Biotechnology

New hope for stem cell approach to treating diabetes!

Scientists working to develop more effective treatments for diabetes are turning to stem cells. Such cells can be transformed into cells that produce insulin, the hormone that controls blood sugar.

But there’s a significant challenge: the amount of insulin produced by these cells is difficult to control.

Major Complications of Diabetes

Out of the many disparate complications associated with diabetes are acute & chronic ones; hypoglycemia and hyperglycemia are deemed acute ones; while the damage of the blood vessels in many vital organs are considered chronic such as cardiovascular disease, diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy.

Cardiovascular Diseases

Since diabetes effects on different organs of the human bodies and the blood vessels aren’t an exception; too many sugars elevate the blood glucose levels in the blood which in return make it more viscous and then the formation of plaques blocks the arteries. Therefore, patients should continuously regulate their blood glucose levels.

Diabetic Retinopathy

In response to the elevated blood glucose levels, a pull occurs for the fluid from the lenses and tissues of the eyes, and this happens to counteract the increased blood sugar level. As a result, patients have focusing problems.

Furthermore, this effect doesn’t appear early; however, if patients left without treatment; it might lead to complete blindness, and the case is termed diabetic retinopathy.

Diabetic Nephropathy

The intrinsic function of the kidneys is to filter the present waste from them, and they carry out such a function by the present blood vessels in each of the twos. In the case of high blood glucose levels, the risk of destroying those tiny vessels, and the patients might experience diabetic nephropathy [Kidney failure].

Diabetic Neuropathy

The nerve system is also affected by diabetes, which is termed as peripheral neuropathy. The causes include; feeling lost, in addition to pain and tingling and sometime may lead to amputation.

Stem cell Diabetes
Diabetes Mellitus – Global Statistics & Awareness: The global prevalence of Diabetes among adults over 18 years of age has risen from 4.7% in 1980 to 8.5% in 2014. Image: Villa Medica

Management and treatment of the Diabetes Mellitus

The best way is to control the glucose levels in the blood, and that’s to prevent the complications associated with the disease. Which, in return, restore the carbohydrates metabolism to their normal state.

Therefore, some patients with insulin deficiency require insulin therapy. This can be applied in many ways, such as insulin pump, insulin injection pens, and insulin jet injectors.

Moreover, exercises and dietary modifications could be used to correct the insulin resistance.

Dietary changes could manage type 1 diabetes, and insulin therapy could be applied in worst cases “advanced stages.” While type 2 is controlled with non-insulin medications, and insulin also might be administered afterward for the treatment purpose.

Additionally, some oral medications could be taken by patients to regulate their blood glucose levels.

Healthy Diet for Diabetes

No specific diet to be made for diabetic patients; however, a patient should eat vegetables, fruits, and low-fat. Eating low glycemic index foods is a must for them, and they should eat smaller amounts of animal productions. GI is a measurement of how quickly an increase in the blood glucose levels is caused by food; therefore, the diabetic patients should eat food enrich with fibers such as corn, beans, most of the fruits except grapes & melons, carrots, and sweet potato.

Physical Activity for Diabetes

Diabetic patients [type 1 & 2] should continuously practice exercises even if they didn’t use to do so. Exercises play an intrinsic role in maintaining the average blood glucose by increasing the body’s sensitivity to insulin.

Monitoring Blood Sugar levels

One of the most important things to be done by diabetic patients is to screen for their blood glucose levels continuously now and then a day. Continuous screening helps to know if the glucose levels are within normal ranges or not and also to understand whether the medication is giving its therapeutic effect or not.

Diabetes medications

Type 2 diabetic patients rely mostly on exercise and diet; however, certain cases require medications and insulin therapy in the worst cases.

There are many ways by which the medications are producing their therapeutic effect; since some can induce insulin production in addition to reducing the absorption of the blood glucose, while some can elevate insulin effectiveness.

