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Displaying glucose control


Behind the headlines: a laser-powered blood glucose test?

You may have seen the news today about a device that could check a person’s blood glucose levels without the need for fingerprick testing. Instead, the device uses a low-powered laser to measure blood glucose levels through the skin.

At the moment, the device, which is being developed at the University of Leeds, is in the early stages of testing: it is currently the size of a shoe box and has only been tested in a trial of 12 people. However if the results from the prototype are promising – the Leeds team believes they are – a smaller, more portable version could be developed to undergo a further round of testing.

This may even take the form of a device that continuously monitors blood glucose, according to Professor Gin Jose, who led the study: ‘Currently, we are piloting a bench top version in our clinical investigations but aim to develop two types of devices for the market. One will be a finger-touch device similar to a computer mouse. The other will be a wearable version for continuous monitoring.’

Conor McKeever, Research Communication Officer at JDRF in the UK, commented: 'It's great that scientists are innovating with different techniques to make life easier for people living with type 1 - we’ll be watching with interest to see how the team turns this prototype into new devices.’

‘However, much larger clinical trials of these devices will be necessary before any regulatory agency will consider them equivalent to fingerprick testing.'


Inhaled insulin launches in the US

Afrezza, the inhaled insulin developed by MannKind and licensed to pharmaceutical company Sanofi, has gone on sale in America this week. This means that American adults with type 1 or type 2 diabetes can now get Afrezza on prescription as a bolus insulin.

However, the drug is not yet approved for people outside the US, for children or for people with chronic lung conditions.

Afrezza is taken using a thumb-sized inhaler at the start of the meal, and passes through the lungs into the bloodstream. The peak insulin level in the blood occurs around 12-15 minutes after use, making it more similar to insulin produced naturally by the pancreas in people without type 1. Most ‘rapid’ insulins peak 30-90 minutes after use.

This led JDRF to fund a trial using Afrezza in 2010, as part of a programme developing faster insulins for the artificial pancreas. The participants used it at meals to fine tune their blood glucose levels, alongside the slower-acting insulin being given by the artificial pancreas. This led to smaller blood glucose level peaks at mealtimes.

An additional benefit of the drug is that it could be used as by people who do not want to inject insulin. Pierre Chancel, Senior Vice President of Sanofi’s Diabetes Division, commented: ‘There is a recognized need for an insulin that doesn't require an injection, and our organization is committed to making this new treatment option available to patients.’

We previously covered Afrezza in June 2014 when it was approved for sale by the FDA, making it the only inhaled insulin on the market. A previous inhaled insulin developed by Pfizer, called Exubera, was withdrawn after poor sales and suggestions of an increased risk of lung cancer.


Behind the headlines: a probiotic cure for diabetes?

This morning, the Daily Express ran a headline saying ‘Breakthrough pill can CURE diabetes: New drug fights both types of killer disease’. So is it true, can a pill now cure both type 1 and type 2 diabetes?

Sadly, no. But the study behind the headline is really interesting.

Researchers at Cornell University, led by Professor John March, have developed a ‘probiotic’ pill containing modified bacteria that are typically found in the human gut and given them to rats with diabetes.

Central to the story is a hormone called glucagon-like peptide 1, better known as GLP-1. GLP-1 helps to regulate the body’s response to glucose in a meal. It does this by blocking the production of glucagon, so that glucagon does not act to raise glucose levels in the blood still further.

Professor March’s team engineered bacteria so that they would produce GLP-1, then gave a group of diabetic rats feed supplemented with this new ‘probiotic’ and compared them with a group of diabetic rats with un-supplemented feed. Rats given the supplemented feed developed insulin producing cells in their gut – some of the regular gut cells were ‘reprogrammed’ to make insulin. This meant that they showed significant increases in their insulin levels and the research teams estimated that these cells were sufficient to produce up to 33 per cent of a healthy rat’s insulin capacity.

So while this study does not herald a cure for type 1 diabetes, it does show that GLP-1 may have an important role to play in improving treatment for people with the condition.

