From: kutchScience
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Sent: Monday, March 14, 2005 12:40 PM
Subject: Transplant cures man of diabetes
http://news.bbc.co.uk/1/hi/health/4330717.stm & Study suggests 'type 3 diabetes'
http://news.bbc.co.uk/1/hi/health/4315609.stm


Dear Docs & science friends,

Transplant cures man of diabetes http://news.bbc.co.uk/1/hi/health/4330717.stm
&
Study suggests 'type 3 diabetes' http://news.bbc.co.uk/1/hi/health/4315609.stm
A 61-year-old man has become the first person in the UK to be cured of type 1
diabetes thanks to a groundbreaking cell transplant technique.
After receiving insulin-making cells from the pancreases of dead donors, Richard
Lane of Bromley, Kent, no longer needs insulin injections. The King's College
Hospital team said the breakthrough was hugely exciting for people with type 1
diabetes. But the technique is not perfect. Many patients still require top-up
insulin.

Mr Lane, who has had diabetes for over 30 years, had his first islet transplant
in September, followed by a second transplant a month later and the third at the
end of January. He told the Guardian newspaper: "I haven't felt better in myself
for 30 years. I have to pinch myself to ensure I am not dreaming." Mr Lane said
he used to suffer attacks of low blood sugar which could lead to
unconsciousness.

"My wife used to dread me going out of the front door in case there was a call
from the ambulance service. I am now doing half an hour's brisk walk every day,
and I have lost a stone-and-a-half in six months," he said. "It is almost like
being a totally different person." He now has to take drugs to stop his body
rejecting the transplanted cells. Two other UK patients who have been treated
with the procedure still need small doses of insulin.

Canadian researchers were the first to demonstrate that people with type 1
diabetes could remain free of insulin injections after the treatment was
complete. In diabetes, blood sugar is too high because the body cannot use it
properly. This is because the hormone insulin which enables the body to control
blood sugar levels is either not produced by islet cells in the pancreas or does
not work properly. For the transplant, healthy islet cells are taken from donor
pancreases and injected into the patient's liver. Once there, they develop their
own blood supply and begin to produce insulin.

Short supply

Professor Stephanie Amiel, who leads the diabetes team at King's College
Hospital, said: "The implications for the future are enormous. "Eventually this
could mean the end of insulin dependence for all type 1 diabetes sufferers." But
she said there was a shortage of donor pancreases from which to extract islet
cells, which means they could not treat everyone with type 1 diabetes. In the
UK, 250,000 people have type 1 diabetes, also known as insulin-dependent
diabetes. The condition usually appears before the age of 40. Japanese
researchers recently said they successfully transplanted islet cells from a
living donor.

Scientists have also been looking at ways to make more of the cells required
using stem cells. Jo Brodie of Diabetes UK said: "The success of islet
transplants is a major breakthrough in improving the lives of people with
diabetes. "Diabetes UK is now funding the work which we hope will turn this
breakthrough into a cure for all people with the condition. "The transplant work
is moving forward all the time and we hope it will become more widely available
in the future."

Annwen Jones, chief executive of Juvenile Diabetes Research Foundation, which is
also funding research into islet cell transplants, said: "Great improvements
have been made since the first procedure of this type in 2001 and we are
delighted that we now have the expertise to achieve insulin independence in the
UK."

Study suggests 'type 3 diabetes' http://news.bbc.co.uk/1/hi/health/4315609.stm

Scientists say they may have discovered a previously unknown form of diabetes,
after finding the brain produces insulin as well as the pancreas.

Unlike other types of diabetes, the form - dubbed type 3 by the US Brown Medical
School team - is not thought to affect blood sugar. Type 3 affects brain insulin
levels, and appears to be linked with Alzheimer's disease. The team's research
appears in the Journal of Alzheimer's Disease.

It raises the possibility of a type 3 diabetes

Study author Dr Suzanne de la Monte


Diabetes linked to Alzheimer's

Type 1 and type 2 diabetes occur when the body is unable to produce or use
insulin from the pancreas. The so-called 'type 3' diabetes refers to lower than
normal levels of newly discovered brain insulin, which appears to be associated
with Alzheimer's disease in some way. Scientists have known for some time that
people with diabetes have an increased risk of Alzheimer's disease - by up to
65%. They have also discovered that many type 2 diabetics have deposits of a
protein in their pancreas which is similar to the protein deposits found in the
brain tissue of people with Alzheimer's disease. Research has been going on to
find out what links the two conditions. Dr Suzanne de la Monte and colleagues
now believe it is down to what they are calling type 3 diabetes. By looking at
rodents and post-mortem brain tissue from people with Alzheimer's disease they
have found that insulin and its related proteins are actually produced in the
brain, and that reduced levels of both are linked to Alzheimer's disease.

'Brain' insulin

They say this insulin and its related growth factors and receptors in the brain
are vital for the survival of brain cells. If they are not produced at normal
levels, the cells die. In the case of Alzheimer's, the cells that die are
located in the part of the brain involved with memory, called the hippocampus.
Dr de la Monte, who is a neuropathologist at Rhode Island Hospital, said: "What
we found is that insulin is not just produced in the pancreas, but also in the
brain.

I suspect that the brain insulin itself is not very significant

Professor Greg Cole of the University of California, Los Angeles

"These abnormalities do not correspond to type 1 or type 2 diabetes, but reflect
a different and more complex disease process that originates in the central
nervous system." Not only does this opens the way for targeted treatment to the
brain and changes the way we view Alzheimer's disease, "it raises the
possibility of a type 3 diabetes", she said. "The implication is that treating
type 1 or type 2 diabetes may have no impact on Alzheimer's disease. We believe
that therapeutic agents need to be designed that specifically influence the
actions of insulin in the brain," she said. Cathy Moulton, care advisor at
Diabetes UK, said: "So far studies on a potential link between Alzheimer's and
diabetes have come up with inconclusive results.

'More research'

"There is some evidence to suggest that poorly controlled diabetes also affects
the functioning of the brain. "However, far more research on a link between
Alzheimer's and diabetes is needed before we can draw any firm conclusions." A
spokeswoman from the Alzheimer's Research Trust said: "Researchers have believed
for some time that the role of insulin and its growth factors are very important
in Alzheimer's disease. "Scientists have suggested that the link could be down
to molecular changes affected by insulin. "Work funded by the Alzheimer's
Research Trust is currently investigating the way insulin acts on the brain and
should improve our understanding of Alzheimer's and hopefully lead to way to new
treatments. Professor Greg Cole, from the University of California Los Angeles'
Alzheimer's Disease Research Center, said: "This is a new finding. It is
interesting that the brain makes very low levels of insulin. "But its
significance is unclear. The levels are so low that they have not been detected
with less sensitive methods. I don't think we can say they are high enough to
matter. "I suspect that the brain insulin itself is not very significant and
neither is its deficit in Alzheimer's disease and, therefore, I wouldn't call it
type 3 diabetes." But he said there was evidence that diabetes and Alzheimer's
are linked in some way.

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