Friday, February 3, 2012

Can Type 1 Diabetes Be Reversed?


Can Type 1 Diabetes be reversed?

I sure hope so. But we all got more disappointing news this week.

Unlike the more common Type 2 Diabetes, Type 1 Diabetes is an autoimmune disease. Type 1 Diabetes had been called juvenile onset diabetes but Type 1 Diabetes can start at any age. So the term Type 1 is used now.

About 5% of people with diabetes have Type 1 Diabetes.
Insulin injections are required for control of blood glucose and insulin is needed for survival.

Type 1 Diabetes is a challenging disease to treat.
Type 1 Diabetes is a challenging disease to live with.

Type 1 Diabetes is caused by destruction of the insulin producing cells.
These beta cells are attacked by the immune system.
Studies performed to see if Type 1 Diabetes can be reversed are typically focused on reducing the immune attack on the beta cells.

These studies on Type 1 Diabetes involve people with Type 1 Diabetes who have been recently diagnosed.
Early on, after diagnosis of Type 1 Diabetes, the pancreas is still making some insulin. But years after the diagnosis, most people with Type 1 Diabetes make virtually no insulin.
At that point, there are very few of those beta cells left. Most are destroyed by the continuing attack from the immune system.

The aim in these trials of Type 1 Diabetes is to help the beta cells continue to make insulin.

Our site participated in a previous trial for newly diagnosed persons with Type 1 Diabetes. 
Sadly, that trial failed. We were all so very disappointed: our staff, the study participants, all others with Type 1 Diabetes and the company.

But all of those in the medical community and those with diabetes continue to hope that a safe effective treatment might keep insulin production going for those with Type 1 Diabetes.

Maintaining some of the body’s own insulin secretion can be very helpful. Control of the blood glucose is easier. And better control means a lower risk of diabetes related complications, like eye, nerve and kidney problems.

Sure we would all wish for normal sugars without the need for any insulin injections. That  would be  a cure for Type 1 Diabetes. But stopping the immune assault  on the beta cells would help continue some insulin secretion. Some insulin secretion is better than none, as long as the treatment is relatively safe.

And now our site is  participating in another study for recently diagnosed Type 1 Diabetes. This study involves adults only. We hope that this will bear fruit. The data thus far are quite promising. But as I said, we've been disappointed before! We can still hope and continue the research.
You can learn more about this international, multi-center trial here.

Until those results are in, keeping blood sugar under excellent control is the way to go.
There is no question that excellent blood glucose control helps beta cells make more insulin.

And now there are  better tools to help people with Type 1 Diabetes get under good control with a low risk of hypoglycemia.

Endocrinologists can offer our patients continuous glucose monitoring systems, insulin pumps and insulin treatment with better insulin.

There are clearly smart ways to use insulin. And there are not so smart ways.
We advise patients to "take it like you make it".
In other words, insulin is best used in the way the pancreas might normally make insulin.
See a previous post to learn more about taking insulin sensibly.

Please stay in control. Stay in touch. And feel free to leave a comment or question.

Your Diabetes Endocrine Nutrition Group



2 comments:

  1. Do you feel that an insulin pump offers better control than a combination of Lantus and Humalog? What does the research show?

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  2. Many patients can get excellent control with a treatment program using mealtime insulin and basal insulin such as that with Humalog and Lantus. For those who cannot despite their best effort, insulin pump therapy often is very helpful. So the short answer is: it depends on the individual. Sometimes pump therapy does not offer much more benefit. But often it is better than multiple daily injections. The research is consistent with this conclusion.

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