GLP-1, and molecules that mimic its effect (known as GLP-1 agonists), have been widely researched in type 2 diabetes, and there are now a number of GLP-1 agonists available to help in treating type 2 diabetes. But these drugs have only recently started being investigated in type 1 diabetes – thanks in part to funding from JDRF.

Rachel Connor, Head of Research Communication at JDRF comments: ‘The Cornell team’s study adds to our understanding of the role GLP-1 and also demonstrates a novel way of increasing GLP-1 levels in the body. It’ll be interesting to see whether the same effects can be observed in humans with diabetes.’


Molecule supports glucose removal without raising hypo risk

JDRF-funded researchers in Boston, USA, have developed a way to support insulin in removing glucose from the blood, without increasing a person’s risk of hypoglycaemia.

The chemical, known as a glucokinase activator, could also indirectly improve the survival rate of beta cells, and so could theoretically be used to treat both the causes and the symptoms of type 1 diabetes.

Glucokinase activators are so called because they support the work of molecule called glucokinase. This is produced by the body to help remove glucose from the blood, converting it into a similar chemical that can be either stored or broken down. Because of this, glucokinase activators have been investigated in people with type 2 as a complement to insulin in lowering glucose levels.

In addition, some studies have suggested that the presence of glucokinase supports healthy beta cell growth, which would be beneficial to people with type 1. This would also require a glucokinase activator, since in the body glucokinase production is encouraged by rising insulin levels – something that people with type 1 lack since they no longer produce their own insulin.

However, previous attempts at formulating glucokinase treatments have focused on changing the shape of the glucokinase molecule to make it better at interacting with glucose. This is useful when glucose levels are high, as the removal can happen more quickly, but when glucose levels fall, this increased ability to react runs the risk of causing hypoglycaemia, since unmodified glucokinase would normally stop working below a certain level.

The research team, led by Drs Loren Walensky and Nika Danial, created a new glucokinase activator that drives glucokinase to remove glucose more efficiently, but stop once levels fall to normal – at the point when it naturally stops working.

This would allow it to work without increasing the person’s risk of hypoglycaemia.

Although the research is currently at an early stage – in pre-clinical lab studies – the investigators suggest the molecule could eventually be used alongside insulin to help manage glucose levels. They predict that this will be especially useful for people with type 2, given the lower levels of glucokinase found in people with type 1, but say that ‘improvement of both beta cell function and mass through increased glucokinase activity may well expand the potential utility of synthetic glucokinase activators beyond [type 2] to restoration and maintenance of functional beta cell mass for the treatment of type 1 diabetes.’

The research was published in the journal Nature Structural & Molecular Biology.


Children with diabetes not receiving adequate care

Just 6.7% of children with diabetes in England and Wales (96% of whom have type 1) are receiving their full set of annual recommended checks, a report by the Royal College of Paediatrics and Child Health has revealed.

This is a slight improvement over last year, when only 5.8% of children received all seven checks recommended by NICE. However, it stands in stark contrast to the 60% of adults who are receiving the full level of care.

Missing out on these checks, which include HbA1c monitoring, blood pressure tests and eye screens, means that any developing complications are less likely to be spotted early. In many cases, early treatment of complications can significantly reduce their impact.

The report also found that just 17.4% of children are meeting the HbA1c target of below 58 mmol/mol (7.5%), with over 25% having levels above 80 mmol/mol (9.5%).

These numbers were also slightly improved from last year, when 15.8% of children met the target, although a change to the way HbA1c levels were recorded means the results may not be comparable.

High HbA1c levels are an indicator of poor glucose control, and can increase the risk of long-term complications. For this reason, NICE recommends that children with levels consistently above 80 mmol/mol (9.5%) should be offered additional support by their diabetes care teams to help them improve their glycaemic control.

Dr Justin Warner, who co-authored the report, said: ‘Diabetes is a serious, yet manageable, condition. It is heartening to see some improvement in numbers of children and young people with diabetes achieving excellent glucose control, but it is also concerning that significant numbers of children still do not have access to a level of control that would reduce their risk of developing associated complications long-term.’