Metformin (Glucophage & Glumetza)

The first drug to be prescribed for type 2 diabetic patients is the metformin; since it elevates the sensitivity of the tissue to the insulin. It allows the human body to make use of insulin efficiently. Additionally, it decreases glucose production in the liver.

A side effect of Metformin include diarrhea and nausea

Sulfonylureas

Sulfonylureas are organic anti-diabetic compounds. Surprisingly, the drug helps in insulin production from the Langerhans β cells in the pancreas. Out of the numerous examples are glipizide (Glucotrol) and glimepiride (Amaryl).

Weight gain and low blood glucose are the possible side effects of Sulfonylureas.

Meglitinides

Their function is the stimulation of insulin production as the sulfonylureas; however, they are reported to give their therapeutic effects faster. Side effects include hypoglycemia, but it is lower than with the latter and gaining weight.

Examples are Repaglinide (Prandin) and nateglinide (Starlix).

Thiazolidinediones (TZDs)

Usually, this class of medications is not recommended because of the associated severe side effects with it; since it might lead to heart failure.

Examples include rosiglitazone (Avandia) and pioglitazone (Actos).

Glucagon-like peptide-1 receptor agonists (GLP-1)

These medications act by slow the digestion, which results in normal blood glucose levels, however, sulfonylureas are deemed more effective.

Insulin Therapy

Type2 diabetic patients may also need insulin therapy in addition to the oral medications; as they start using the insulin with one long-acting shot at night. On the other hand, type1 diabetic patients require multiple injections a day in a view to maintaining healthy blood glucose levels.

Insulin therapy for diabetes
Insulin therapy requires frequent dosage adjustments to maintain adequate blood glucose levels. Image:  Michigan Health

There are many types of insulin, and they do work differently; as there is insulin glulisine (Apidra), insulin lispro (Humalog), insulin aspart (Novolog), insulin glargine (Lantus), insulin detemir (Levemir), and insulin isophane (Humulin N, Novolin N).

Each type of the previous kind differs in its effect duration as there are rapid-acting, short-acting, intermediate-acting, and long-acting.

Physicians are responsible for giving the appropriate dosage insulin to the diabetic patients; as in some cases, they can prescribe low dose aspirin therapy as well as blood pressure and cholesterol-lowering medications to prevent heart and blood vessel diseases.

Stem Cell Approach to Treat Diabetes

Researchers keep searching now whether the stem cells could be used for the diabetes treatment and now there are many approaches;

– Embryonic stem cells could be used for making beta cells. They could also be grown in the lab having the ability to be any cell type in the human body. They could be insulin-producing cells or glucose-sensing cells.

– The second approach is to stimulate the beta cells to make many copies of them. Naturally, beta cells already make many copies in the body; however, this reduces when humans get older. Now researchers are searching for a drug to induce this self-renewal as a treatment for type 1 or type 2 diabetes mellitus.

– Protecting beta cells from immune attack: Immunologists and bioengineers are working on a range of strategies to protect transplanted cells from immune attack. One approach is to use cellular engineering to make the cells more resistant to such an attack, and another is to encapsulate the cells within semi-permeable membranes to protect them from the cells of the immune system. Such capsules are porous and would allow small molecules such as glucose and insulin to pass through while preserving the beta cells from the cells of the immune system.

Research Done

In 2019, Researchers from the Washington University School of Medicine in St. Louis tweak human stem cells into beta-cells (insulin-secreting cells) that respond more effectively to the fluctuation of glucose level in the blood.

In 2016, the Washington University School of Medicine in St. Louis and Harvard University researchers utilized the patient’s stem cells and produce new insulin-secreting cells.

In 2011, Researchers at Yale School of Medicine found new ways of controlling diabetes that involve stem cells from uterus lining. The finding claims that the endometrium or uterine lining stem cells could be utilized to develop islet cells (insulin-producing cells) found in the pancreas.

Explore More: 11 Diseases CRISPR Technology Could Cure!

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