TWC News Update: Special Report: Diabetes Care

Notre Dame Receives Funding for Wound Repair

  Officials with the American Diabetes Association (ADA) have announced a $1.6 million Accelerator Award to a research professor at the University of Notre Dame (ND) to focus on the “Strategy to Accelerate Diabetic Wound Repair” project. Headed by Mayland Chang, PhD, the research is broadly focused on exploring the molecular basis of disease and designing small molecules for therapeutic interventions. Part of the ADA’s Pathway Awards program, the grant will provide funding over five years.

  Using a mouse model and a novel diagnostic resin that binds to active forms of matrix metalloproteinases (MMPs), proteases involved in tissue remodeling, Chang’s research group found that MMP-9 may cause diabetic wounds and MMP-8 may be involved in wound repair, according to the university. They also demonstrated that selective pharmacological inhibition of MMP-8 delayed wound repair and inhibition of MMP-9 accelerated wound healing. Through a combination of research techniques, Chang’s project will reportedly identify the mechanisms associated with diabetic wound development, progression, and healing; study bacterial colonization in diabetic wounds; and find interventions that expedite the healing process. To achieve these goals, she will validate the roles of MMP-8 and MMP-9 in diabetic wounds, investigate the relevance of these MMPs in human patients, evaluate novel MMP-9 inhibitors, and determine the contribution of bacterial infection on wound repair, ND officials said.

   “This research project will allow intervention of chronic wounds, a complication of diabetes for which pharmacological clinical recourse is not available,” Chang added. “Our work holds great promise in addressing an unmet medical need.”

  Accelerator Awards are designed to support early-career investigators or established researchers who are accomplished in other fields and would like to apply their expertise to innovative diabetes-related research topics, according to the ADA. A newer area of work for Chang is to understand why diabetic wounds are so difficult to treat and to develop novel therapeutics to promote wound healing, ND officials said.

UT Researchers Create Blood Sugar-Normalizing Cells

  Researchers at the University of Iowa (UI) say recent findings may be a first step toward developing patient-specific cell replacement therapy for those living with diabetes type 1. The researchers claim that, starting from human skin cells, they’ve created human insulin-producing cells that respond to glucose and correct blood-sugar levels in diabetic mice. For the new study, which originally published in the journal PLOS ONE, the UI team reprogrammed human skin cells to create induced pluripotent stem (iPS) cells, which were then coaxed into forming insulin-producing cells. When these cells were transplanted into mice, the cells secreted insulin and reduced blood sugar levels to normal or near-normal levels. Although the cells were not as effective as pancreatic cells in controlling blood sugar, researchers said the results are “encouraging” in progressing toward a goal of generating effective insulin-producing cells that can be used as a potential cure. The UI study is reportedly the first to use human iPS cells to create insulin-producing cells. Creating these cells from a patient’s own cells would not only eliminate the need to wait for a donor pancreas, but would also mean patients could receive transplants without needing to take immunosuppressive drugs, researchers said, adding that using iPS cells rather than embryonic stem cells as a starting point also avoids the ethical concerns some people have with using embryonic stem cells. In the mouse study, insulin-producing cells were placed under the kidney capsule, where they developed into an organ-like structure with its own blood supply. This new “organ” secreted insulin and gradually corrected the blood sugar levels in the mice over a period of several months. In addition, after the mice became normoglycemic, the glucose levels stayed steady, researchers said. By developing the cells in a stepwise fashion, the UI team was also able to collect and use only those cells that would develop into pancreatic cells. This meant they were able to remove very immature (undifferentiated) cells that could form tumors. None of the mice developed tumors from the transplanted cells, according to researchers.

ADA Revises Guidelines for Statin Treatment With Diabetes

  New recommendations from the American Diabetes Association (ADA) call for most patients who live with diabetes to receive at least a moderate statin dosage regardless of their cardiovascular disease-risk profile. According to the ADA’s “Standards of Medical Care in Diabetes – 2015” recommendations on assessing patients for statin treatment should shift from a decision based on blood levels of low-density lipoprotein cholesterol to a risk-based assessment. This change brings the ADA’s position in line with that of the 2013 guidelines of the American College of Cardiology and the American Heart Association. The revised standards recommend a “moderate” statin dosage for patients ages 40-75 as well as those who are older than 75, even if they have no other cardiovascular disease risk factors. Dosages should be intensified to “high” for patients diagnosed with cardiovascular disease and for those ages 40-75 and living with other cardiovascular disease risk factors. For patients older than 75 living with cardiovascular disease risk factors, the revisions call for either a moderate or high dosage.

  Among patients younger than 40 with no cardiovascular disease or risk factors, the revised standards call for no statin treatment, a moderate or high dosage for patients younger than 40 with risk factors, and a high dosage for those with cardiovascular disease.