Karen Addington, Chief Executive of JDRF, said: ‘It is deeply concerning to hear that children with type 1 diabetes who face the risk of devastating complications from their condition are still not receiving all the checks recommended by NICE to help reduce this risk. It highlights once again why research into type 1 diabetes and its complications, and access to the treatments that come from this, is so vital.’


Beta cells grow up

JDRF-funded scientists at Harvard University have provided new insights into to how stem cells develop to become insulin-producing beta cells.

The team, lead by Professor Doug Melton, have identified a marker which allows them to distinguish mature beta cells (which can produce insulin) from immature beta cells (which cannot).  The study is published in this month’s issue of the prestigious journal Nature Biotechnology.

Many scientists are working on ways to turn stem cells into beta cells. So far, they have managed to turn stem cells into immature beta cells in the lab, that when transplanted into mice will become mature beta cells that release insulin in response to glucose.  Although this is excellent progress, transplanting immature beta cells into humans is not ideal as there is a chance that some of the immature beta cells may not develop as expected, and instead begin multiplying out of control, causing cancer. For this reason, scientists want to be able to make fully mature beta cells in the laboratory which would then be much more suitable for transplantation.

Professor Melton’s work takes us a step further towards making mature beta cells in the lab. They have identified a protein that is found in mature beta cells but not in immature non- insulin producing ones. The protein, called urocortin-3, can now be used as a marker of mature insulin producing cells and will help scientists identify mature beta cells more easily when testing out new  ways to make them from stem cells. 

Rachel Connor, Head of Research Communication at JDRF said ‘Stem cells provide exciting possibilities for studying type 1 diabetes and potentially treating the condition in the future. Professor Melton’s study helps us understand more about how beta cells develop and crucially, also provides a way to efficiently test if new techniques for making mature beta cells from stem cells are working effectively’.


Improved access to insulin pumps in Scotland

JDRF welcomes the news that all eligible under eighteens with type 1 diabetes in Scotland will now have access to insulin pumps. The Scottish Government has said it is committing funding of at least £1 million to help NHS Boards deliver pumps to under eighteens who need them, as well as tripling the amount of pumps available to all people with the condition in Scotland.

Health Secretary Nicola Sturgeon made the announcement saying, ‘Insulin pumps mean freedom from having multiple insulin jabs a day - giving Scotland's youngest diabetics a normal childhood. By the end of March 2013, this treatment will be made available to the 480 children and teens struggling with type 1 diabetes who could benefit from it. Over the next three years, NHS Boards will also increase the number of insulin pumps available to all Scots to 2,000, tripling the current amount.

‘Diabetes is a growing problem for Scotland - around 10 per cent per cent of overall hospital expenditure relates to diabetes treatment and complications. Not dealing effectively with diabetes can cause long term health problems and we need to make sure that the youngest people with type 1 diabetes get the best possible treatment as early as possible.’

Karen Addington, Chief Executive of JDRF said: ‘This is good news for young people with type 1 in Scotland. Insulin pump therapy can help people manage their condition more effectively and reduce the risk of the devastating long term complications of type 1.

JDRF is focused on improving lives, until we find the cure, and we have been campaigning for some time for improved access to pumps. We are delighted that Scotland is taking the lead in providing excellent treatment for people with type 1 and we hope to see similar improvements across the rest of the UK in the future.’


Behind the headlines: diabetes increases the risk of birth defects

You may have read in yesterday’s newspapers reports that children of women who have diabetes are more likely to be born with a birth defect.

These articles discussed a new study by the researchers at Newcastle University. This study showed that  that seven out of every 100 babies born to women with either type 1 or type 2 diabetes were born with birth defects. These defects occur in about two in every 100 babies born to women who do not have diabetes, so this means women with diabetes 3.8 times more likely to have babies with birth defects.

The researchers looked at the records from 401,000 women who gave birth between 1996 and 2008 to see if birth defects were more common in people with diabetes.

Previous research has highlighted this increased risk for women with diabetes, but has also shown that this risk can be significantly reduced by keeping HbA1c levels low at the time of conception. The current research study provides further evidence of this effect:  fewer babies with birth defects were born to women with lower HbA1c levels.

