Diabetes Treatment News
MU researchers pioneer animal diabetes treatment
Studies show the incidence of diabetes in dogs has increased 200 percent over the past 30 years. Now, University of Missouri veterinarians have changed the way veterinarians treat diabetes in animals by adapting a device used to monitor glucose in humans.
Dogs are susceptible to type 1, insulin-dependent diabetes. Affected animals are unable to utilize sugar in their bloodstream because their bodies do not produce enough insulin, a hormone that helps cells turn sugar into energy. Veterinarians treat animals with this type of diabetes similarly to the way humans are treated, with insulin injections and a low-carbohydrate diet.
Amy DeClue, assistant professor of veterinary internal medicine, and Charles Wiedmeyer, assistant professor of veterinary clinical pathology, have been studying the use of a “continuous glucose monitor” (CGM) on animals since 2003. A CGM is a small flexible device that is inserted about an inch into the skin, to constantly monitor glucose concentrations.
“Continuous glucose monitoring is much more effective and accurate than previous glucose monitoring techniques and has revolutionized how veterinarians manage diabetes in dogs,” said DeClue. “The CGM gives us a complete view of what is happening in the animal in their natural setting. For example, it can show us if a pet’s blood glucose changes when an owner gives treats, when the animal exercises or in response to insulin therapy.”
CGMs have become more commonly used in dogs with diabetes that are not responding well to conventional treatment. The monitor provides detailed data for glucose concentrations throughout the course of three days in a dog’s usual environment, so veterinarians can make better treatment decisions. Previously, veterinarians would have created an insulin regimen based on a glucose curve by taking blood from the animal in the veterinary hospital every two hours over the course of a single day. The glucose curve was often inaccurate due to increased stress from the animals being in an unnatural environment.
Dogs show clinical signs of diabetes similar to humans. Clinical signs include increased urination, thirst, hunger and weight loss. Typically, no direct cause is found for diabetes in dogs, but genetic disposition and obesity are thought to play a role in causing diabetes, according to DeClue. Just like people, dogs suffering with diabetes must be medically managed or complications can arise.
“Typically, dogs that are treated properly for diabetes go on to live a long, full life,” said Wiedmeyer.
“Actually, dogs with diabetes are similar to young children with diabetes but somewhat easier to manage. Dogs will eat what their owners give them at the same time each day and they won’t ask for a cupcake at a friend’s birthday party. With tools like the continuous glucose monitor to assist with disease management, the outlook is very good for a dog with diabetes.”
In the future Wiedmeyer projects that the device will become smaller and less invasive. In addition, he hopes device manufacturers develop a device that would monitor blood sugar levels remotely.
DeClue and Wiedmeyer’s most recent article on methods for monitoring and treating diabetes in dogs was published in the journal, Clinic in Laboratory Medicine.
Hospital to pioneer new diabetes treatment
Doctors from Hackensack University Medical Center hope to find a cure for diabetes as they embark on a partnership with one of the world’s leading researchers for the disease.
The hospital will be the first to try a procedure on humans with diabetes that is currently being tested on monkeys in Florida — a collaborative effort with Dr. Camillo Ricordi, a pioneer in the field and the scientific director and chief academy officer of the University of Miami Diabetes Research Institute.
“Dr. Ricordi wants to find a cure for diabetes, and he doesn’t care how many people are involved in the process or share in the credit,” said Dr. Michael Shapiro, Hackensack’s chief of organ transplantation and leader of the diabetes partnership. “This collaboration will do great things for diabetes research.”
Diabetes occurs when the body cannot produce or properly use insulin, a hormone that helps the body metabolize glucose into energy and control blood sugar levels.
With Type 1 diabetes, sometimes called juvenile diabetes and the most serious form of the disease, the body’s immune system destroys the cells from the pancreas that make insulin, called islets. People with Type 2 diabetes make insulin, but their body doesn’t utilize it correctly and production of it typically declines as they age. More than 25 million Americans have diabetes, and about 3 million of those suffer with Type 1.
Health care experts expect the number of diabetics to increase dramatically, as obesity can trigger Type 2 diabetes and Americans continue to get heavier.
Living for years with unregulated blood sugar levels can cause a myriad of symptoms, some as severe as blindness, poor circulation that leads to limb amputation, and kidney failure.
Typical treatment for diabetic patients includes insulin pumps, injections and oral medications. Transplanting islets from deceased donors is sometimes effective, but it frequently triggers other complications because the islets need to be implanted in the liver. The number of organ donors also falls way short of the number of diabetics who would benefit from a transplant.
In this latest study with monkeys, Ricordi loads islets on a disc and then implants them in the abdomen, rather than in the liver.
“The challenge is we’re dealing with an autoimmune disease so we have to replace or get cells to regenerate that were destroyed,” Ricordi told dozens of HUMC executives, physicians and health care workers this week. “And the key is to do this without a lifelong regimen of autoimmune rejection drugs.”
Based on the success with the primates, Shapiro is hoping to have four patients undergo the procedure in early 2012, though recruitment hasn’t begun. The ideal patients will be those who aren’t responding to other treatments.
Physicians attending the announcement highlighted Ricordi’s expertise and advances in treatment of the disease.
His creation, the Ricordi Chamber, is so well-known in the field that it was mentioned in a recent episode of the medical drama “Grey’s Anatomy.” Critical for a transplant, it is able to efficiently separate islets from the pancreas.
But successfully transplanting the islets will only be part one of the cure. Researchers need to figure out how to create islets in the lab so there will be enough to treat all diabetic patients who need them. Another research team is working on that endeavor in the Miami institute.
Still, the partnership has hospital executives determined and diabetic patients hopeful.
“I’m absolutely sure we’ll find a cure,” said Robert Garrett, president and chief executive of HUMC.
Stephanie Stone, who was diagnosed with diabetes at 10 and is now 18, attended the announcement with her Franklin Lakes, N.J., family.
“I’m optimistic for the future,” Stephanie said. “If this isn’t a cure, it sounds like it’s a better treatment before a cure is found.”
CeQur Develops Diabetes Compliance Device
An important drawback of current diabetes treatment regimens is patient compliance, particularly for insulin injections that are painful and must also be timely administered. CeQur has developed an innovative technological platform to address this concern, actualizing a minimally invasive wearable drug patch infuser that provides relatively painless, continuous subcutaneous delivery of insulin in basal doses, as well on-demand doses at the push of a button. The company’s minimally invasive subcutaneous route of drug administration precludes the use of the existing injection-based insulin regimens that are burdensome to patients due to their painful nature, which can significantly lower patient compliance. The company has shown through clinical trials that its technology accurately delivers insulin while improving patient comfort and compliance, and is currently waiting health board approvals.
Jim Peterson, CeQur President and CEO contends that insulin delivery devices and technologies are coming and will be a major help for people with Type II diabetes, a major help for them in overcoming the barriers to taking insulin properly and consequently living longer and healthier lives. “People have always known that there are four times as many Type II diabetics taking insulin as Type 1, and 80 percent of all insulin in the world is consumed by Type II diabetics,” he said in an interview for Mass Device last year. “However, the Type II diabetic population has been very under-served as far as technologies helping them with that struggle. It’s estimated that the market is easily a $2 billion marketplace for this new generation of products.”