The Forgotten Killer (Insulin Dependent Diabetes)

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Product:	Insulin Dependent Diabetes
Date:	14/02/01 (503 review reads)
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DIABETES - The "Forgotten" Killer


~ ~ Cancer and heart disease are usually the first things that spring to mind when we think of killer diseases. Diabetes isn’t high on most peoples’ list. Yet a person dies from this little understood disease every three minutes. It is the leading cause of adult blindness, kidney failure, and non-traumatic amputations of the lower limbs.
Type 1 or Insulin Dependant Diabetes is most commonly diagnosed in children, but can in fact occur at any age. It’s one of the most costly, chronic diseases of childhood and one you never outgrow.

~ ~ It is an autoimmune disease, in which the body attacks itself, destroying the insulin producing cells in the pancreas. Its exact cause is not known, but it results from a combination of genetic traits and environmental triggers.
Because insulin is necessary for life, people with Type 1 diabetes must take several insulin injections a day for the rest of their lives, and test their blood sugar levels by pricking their fingers for blood six or more times per day.

~ ~ Strict attention must be paid to diet and exercise, and diabetics must be constantly prepared for either high or low blood sugar reactions, which is life threatening. Great care must be taken to ensure the correct amount of insulin is injected or the result is a diabetic coma. Other factors also come into play. Stress, hormonal changes, periods of growth, illness or infection, and fatigue, can all adversely affect a diabetic’s blood sugar control.
The life expectancy of diabetics averages fifteen years less than the general population. They are up to four times more likely to suffer from heart disease and one third of all new kidney dialysis patients have diabetes-caused kidney failure.
Blood circulation is usually poor, often causing ulceration of the feet, and in later life, this can lead to amputation of the legs. Eye disease is common, and can lead to
permanent blindness.

~ ~ Before treatment with insulin, diabetes was a death sentence, with sufferers surviving, at most, one year after diagnosis.
Two Canadian scientists from the University of Toronto called Frederick Banting and Charles Best discovered insulin in 1922.They extracted insulin from the pancreas of cattle from slaughterhouses, which they then injected into diabetic dogs. This restored the dogs to normal health – for as long as they had the insulin.
A diabetic teenager from Toronto, Leonard Thompson, became the first human to receive an injection of insulin in January, 1922. His improvement was immediate and dramatic, and the following year, 1923, the two pioneers received the Nobel Prize for Medicine for their discovery. Insulin production was licensed and its use became widespread, saving countless lives.

~ ~ It was not until the late 1970’s that the next major breakthrough came. In 1978, scientists managed to synthesise the protein that constitutes human insulin,and thus made it possible for it to be manufactured in bulk quantity.
Called ‘Humilin’, it came into general use in the early 1980’s, and is now used by
almost all diabetics in preference to animal insulin.
In 1996, a new fast acting insulin called Lispro (brand name ‘Humalog’) was developed, which enabled diabetics to quickly counteract a high blood sugar count.

~ ~ But despite all the advances in insulin treatment, insulin is not a cure for
diabetes. While it allows a person to stay alive, it does very little to prevent the
long-term complications of the disease.
In the words of actress Mary Tyler Moore, International Chairman of the Juvenile Diabetes Federation; “I’ve had Type 1 diabetes for over thirty years. It changes everything about a child’s and a family’s life. And to add to the day-in, day-out hassles of living with diabetes – the balancing
of diet, exercise, and insulin, the shots, the terrible episodes of low blood sugar – is the knowledge that even if you do all you can to be as normal as possible, you’re not, you’re different, and you face the uncertainty of an adulthood visited by early blindness, kidney failure, amputation, heart attack or stroke.”
Those who suffer from diabetes should have more to look forward to than life coping with an incurable disease, and thrice daily injections of insulin.



New Treatments.

~ ~ Huge advancements have been made recently in the treatment of diabetes.
A recent innovation, which monitors blood sugar, is the ‘Glucowatch’. Developed in California by the Cygnus Corporation, this device is worn like a conventional wristwatch, and checks glucose levels automatically every twenty minutes. Electrical impulses are passed through the skin, giving an instant readout on the monitor. An in-built alarm beeper warns the diabetic of potentially dangerous high or low blood counts. The benefit is that constant finger pricking to test blood is no longer necessary.