This research highlights the importance of specialised care for pregnant women with diabetes, as careful glucose control is very important during this time. The National Institute for Health and Clinical Excellence (NICE) recommends that women who are planning to become pregnant should aim for an HbA1c level of 6.1, if this can be safely achieved.

Rachel Connor, Head of Research Communication at JDRF, said, ‘This study is helpful because it shows that while there are increased risks for women with type 1 diabetes who are planning a family, it is possible to reduce those risks significantly. By working with specialist diabetes teams, and potentially making use of glucose control technologies such as insulin pumps and continuous glucose monitors, women with diabetes can minimise any risks to themselves and their developing babies’.


Pass the parcel

Could tiny packets of stem cells help people with type 1 diabetes to produce their own insulin again? JDRF has joined forces with Viacyte, a US based biotechnology company, and the California Institute for Regenerative Medicine (CIRM) to help answer this question.

The organisations have come together to conduct preclinical testing of a first-of-its-kind cell therapy for type 1. The potential treatment is an innovative combination of cells and a special ‘packaging’ material. One of the unusual things about the therapy is that the cells, derived from embryonic stem cells, are not mature when they are packaged – rather they are immature human pancreatic hormone cells.

Initial tests have shown that once implanted, within their protective packaging, these immature cells develop into mature hormone producing cells, including the vital insulin producing beta cells that are missing in people with type 1. Tests in rodents have shown that once mature, these packets of cells are capable of regulating blood glucose levels.

Existing cell therapies such as islet and pancreas transplantation have the potential to cure type 1 by restoring normal islet function in people with the condition. But because there is a huge shortage of pancreatic islets from organ donors, it is important to find a replenishable supply of functional insulin-producing cells. This product, by using stem cells rather than tissue form organ donors could overcome this hurdle. Furthermore, packaging the cells in a device that creates a physical barrier around the cells (a process called "encapsulation") has the potential to protect the transplanted cells from immune rejection, and may eliminate the need for chronic immunosuppressive drugs.

The three-year series of preclinical studies being co-funded by JDRF will help prepare the information necessary to apply for regulatory approvals to study the system for safety and efficacy in people with type 1 diabetes.

Rachel Connor, Head of Research Communication at JDRF said ‘JDRF is excited to be working with Viacyte and CIRM on this pioneering project. Encapsulation technologies and stem cell therapies have fantastic potential in treating type 1 diabetes, so this type of innovation could be a huge step forward for people living with the condition.’


Is pure technology the only reason people who use insulin pumps can achieve better glucose control?

Professor Simon Heller, a member of JDRF’s Scientific Advisory Committee has just launched a trial to answer some of the questions he discussed in an interview with Type 1Discovery magazine two years ago…

In Type 1 Discovery issue 50, we interviewed Professor Heller about hypoglycaemia and ways people with type 1 can manage their condition to maintain good control and avoid hypos as far as possible.

In the article Professor Heller talked about both the Dose Adjustment For Normal Eating (DAFNE) programme and the role of technology in treating type 1. He also discussed how complex it is for doctors and people with type 1 alike to weigh up the advantages and disadvantages of different ways of treating type 1 for different individuals.

Most research around starting to use an insulin pump in adulthood has been done comparing people who start using a pump with people who continue to use multiple daily injections, without any additional training. This means there is a gap in the research evidence. It is possible that the training people receive when they begin using a pump, particularly around carb counting, may be at least partly responsible for the improvements in control that studies on pump use suggest.

The Relative Effectiveness of Pump Therapy Over MDI and Structured Education (REPOSE) trial seeks to find out if this is the case. Volunteers to the study will be randomly assigned to one of two groups. One group will participate in the DAFNE course, while the other group will participate in DAFNE and begin using an insulin pump. Both groups will be followed up for two years, and the researchers will collect information on how glucose control in both groups changes during the trial. They will also collect a range of information about how people in the trial feel about their type 1 treatment, their quality of life, and importantly their fear of hypoglycaemia.

The results of the trial will help doctors and decision makers within the NHS to understand how information and training can work alongside different technical ways of treating type 1 diabetes. If the trial demonstrates an added benefit of insulin pumps above injections then the hope is that diabetes teams may be more willing to refer people for pump therapy which is relatively underused in the UK.

