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Kos Diabetes Group: Diabetes News for January 2023 [1]

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Date: 2023-01-13

I couldn’t find a picture of an insulin pump so you get these cute kittens instead

Artificial Pancreas for Type 2 Diabetes

University of Cambridge scientists have successfully trialed an artificial pancreas for use by patients living with Type 2 diabetes. The device combines an off-the-shelf continuous glucose monitor and an insulin pump with an app developed by the team, known as CamAPS HX. This app is run by an algorithm that predicts how much insulin is required to maintain glucose levels in the target range. They have shown that the use of the device with their app can double the amount of time patients were in the target range for glucose compared to standard treatment and halved the time spent experiencing high glucose levels.

The researchers have previously shown that an artificial pancreas run by a similar algorithm is effective for patients living with Type 1 diabetes, from adults through to very young children. They have also successfully trialed the device in patients with Type 2 diabetes who require kidney dialysis.

I know it’s in the UK but it will get here. I just hope that insurance companies will cover it.

Insulin Pill May Be on the Way

People affected by diabetes often take insulin multiple times per day. Because frequent injections can be painful, some patients don’t take the recommended doses at the correct times.

This could be replaced with an easy to swallow pill

An oral form of the drug would solve this problem, but the harsh environment of the stomach breaks down and neutralizes the insulin before it can be absorbed by the intestines and get into the bloodstream. Previous attempts at oral administration protected the hormone from stomach acids with micro- or nanocarriers but relied on insulin to passively diffuse into the cells that line the colon, which isn't very efficient. A better approach would be actively moving the medicine around the body instead. Yingfeng Tu, Fei Peng, Kun Liu and colleagues wanted to achieve this effect with their insulin-loaded mini-tablets, which featured tiny, chemical "micromotors" that could deliver insulin to the colon safely and effectively.

To make these tablets, the researchers covered magnesium microparticles with a layer of an insulin-containing solution and a layer of liposomes. They then mixed these particles with baking soda, pressed them into mini-tablets that were about 3 mm long then covered them with an esterified starch solution. The starch protected the tablets from stomach acid, allowing them to reach the colon intact. As they broke down, the magnesium microparticles reacted with water to generate a stream of hydrogen gas bubbles, which acted as micromotors that propelled insulin toward the colon's lining to be absorbed. The team tested their mini-tablets in rats and found that they could significantly reduce the animals' blood glucose levels for over five hours. In fact, they could maintain a glucose level almost as low as injection-delivered insulin. Though more work is needed, the researchers say this is a concrete step toward creating more oral formulations of traditionally injection-only medications.

Can Gut Bacteria Cause Diabetes?

For years, researchers have sought to understand why people develop diabetes by studying the composition of the microbiome, which is a collection of microorganisms that include fungi, bacteria and viruses that live in the digestive tract.

This sleepy pup is nicer to look at than gut bacteria

The microbiome is thought to be affected by medications and diet. Studies have also found that people who don't process insulin properly have lower levels of a certain type of bacteria that produce a type of fatty acid called butyrate.

A study published in the peer-reviewed journal Diabetes,by the researchers at the Diabetes Research at Cedar-Sinai found people with higher levels of a bacterium called Coprococcus tended to have higher insulin sensitivity, while those whose microbiomes had higher levels of the bacterium Flavonifractor tended to have lower insulin sensitivity.

Coprococcus and related bacteria formed a network of bacteria with beneficial effects on insulin sensitivity. Despite being a producer of butyrate, Flavonifractor was associated with insulin resistance; prior work by others have found higher levels of Flavonifractor in the stool of people with diabetes.

Researchers will continue to study samples from patients who participated in this study to learn how insulin production and the composition of the microbiome change over time. They also plan to study how diet may affect the bacterial balance of the microbiome.

Researchers stated that it is too early to know if or how people can change their microbiome to reduce their diabetes risk. More research is required to identify the specific bacteria that need to be modulated to prevent or treat diabetes, but researchers are hopeful that the answer will be found in the next five to 10 years.

Metformin Use May Lessen the Need for Hip and Knee Replacements

Experts from China, Taiwan, and Australia analyzed data on 40,694 people diagnosed with type 2 diabetes.

I couldn’t find a pill picture I liked so you get these guys instead

They focused on patients at least 45 years of age diagnosed with Type 2 diabetes between January 2000 and December 2012. Half of the subjects identified were women, and the mean age was 63.

The researchers matched 20,347 metformin users with 20,347 nonusers by age, gender, and time of diabetes diagnosis. The team also considered diabetes severity, pain medications, insulin, and other diabetes medications such as sulfonylureas. They accounted for comorbidities, including obesity, hypertension, depression, COPD, rheumatoid arthritis, and osteoporosis.

Looking at the 14-year follow-up period, they found that metformin use correlates with a lower cumulative incidence probability of total knee replacement or total hip replacement.

The incidence of knee or hip replacement throughout the study was 3.40 per 10,000 person-months among users, compared to 4.99 per 10,000 person-months among nonusers.

The multinational team will continue exploring metformin’s potential to help people with osteoarthritis and obesity.

All of these studies and findings are very promising. Little by little we are unlocking the mysteries of the human body.

Read more here

https://www.sciencedaily.com/news/health_medicine/diabetes/

https://www.medpagetoday.com/endocrinology/diabetes/102293

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[1] Url: https://www.dailykos.com/stories/2023/1/13/2146962/-Kos-Diabetes-Group-Diabetes-News-for-January-2023

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