UTMB gives hope for diabetes cure

From staff reports The Galveston Daily News

Published May 26, 2007

GALVESTON — A stem-cell cure for diabetes could be one step closer, thanks to a discovery at UTMB that is exciting the medical world.

Researchers at the Galveston facility have found a way to produce insulin by engineering the stem cells from umbilical cords rather than from embryonic stem cells.

Their discovery someday may help cure type 1 diabetes by allowing sufferers of the disease to grow their own insulin-producing cells for a damaged or defective pancreas.

The researchers announced their laboratory finding, which caps nearly four years of research, in the June issue of the medical journal Cell Proliferation, posted online this week.

Their paper called the process “the first demonstration that human umbilical-cord-blood-derived stem cells can be engineered” to synthesize insulin.”

At present, the discovery is extremely basic research, Dr. Randall J. Urban, senior author of the paper, said. “It doesn’t prove that we’re going to be able to do this in people — it’s just the first step up the rung of the ladder,” he cautioned.Urban, professor and chair of internal medicine at UTMB and director of its Nelda C. and Lutcher H. J. Stark Diabetes Center, said: “This discovery tells us that we have the potential to produce insulin from adult stem cells to help people with diabetes.”

The lead author of the paper, UTMB professor of internal medicine-endocrinology Larry Denner, said that, by working with adult rather than embryonic stem cells, doctors practicing so-called regenerative medicine eventually may be able to extract such cells from an individual’s blood, then grow them in the laboratory to large numbers and tweak them to direct them to create a needed organ.

In this way, he said, physicians could avoid the usual pitfall involved in transplanting cells or organs from other people — organ rejection, which requires organ recipients to take immune-suppressing drugs for the rest of their lives.

Huge numbers of stem cells are thought to be required to create new organs. Researchers could remove thousands of donor cells from an individual and grow them in the laboratory into billions of cells, Denner explained.

Then, for a person with type 1 diabetes, researchers would engineer the new cells to become islets of Langerhans, the cellular masses that produce the hormone insulin, which allows the body to utilize sugar, synthesize proteins and store neutral fats, or lipids.

“But we’re a long way from that,” Denner warned. The researchers used human umbilical-cord blood because it is an especially rich source of fresh adult stem cells and is easily available from donors undergoing Caesarian section deliveries in UTMB hospitals.It also avoids the moral and legal difficulties associated with embryonic stem-cell research in this country.

“However,” Denner added, “embryonic stem-cell research was absolutely necessary to teach us how to do this.”Embryonic stem cells have been engineered to produce cardiac, neural, blood, lung and liver progenitor cells that perform many of the functions needed to help replace cells and tissues injured by many diseases, the paper notes.

Among the insights into cell and tissue engineering gained from work with embryonic stem cells, it adds, are those “relevant to the engineering of functional equivalents of pancreatic, islet-like, glucose-responsive, insulin-producing cells to treat diabetes.”

In addition to Denner and Urban, co-authors of the study — entitled “Directed engineering of umbilical cord blood stem cells to produce C-peptide and Insulin” — included Yvonne Bodenberg, Jiangang Zhao, Margaret Howe and Ronald G. Tilton, all of UTMB’s Stark Diabetes Center and McCoy Diabetes Mass Spectrometry Research Laboratory.

They were joined by Julie Cappo, formerly of UTMB and now of Institut Universitaire de Technologie, Montpellier, France; John A. Copland, of the Department of Cancer Biology, Mayo Clinic Comprehensive Cancer Center, Jacksonville, Fla.; and Nico Forraz and Colin McGuckin of the Institute of Stem Cell Biology and Regenerative Medicine, University of Newcastle Upon Tyne, England.

I went to the doctor and the doctor said...

...I have a bunch of changes to make. This is my last week with the Navigator and I am beginning to get pretty bummed about that. Yesterday I met with my diabetes educator, who hung the moon, and we looked at my blood sugars from the CGM on the CoPilot software. She'd look at day after day of readings and say, "See here, you are dipping a little at 5:00 a.m. and you seem to be rising after lunch each day."

There is NO WAY she could have ever seen those changes without the CGM. We made a new pattern for my week (or two) of hormonal changes after I ovulate (TMI for you guys, but I bet you have hormone fluctuations, too) and we made many adjustments to my basal rates and also to my sensitivity.

I also learned that my older version of the Minimed pump (712) does not have a way to change the duration of the insulin board based upon what kind of insulin you use. It is automatically set to assume that it is hanging in there for eight hours after a bolus, whihc really messes with correwctions post meal. I have seen with the CGM that two hours post meal (where I had a correction with my meal) it says 216. I try to do a correction, but it says 0.0, assuming I have insulin on board that will cover the high. I check again at four hours, still high and says no correction, BUT, the insulin is long gone. SO, now if I see highs four hours after a meal or correction and my sugar hasn't gone down, I will ignore the 0.0 and do the correction.

I would have ever seen the subtly and nuance of my blood sugars and reaction to food without this thing.

Can you hear the woe in my voice? I talk about this CGM like it is a friend who has walked away from me to hang out with the cool kids. Of course, I can just go buy the Minimed version, but I want the smaller sensor; I want second generation technology, not the huge two piece unit. I want one with the kinks worked out. So, I wait and I guess I'm going to have to check my blood sugars more than a couple times a day.

HOWEVER, I have today, Thursday and the morning on Friday to use this tool and work out the kinks of the changes we made. Pretty drastic changes and I am excited to see if they fix my low-highs (low 200s).

Headed to a press conference at 11:00 a.m. at the Texas State Capitol where a very positive stem ell research bill that supports research for degenerative diseases and conditions (that means diabetes) will be announced.