The trial is completely funded by the NIHR Health Technology Assessment programme. It is currently recruiting volunteers all around the country: if you are over 18, do not use a pump and have never done the DAFNE course, why not get in touch with the REPOSE team to see if a hospital near you is involved in the study?

Please contact:
Diana Papaioannou, REPOSE Trial Manager 
email: phone: 0114 222 0766
Lucy Wraith REPOSE Trial Support Officer 
email: phone:  0114 222 0866


Access to insulin pumps improves in Scotland

Last Friday, Scottish government announced that a quarter of young people with type 1 diabetes in the country will have access to insulin pumps by 2013. It was also confirmed that over the next three years, the number of insulin pumps available to people of all ages with type 1 diabetes will almost triple to more than 2,000.

JDRF is delighted that the government in Scotland have recognised the need for greater uptake of insulin pumps. We feel its vital that people with type 1 diabetes have access to the medicines and equipment that help them to stay healthy and manage their condition effectively whilst we search for the cure.

Health Secretary Nicola Sturgeon said, “The pumps can mean freedom from having multiple injections a day, and, for the youngest diabetics, can go some way to giving them back a normal childhood. I want to see insulin pumps made available to 25 per cent of children and teens with type 1 diabetes by 2013. We will also increase the number of pumps available to all Scots to over 2,000 - almost tripling the current amount over the next three years. 

"Diabetes is a growing problem for NHS Scotland. It’s now thought that around 10 per cent per cent of overall hospital expenditure relates to the treatment of diabetes and its complications."

“The consequences of not dealing effectively with diabetes can cause long term health problems and we need to make sure that the youngest people with type 1 diabetes get the treatment that’s right for them as early as possible.”

These plans were announced as part of the Diabetes Action Plan which was published in August of this year. You can read the full report here

JDRF works hard to raise awareness of the issues people with type 1 diabetes face and to ensure they have access to the best treatments and equipment to manage their condition. You can read about the campaigning work we do in more detail here


Professionals agree: continuous glucose monitoring can help in managing type 1 diabetes

A new clinical guideline spells out that continuous glucose monitoring (CGM) can be a beneficial tool to help maintain target blood glucose levels, and limit the risk of hypoglycaemia.

The guideline was developed by the Endocrine Society, an international organisation for researchers and clinicians who work on hormone disorders like type 1 diabetes. The complete guideline is published in the current issue of Journal of Clinical Endocrinology and Metabolism

A team of experts from the society reviewed all of the evidence around CGM use published to date in order to come up with the new guidelines. They found that there was high-quality evidence to recommend the use of real-time CGM in children and adolescents with type 1 diabetes who are at least eight years old, and in adults with type 1 diabetes as well. But the guideline does stress that CGMs are only useful if the person with type 1 is prepared to use it on a daily basis.

The chair of the task force that drew up the guideline, Dr David Klonoff of Mills-Peninsula Health Services in San Mateo, California, said “There are some caveats to consider before accepting continuous monitoring of glucose as a routine measure to improve glycaemic control in diabetes. There are still concerns about the high costs of CGM and the accuracy of the various systems available. However, the new CPG shows that CGM can be a beneficial tool to help maintain target levels of glycaemia and limit the risk of hypoglycaemia.”

Rachel Connor Head of Research Communication at JDRF UK said “This new clinical guideline may help to convince some clinicians, who may still feel uncertain about the accuracy and usefulness of CGM, that this technology has a place in the management of type 1 diabetes.”

The Endocrine Society’s patient education affiliate, The Hormone Society has produced a really helpfulpatient guide to CGM, which includes information about the new recommendations.


Getting teenagers involved in research

Here at JDRF we receive lots of enquiries from people interested in taking part in clinical trials. This is great news. All the valuable fundraising by our supporters would not be nearly as useful if there were not lots of willing volunteers to test new treatments, drugs and devices. 

We also know that trials of new treatments for teenagers are particularly important as it can be a really difficult time to maintain good glucose control,  due to changing hormones and lifestyles. However, teenagers can be a tricky group to pin down for clinical trials, which is where you may be able to help.

