan.  Of course, a true “success report” for Type 1Ds would show a TAB that says: “CURED.” Sorry, but I have not found this category yet on the Dexcom app.

If you’re looking for good news, here it is: My quarterly check up in April produced my best A1c number in almost 2 years — a 7.5 A1c! This is down from my 7.8 A1c in January, and my better-than-average result also produced a Standard Deviation number of 51 for April — way, way down from my Feb/March SDs in the high 60s.  I am thrilled with the current trend line and I better understand how hard work, diet and exercise, paying attention to the mathematics of diabetes and some luck produces better blood glucose control and fewer serious medical complications. This cause-and-effect was established in  the landmark DCCT study done more than two decades ago. The Diabetes Control and Complications Trial (DCCT) showed that keeping blood glucose levels as close to normal as possible slows the onset and progression of the eye, kidney, and nerve damage caused by diabetes. In fact, it demonstrated that any sustained lowering of blood glucose, also called blood sugar, helps, even if the person has a history of poor control.

However, here’s where the mathematics, Mary Tyler Moore and standard deviation come back into the story:

How can anyone spend 24/7, 365 days a year — every year for the rest of my life — working this hard at a full-time job that brings with it no pay, no days off, no miracle cures,  and the uncertainty that better blucose control– the goal is under 7.0  A1c — actually reduces medical complications?  As the Mary Tyler Moore TV theme song might actually ask: “You might just make it after all?”

Despite my recent well-earned success, my monthly and quarterly results still show that I’m still spending about 30% of my days ” out of my target” blood glucose zone ( 80 to 170) and, therefore, I still have not achieved true “control”  and may face potential health risks as I age.

Graph showing my Diabetes Glucose Control

My Dexcom Success Report shows better “In Target” results but shows I’ve still got a long way to go to achieve auto glucose control over my Type 1 Diabetes.

Here’s what my flight crew told me this month about my Type 1 Diabetes and how I’m doing on my journey toward better, healthier outcomes.

My Endocrinologist: “I don’t look for a certain standard deviation number, whether that’s 50 or lower. The key is to get the number as low as possible.  Your A1c is moving in the right direction but it needs to be lower.”

My Dietitian — first time I’ve met with one in 10 years. “People with Type 1 have all these numbers running around in their heads. They are constantly thinking about glucose numbers, A1Cs,  carbohydrates and is their trend line going up and down. I think it gets to be a little overwhelming at times. You should give yourself some credit because you are managing things that a person with a normal, functioning pancreas never thinks twice about. My glucose numbers may be the same as yours in a given day, but I don’t spend a minute thinking about it because my pancreas is doing it for me.”

My Dexcom Rep who is also a Type 1 diabetic — “The most important goal is more stable blood sugars. Our goal should be below 50. Even below 40. Our bodies like stability. There is a lot more to diabetes than just controlling one measurement or number. There are so many factors and stress is one of the biggest. If you have a good day and your numbers are improving, that’s a good thing. But some of this is really out of our hands.  We are humans after all.”

I turn to technology to help best manage my diabetes because my pancreas stopped making insulin almost two decades ago, and these advances in treatment have improved my quality of life immeasurably in some ways (emotional health) and very measurably in others (better blood sugar control). The technology we need now is the Auto Pilot Easy Button — or the Artificial Pancreas closed loop system. Push it and it’ll be almost like your pancreas is flying the plane again.


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Ending the A1C Blame Game: Reposting a “Must Read” From MD on Insulin Nation

Research Corner: Ending the A1C Blame Game (via http://www.insulinnation.com)

When glucose sensors first became available in clinical trials some 2 decades ago, I decided to wear a sensor to compare my glucose levels as a non-diabetic individual with glucose levels of my patients. I was excited to have this new tool, which measured…


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Are You Curious About ViaCyte’s Upcoming T1D Clinical Trials? Here’s More Information

Cross-Section Graphic of Viacyte's VC-01 Encapsulated Delivery System

The VC-01 combination product is expected to be implanted under the skin of the patient through a simple outpatient surgical procedure. The cells are then expected to further differentiate to produce mature pancreatic cells that will synthesize and secrete insulin and other factors, thereby regulating blood glucose, commonly referred to as blood sugar levels.

In the closing paragraph of my last blog post, I tried to strike a balance between hope and realism when describing ViaCyte’s VC-01 combination product and pending clinical trials aimed at a virtual cure for Type 1 diabetes.

The possibility/probability of successful clinical trials makes you anxious, optimistic, and fearful of another big letdown. It also leaves you with lots of questions. So I contacted ViaCyte to say “Thank You” for presenting at the JDRF Research Summit in Bethesda, MD last month  and asked a few follow-ups.  To my delight, I got an email response from a person named “Howard” at the San Diego-based company.

Q: How will you recruit or identify prospects for the upcoming clinical trials?

A: Currently, ViaCyte is still in preclinical development with our diabetes product VC-01; we are not conducting any clinical trials at present.  However, we do anticipate completing the necessary preclinical studies and filing an application with the FDA so as to be able to proceed with human trials sometime later this year.  Note that when the clinical trial starts, ViaCyte will adhere to Good Clinical Practice (GCP) guidelines, which preclude the Sponsor (ViaCyte) from having direct contact between clinical study subjects.

Q: How does the proprietary device ” KNOW” when and how much insulin to release?  Are the stem cells smart enough to automatically ” sense ” the amount of glucose in the body and respond in a measured fashion  just like a healthy pancreas does in non Type 1 Diabetics?

A: Yes, the cells contained in the device are smart enough to know when to secret insulin. Strictly speaking, the cells in the device are not stem cells. They are derived from stem cells but have undergone differentiation to a point where they are no longer considered stem cells. The most current information about our progress and technology can be found on our website.

Q:  Will clinical trial participants be required to take immunosuppressant drugs, and,  if this therapy works, will these drugs be required for the rest of the patient’s life?

A: At the present time we do not anticipate that any immunosuppressive therapy will be required, either during the clinical trial or at any time thereafter.

Q: Is there an age range for eligible human trial participants? If people are interested in the clinical trial or applying, how do they contact ViaCyte?

A: In our first clinical trial we anticipate that the age inclusion range will be from 18 – 55 years. Once clinical trials start, information on the location of clinical study sites will be available online at clinicaltrials.gov, the US government database of current clinical trials. Additionally, information should be available on our website once the trial is closer to launch.

Q: Finally, how will this implantable device actually cure my diabetes?

A: By acting essentially as a replacement endocrine pancreas, the source of insulin and other regulatory hormones produced in our bodies, ViaCyte’s VC-01 combination product has the potential to be a virtual cure for type 1 diabetes. The VC-01 therapy is the combination of:

  • PEC-01 cells: A proprietary pancreatic endoderm cell product derived through directed differentiation of an inexhaustible human embryonic stem cell line, and
  • Encaptra drug delivery system: A proprietary immune-protecting and retrievable encapsulation medical device.
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