~ ~ Another device currently under development is the insulin inhaler. Dry, powdered insulin is ingested into the blood through an inhaler, similar to those used by asthma sufferers. The obvious benefit is that the diabetic is no longer required to inject insulin on a daily basis.
As Dr. Jay Skyler, head of inhaler studies at the University of Miami states,“All patients have to do is breathe, and that’s something that everybody has learned to do by the time they were born.”
In trials, over 200 patients have used the inhaler with remarkable success, but a
potential drawback is the possibility of long term lung tissue damage.



Permanent Cure

~ ~ The worldwide market for diabetic products is in the region of £3 billion annually. A permanent cure for diabetes would decimate the
massive profits earned by the drug companies, so the most likely source of a cure is publicly funded research. A cure is tantalisingly close, but still eludes researchers.

One approach has been the transplantation of islets or whole pancreases from suitable human donors. But as the recipient’s immune system immediately attacks and destroys the foreign implant, the diabetic is required to take massive doses of anti-rejection drugs for the rest of their lives.
Because of the shortage of potential organ donors, and the toxicity of immunesuppressing drugs, pancreas transplant is usually only carried out when the diabetic has suffered renal failure and must undergo a kidney transplant for which the drugs are required in any case.

~ ~ The most probable cure currently under research is Islet Xenotransplantation, or transplanting islets cultivated from pigs. Most researchers believe pigs offer a safe and plentiful source of islets for the treatment of diabetes, and insulin cultivated from pigs has already proven itself as it was used successfully for seventy-five years as a source of injected insulin.
To prevent rejection, the islets are encapsulated in a semi-permeable capsule made from material called alginate, an extract of seaweed. It stops antibodies and other agents entering from the diabetic’s immune system to attack the foreign islets, but conversely allows insulin to flow freely.
The islets are placed in the diabetics’ peritoneal cavity, the area containing the major abdominal organs, a very simple procedure requiring only a local anaesthetic and conventional injection. No invasive surgery is necessary, so the islets are easily removed or replaced.
Dr. Anthony Sun of the University of Toronto has reversed diabetes in monkeys using this procedure. They suffered no ill-effects and achieved normal blood sugar levels for up to 26 months.
It is curiously co-incidental that this research is ongoing in the ve
ry establishment where Banting and Best first discovered insulin way back in 1922.

~ ~ Dr. Robert Elliot at the Auckland School of Medicine in New Zealand also transplanted a controlled amount of pigs’ islets into two human subjects in mid-1996. Again, there were no adverse effects, and the results showed vastly improved blood sugar control and quality of life.

~ ~ Another major breakthrough took place in 1999 at Aberdeen University in Scotland. Scientists discovered that cells taken from the pancreases of new-born babies suffering from the relatively rare PHHI disease – neo natal hypoglycaemia in which they have too much insulin in their blood – could be cultured. Using genetic engineering techniques they managed to repair the defects in these cells and produce the first ever human insulin secreting cell line which responds to glucose. It is possible that these cells could be encapsulated in the same way as pigs’ islets. Animal trials are expected to last 3 years, and if successful the procedure could be available to humans by 2005.

~ ~ To quote Alaistair T. Gordon, President of The Islet Foundation in Ontario, Canada, who gave invaluable assistance in the researching of this article. “As a journalist, I hope you are able to let everybody know that there is a REAL (his emphasis) possibility of curing diabetes, and that research monies should go to islet replacement, rather than new treatments for diabetes. If enough people realise the potential of islet replacement, then affected families may press much harder for more intelligent use of research funding.”
None of these experiments or outcomes is proof positive of a definitive cure for the heartbreaking disease of diabetes. However, if the ongoing development required to build on these early successes is supported and nurtured, perhaps a cure for diabetes will become a long awaited reality in the very near future.


FOOTNOTE

><br><br><br><br>~ ~ It is only in the past week that the news has broken that the insulin inhaler I referred to in this article has now been approved for general use by the FDA in the United States.
This is WONDERFUL news, and will make a huge difference in the future treatment of the disease, with far fewer actual insulin injections having to be administered on a daily basis.

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