If you know someone between 10 and 16 years old with type 1 who might be interested in taking part in a trial, read on.

The Adolescent type 1 Diabetes cardio-renal Intervention Trial (AdDIT) is a clinical trial being led by Professor David Dunger, who is a Professor of Paediatrics at Addenbrooke’s Hospital at the University of Cambridge. The aim of the work is to prevent the progression of cardiovascular and renal complications in high-risk adolescents. 

Blood pressure and fat lowering drugs are frequently used in adults with Type 1 diabetes to reduce risk for future complications. They may also be of value during adolescence when HbAIc  levels may be less well controlled. We plan to find out whether these drugs have a role in the treatment of adolescents through a large trial involving nearly a thousand young people. 

These teenagers will take part in the project which will take place in the UK, Australia and Canada.  It will take five years to complete and is currently the only study of its kind. The trial is in its third year but more volunteers are still needed.

In an initial screening stage, volunteers will be asked to provide urine samples. Depending on the levels of protein these samples contain, they may then be invited to take part in the main study testing the effects of blood pressure and cholesterol lowering drugs. To make it even easier to take part, the young people involved in the trial will have study visits arranged to coincide with their routine clinic visits so far as possible, and may even have their routine diabetes care provided through a special AdDIT clinic, so that they do not have the inconvenience of two clinic visits. Others will be invited to take part in a comparison study which will not involve taking any study drugs but in which they will be closely followed up.

Screening is taking place in these regions of the UK:

Aylesbury and High Wycombe
Birmingham (Heartlands)
Newcastle and 

West Suffolk

Or you can also email the coordinating centre:

There is a list of other type 1 diabetes clinical trials on our website with contact details so you can get in touch directly if you are interested. There are also a number of diabetes clinical research organisationsand databases listed on our website who can help you find suitable trials. 


JDRF and InnoCentive Challenge calls for ideas for a glucose-responsive insulin

JDRF has partnered with InnoCentive Inc, a pioneer in crowdsourcing, to announce a $100,000 Challenge calling for innovative ways to approach the discovery and development of a glucose-responsive insulin drug as a treatment for type 1.

Through this challenge, JDRF’s ultimate goal is to discover a glucose-responsive insulin drug that would work only when the body needs it. Glucose-responsive insulin would deliver the precise amount of insulin needed in response to circulating glucose levels, and would control and maintain normal blood glucose levels throughout a daily routine with once-daily or less frequent need for insulin injections or pump infusions.

JDRF is appealing to InnoCentive’s Global Solver Community to uncover solutions for a transformative and sophisticated insulin drug. This Challenge is open to anyone with a solution that fits the published criteria, and requires only a written proposal. Submissions for this Challenge will be accepted through November 9, 2011. The winning solution could then be further developed into a research proposal, giving the winner a change to become a member of the team who will put the idea into practice.

The Challenge is open to the public. More details can be found on the InnoCentive website. 


Are we beating diabetic retinopathy?

The incidence of one of the most common complications of type 1 diabetes appears to be in decline, according to researchers in Finland.

Led by Dr Per-Henrik Groop from Helsinki University Central Hospital, the team studied the rate of severe retinopathy in people with type 1 diabetes diagnosed between 1939 and 2005. They grouped 3,781 patients from Finland according to the year they were diagnosed: before 1975, 1975-1979, 1980-1984 and 1985 and after. Severe retinopathy was assessed according to how many laser treatments patients had received.

The results, published in the September issue of Diabetes Care, reveal a decreasing incidence of severe diabetic retinopathy after 20-30 years of type 1 diabetes. People born in the 1980s were almost 50 per cent less likely to have had severe retinopathy after 20 years than people born in the 1970s or earlier.

Much of this improvement can be attributed to advances in the detection and treatment of retinopathy. The earliest groups may also have had much poorer glucose control earlier in their lives.

JDRF is committed to beating the complications of type 1 diabetes, including diabetic retinopathy. We want to make sure that people with type 1 diabetes stay as healthy as possible while we search for the cure. Through research funded by JDRF, we are now better able to diagnose, treat and prevent the complications of type 1 diabetes. 

