Diabetes

  • Condition

Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels.
Several pathogenic processes are involved in the development of diabetes. These range from autoimmune destruction of the β-cells of the pancreas with consequent insulin deficiency to abnormalities that result in resistance to insulin action. The basis of the abnormalities in carbohydrate, fat, and protein metabolism in diabetes is the deficient action of insulin on target tissues. Deficient insulin action results from inadequate insulin secretion and/or diminished tissue responses to insulin at one or more points in the complex pathways of hormone action. Impairment of insulin secretion and defects in insulin action frequently coexist in the same patient, and it is often unclear which abnormality, if either alone, is the primary cause of the hyperglycemia.1
The number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014. The global prevalence of diabetes among adults over 18 years of age has risen from 4.7% in 1980 to 8.5%. In 2012, an estimated 1.5 million deaths were directly caused by diabetes and another 2.2 million deaths were attributable to high blood glucose.
Almost half of all deaths attributable to high blood glucose occur before the age of 70 years. WHO projects that diabetes will be the 7th leading cause of death in 20302,3. Diabetes is classified according to the pathogenic process that results in hyperglycemia4.
The starting point for living well with diabetes is an early diagnosis – the longer a person lives with undiagnosed and untreated diabetes, the worse the health outcomes are likely to be.2
Diabetes is diagnosed by measuring glucose in a blood sample taken while the patient is in a fasting state, or 2 hours after a 75 g oral load of glucose has been taken (see Annex A). Diabetes can also be diagnosed by measuring glycated hemoglobin (HbA1c), even if the patient is not in a fasting state5Treatment for diabetes involves two aspects prevention is the most important. Once diabetes is diagnosed the main goal is glycemic control. There is an algorithm that includes lifestyle changes and depending on glycemic levels is the pharmacological therapy as monotherapy, dual therapy or even triple therapy6.
There are many studies that show that MSC is a promising therapy for diabetes7.
Murine adipose-derived MSCs differentiated into pancreatic hormone-expressing islet-like cell aggregates, while Marappagounder et al. demonstrated that human bone marrow-derived MSCs differentiated into pancreatic islet-like clusters. Several groups also reported that human adipose-derived MSCs could differentiate into insulin-producing cells, suggesting MSCs as a source of transplantation material in the treatment of diabetes. Fumimoto et al.also demonstrated that implantation of adipose-derived MSCs combined with minced adipose tissue enhanced subcutaneous grafting of islets in diabetic mice. Both these latter studies thus demonstrated the angiogenic and anti-inflammatory potential of MSCs in supporting islet transplantation. Intravenous injection of adipose-derived MSCs also decreased fasting blood glucose levels and suppressed pancreatic islet damage in streptozocin-induced diabetic rats and decreased blood glucose levels and increased glucose tolerance in a high-fat-diet-induced obese mouse model. Finally, a clinical trial exhibited that coinfusion of in vitro-generated insulin-secreting cells differentiated from autologous adipose-derived MSC and bone marrow-derived hematopoietic stem cells into the portal circulation, thymus, and subcutaneous tissue increased serum C-peptide levels and improved glycosylated hemoglobin levels. Although there are still unresolved concerns about the efficacy of stem cell therapy, these data suggest that MSCs are a promising therapeutic option for treatment of diabetes8,9,10,11,12,13,14.

The material that you just read comes from the following links.

References

  1. American Diabetes Asociation; Diagnosis and Classification of Diabetes Mellitus, Diabetes Care 2004;27(suppl 1):s5-s10
  2. Global report on diabetes.World Health Organization, Geneva, 2016. Found in www.who.int
  3. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030.PLoS Med, 2006, 3(11):e442.
  4. Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds. Harrison`s Principles of Internal Medicina, 18e. New York, NY: McGraw-Hill; 2012.
  5. Use of glycated hemoglobin (HbA1c) in the diagnosis of diabetes mellitus. Geneva: WorldHealthOrganization; 2011.
  6. Diabetes clinical practice guidelines AACE2015. National Diabetes Education Initiative. ndei.org
  7. Kahraman S, Okawa ERKulkarni RNIs Transforming Stem Cells to Pancreatic Beta Cells Still the Holy Grail for Type 2 Diabetes?CurrDiab Rep. 2016 Aug;16(8):70. doi: 10.1007/s11892-016-0764-0.
  8. Chandra V, G S, Phadnis S, Nair PD, Bhonde RR; Generation of pancreatic hormone-expressing islet-like cell aggregates from murine adipose tissue-derived stem cells.Stem Cells. 2009 Aug; 27(8):1941-53.
  9. Marappagounder D, Somasundaram I, Dorairaj S, Sankaran RJ; Differentiation of mesenchymal stem cells derived from human bone marrow and subcutaneous adipose tissue into pancreatic islet-like clusters in vitro.Cell MolBiol Lett. 2013 Mar; 18(1):75-88.
  10. Dave SD, Vanikar AV, Trivedi HL; Ex vivo generation of glucose sensitive insulin secreting mesenchymal stem cells derived from human adipose tissue.Indian J EndocrinolMetab. 2012 Mar; 16 Suppl 1():S65-9.
  11. Timper K, Seboek D, Eberhardt M, Linscheid P, Christ-Crain M, Keller U, Müller B, Zulewski H; Human adipose tissue-derived mesenchymal stem cells differentiate into insulin, somatostatin, and glucagon expressing cells.BiochemBiophys Res Commun. 2006 Mar 24; 341(4):1135-40.
  12. Li YY, Liu HH, Chen HL, Li YP; Adipose-derived mesenchymal stem cells ameliorate STZ-induced pancreas damage in type 1 diabetes.Biomed Mater Eng. 2012; 22(1-3):97-103.
  13.  Cao M., Pan Q., Dong H., et al. Adipose-derived mesenchymal stem cells improve glucose homeostasis in high-fat-diet-induced obese mice. StemCellResearch&Therapy. 2015;6, article 208doi: 10.1186/s13287-015-0201-3.
  14. Skyler J,Fonseca V,Segal K, Rosenstock J; Allogeneic Mesenchymal Precursor Cells in Type 2 Diabetes: A Randomized, Placebo-Controlled, Dose-Escalation Safety and Tolerability Pilot Study; Diabetes Care 2015 Sep; 38(9): 1742-1749.

Am I a Candidate?

Find Out if You Qualify