Read more about JDRF complications research. 


$1.9 billion potential healthcare saving for USA with artificial pancreas

A study carried out on behalf of JDRF in the US has revealed the potential savings that could be made to the Medicare programme (which provides health insurance to those over 65 years old or who have disabilities) because of the artificial pancreas. These savings are estimated to total $1.9 billion over 25 years.
The JDRF Artificial Pancreas project aims to link an insulin pump with a continuous glucose monitor (CGM) to provide automatic, real-time monitoring of blood glucose and delivery of insulin. Early studies of a prototype artificial pancreas have already shown clinical improvements in blood glucose control.

The research team, led by Dr Michael J. O’Grady, modelled 25 years of medical costs for people between 30 and 60 years old. Their analysis revealed the accumulated cost savings resulting from avoiding complications in this group.

Poorly controlled blood glucose levels in type 1 diabetes can cause complications later in life, such as diabetic eye disease and cardiovascular disease. A new technology that can significantly slow or stop the progression of these has the potential to deliver substantial health and financial benefits. 


Type 2 drug shows benefit for type 1 diabetes

A new study has revealed that a type 2 diabetes drug can also help people with type 1 diabetes achieve better blood glucose control.

Research published this month in the European Journal of Endocrinology, tested the drug liraglutide (marketed under the brand name Victoza) in 14 people. The results showed that injections of the drug, in addition to insulin, significantly decreased fasting mean glucose levels, and average weekly blood glucose levels in every participant, after one week. 

At the start of the study all 14 people had optimal HbA1c levels under 7. Yet the addition of liraglutide was able to decrease the number of ‘glucose excursions’ – when their glucose level swings outside the normal range. This had the added benefit of reducing the amount of insulin the participants needed to take.

Dr Paresh Dandona, senior author of the study said: “Since the development of injectable insulin, there has been nothing definitive in terms of a significant advance in type 1 diabetes treatments. This study shows that liraglutide can provide even well-controlled type 1 diabetics with additional benefits that help them achieve even better blood glucose levels.”

The results now need to be replicated in a much larger trial to ensure safety and effectiveness, but could result in future changes to the treatment of people with type 1 diabetes. 


T1 Youth Ambassadors meet JDRF CEOs

Some of our T1 Youth Ambassadors met with Karen Addington, Chief Executive of JDRF UK, and Jeffrey Brewer, Chief Executive of JDRF International. Read Ambassador Elizabeth Sheils' account of the day:

"Last Friday I had the opportunity to go to the JDRF offices in London, I managed to see where all my friends work. I also had a peak at the stationary cupboard and spotted many Rufus bears and Pingus! It wasn’t actually the main aim of the day to snoop around the office (that was just a bonus). I was there to meet four other T1 Youth Ambassadors, Karen Addington (chief executive of JDRF UK) and Jeffrey Brewer (chief executive of JDRF International). The Youth Ambassadors had the chance to talk to Jeffrey and ask him all sorts of questions about research, type 1, and how the JDRF runs in the US. I found it was a fascinating day – I learnt lots about the research being undertaken and where it could eventually lead. It was extremely exciting thinking that there are so many ideas surrounding curing type 1 – from once a day injections to small procedures every 18 months inserting ‘protected’ insulin producing cells. Both of these would allow the person with type 1 to live almost as if they did not have type 1 at all, being able to eat without carbohydrate counting and living without the fear of hypoglycemia or hyperglycemia. Unfortunately these types of ‘cures’ are a few years down the line but it encourages me that they are being researched and pushes me to want to do more to raise awareness and money for type 1. I was also greatly inspired by the other T1 Youth Ambassadors and it was fascinating hearing about their work. I really enjoy being part of this programme!

One fact which stood out from the day was about the money used for research into type 1. In 2009, UK government funding bodies committed £51 million to research to tackle diabetes however only £6 million of this was relevant to type 1. Which is a massive contrast compared to the US who spent $150 million, the Australian government committed $36 million and Canada $20 million all on research to help cure, treat and prevent type 1 diabetes. It was shocking to learn that so little is spent on type 1 diabetes however this is also seen in the lack of people using insulin pumps (3.9%) compared to the US (35%) and Europe (15-20%). Even fewer people are using continuous blood glucose monitoring (CGMs). These facts are very concerning when you consider that one of the main pieces of research working to help remove many of the burdens of type 1 is an artificial pancreas composed of an insulin pump, a CGM an algorithm. This would provide the exact amount of insulin and at the correct time to ensure normal blood glucose levels are achieved. However if the UK currently falls behind most of the other developed countries in their uptake for insulin pumps and CGMs this will be a great problem when artificial pancreas systems are readily available. It does seem exceptionally unfair that people who live with type 1 miss out on latest treatments especially if they can make living with the condition a bit easier.

Jeffrey Brewer made an interesting point during the meeting, he said that people living with type 1 have to administer life saving (and threatening) medication everyday for the rest of their lives which definitely puts things into perspective. Type 1 cannot be seen which often leads to people completely underestimating what it is like to live with a life threatening condition. It would be wonderful to have an Artificial Pancreas and I cannot imagine how frustrating it would be if one was released onto the market and only 5% of people could use it!

As T1 Youth Ambassadors we are trying our best to make sure this doesn’t happen! If you would like to join us click here to find out more."

Elizabeth has a regular blog on our T1 Website. Click here to read more about her experience of life with type 1 diabetes.


JDRF urges public to be ‘Hypo Aware’ in National Diabetes Week

As people affected by type 1, unfortunately many of you have experienced hypoglycaemia and live with the worry of either yourself or your child having a hypo. JDRF discovered that despite it being a serious life-threatening health issue, more than half (53 per cent) of UK population do not know it is a dangerous state of low blood glucose.

This YouGov survey of 2075 adults comes 90 years after scientists Banting and Best discovered insulin in the lab, and first saved the life of someone with type 1 diabetes. Since then, treatment has improved greatly, but because people living with type 1 diabetes are still dependent upon insulin injections or pump infusions, we recognise that this means living with the day to day fear of hypoglycaemia.

We are releasing these survey results today to mark National Diabetes Week. We are encouraging the general public to understand how type 1 diabetes affects people in the UK, to learn the symptoms of Hypoglycaemia and to become hypo-aware, so they could help someone in an emergency.

JDRF funded researchers at the University of Cambridge and around the world are currently developing an ‘artificial pancreas’, a piece of technology that may one day provide exactly the right amount of insulin in the body of someone with type 1 diabetes, exactly when it’s needed. This could be the end of hypoglycaemia, as the system would automatically regulate blood glucose levels, mimicking a healthy pancreas. You can read more about the research here 


JDRF and Amylin partner to explore if mixing human hormone with insulin could better treat type 1

Juvenile Diabetes Research Foundation and Amylin Pharmaceuticals have today announced that they will be working together to fund a series of clinical studies testing the use of amylin in type 1 diabetes treatment. The research will establish whether mixing the drug pramlintide, a man-made version of the human hormone amylin, with insulin could improve blood glucose control in people with type 1 diabetes, compared to the use of insulin alone.

In a healthy pancreas, both insulin and amylin are produced and released by the same cells. The two hormones work together to help stabilise blood glucose levels. Insulin helps the body regulate production and storage of glucose, while amylin helps control the rate at which glucose enters the blood after meals.

Currently, patients who use pramlintide must separately administer their daily insulin therapy, either through injections or an insulin pump. Creating a mixture of the two drugs that still offers the benefits of both hormones, might better mimic the way a healthy pancreas works.

This is the second research partnership between JDRF and Amylin working to improve treatments for people with type 1 diabetes. The project is part of JDRF’s Industry Discovery and Development Partnership (IDDP) program aiming to accelerate research that will lead to better treatments and a cure for type 1 diabetes.

Eleanor Kennedy, Head of Research Communication at JDRF said, ‘ It will be interesting to see whether mixing pramlintide with insulin has the potential to help people with type 1 diabetes tighten their glucose control. We look forward to seeing the outcomes of the research resulting from this partnership.”