Diabetes
Stories of Hope: Diabetes
Shannon Combs
My daughter, Taylor, has Juvenile Diabetes. She uses an insulin pump and keeps a good tight control over her disease. It is difficult everyday, and she is beginning middle school next year and I am sure rougher times are sure to come. She is also profoundly deaf and wears a Cochlear Implant, she has nerve damage in her ears. I am a strong supporter of this initiative for these two reasons alone. Taylor is 11 years old and is a beautiful, active and an all-around great little girl. She does not deserve diabetes or deafness...we are committed to the Initiative in every way we can. From what I understand, not only could stem cell research potentially help to rid my daughter of her diabetes, but could help correct her nerve damage by the work of spinal cord/nerve damage research.
We hope that many others will find it in their hearts to understand what positive research this is and that we need to look beyond all the politics, and concentrate on the millions of Americans that will reap the benefits of the stem cell research! Thank you Missouri Cures! As a parent of a child in need, keep going strong so we will get answers to these dreadful impairments and diseases.
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Gina Downey
My 13 year-old daughter Lisa is a great kid! She gets good grades in school and is a very talented violinist. She's pretty and funny and full of life! Lisa was diagnosed with Type I Diabetes at the tender age of 5. For years she has checked her blood sugar at least 4 times a day and taken insulin injections without complaint or ever saying "why me?" She watched as the other kids in class ate the birthday cupcakes that someone's mom brought. Lisa now uses an insulin pump which has made life for her a bit easier, but still is at risk of complications such as developing heart disease, eye disease, kidney disease, neuropathy and blindness along with infections and the possibility of losing limbs to amputation. LISA DESERVES A CURE and I will never give up! Please join me in supporting Stem Cell Research.
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Medical Background
Diabetes is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. Insulin is a cellular protein that regulates glucose levels in the blood.
Type 1 diabetes is often called “juvenile diabetes” because it generally appears during childhood or adolescence. It develops when the body’s immune system mistakenly destroys the insulin-producing islet cells of the pancreas, a small gland behind the stomach. As a result, the body is unable to properly utilize energy in food or control sugar levels in the blood stream.
Type 1 diabetics must endure many painful insulin injections each day in order to live and function normally and, at present, there is no cure. However, recent research indicates that a cure may be possible through transplants of pancreatic islet cells.
Type 2 diabetes usually begins as insulin resistance, a disorder in which the cells do not use insulin properly. As the need for insulin rises, the pancreas gradually loses the ability to produce it. This type of diabetes usually occurs later in life, affecting 90% of patients diagnosed with diabetes.
Type 2 diabetes is associated with older age, obesity, family history of diabetes, physical inactivity and race/ethnicity. African Americans, Hispanic/Latino Americans, Native Americans, and some Asian Americans, Native Hawaiian or other Pacific Islanders are at particularly high risk for Type 2 diabetes. Type 2 diabetes is also increasingly being diagnosed in children and adolescents. Current treatment includes using diabetes medicines, making wise food choices, exercising regularly, taking aspirin daily, and controlling blood pressure and cholesterol.
Diabetes can lead to many serious long-term health problems and early death. It can cause blindness, kidney failure and severe problems involving the gums and teeth. It can also cause nerve damage and blood flow problems that result in impaired sensation or pain in the feet or hands and amputation of limbs. One of the most serious problems caused by diabetes is heart disease. People who have diabetes are more than twice as likely to develop heart disease or a stroke as people without diabetes.
Human and Social Costs
Over 18 million people in the U.S., or 6.3% of the population, have diabetes. Over one million new cases are diagnosed every year. Diabetes was the sixth leading cause of death listed on U.S. death certificates in 2000. Diabetes kills roughly 1,500 Missourians each year, and the American Diabetes Association estimates that diabetes contributes to over 200,000 deaths annually nationwide. However, total deaths caused by diabetes are probably under-reported because it ultimately causes other health problems that may be listed as the cause of death.
In 2000, a total of 129,183 people with diabetes underwent dialysis or kidney transplantation. About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage. The results of such damage include slowed digestion of food in the stomach, carpal tunnel syndrome and other nerve problems.
It’s estimated that diabetes costs Americans a total of $132 billion annually, including $92 billion in direct medical costs and $40 billion in costs related to disability, work loss and premature death. Diabetes accounts for one of every four Medicare dollars spent in the U.S.
The Missouri Department of Health and Senior Services estimates that over 278,000 children and adults in our state have diabetes. About half are over the age of 55 and most of these older patients have Type 2 diabetes. African Americans and Hispanics have higher rates of diabetes than the general population. While African Americans make up 11% of Missouri residents, they account for 14% of Missourians diagnosed with the disease. Hispanics are more than twice as likely to have diabetes as the general population.
A recently published study (online) estimated that over 69,000 Missouri children and adults suffer from Type 1 diabetes and LADA, a similar type of diabetes that develops in adults. The study estimated that the direct health care costs and indirect social costs (lost work time, etc.) associated with Type 1 diabetes and LADA will cost Missourians a total of about $589 million in 2005 and more than $23 billion over the next 20 years. (The study did not estimate costs for Type 2 diabetes.)
The Potential for Stem Cell Cures
More than 50 years of research on adult stem cells, taken from adult tissues, has produced such lifesaving treatments as bone marrow transplants for leukemia patients. And, adult stem cells are likely to provide additional cures for some diseases in the years ahead.
However, the new frontier in stem cell research involves early, or “embryonic,” stem cells (ES cells). Unlike adult stem cells, ES cells have the potential to turn into and regenerate any type of cell or tissue in the human body. As a result, ES cells could provide cures for many currently incurable or common diseases and injuries that cannot be cured with adult stem cells, or more effective treatments than adult stem cells may provide.
There are two basic sources of ES cells for such potential therapies. One source is the leftover embryos at fertility clinics that would otherwise be discarded and destroyed. ES cells can also be produced with Somatic Cell Nuclear Transfer (SCNT), a process that uses a patient’s own cells and an unfertilized human egg to make ES cells. SCNT has the added advantage of producing ES cells that will automatically match the patient’s genetic makeup. As a result, SCNT avoids the need to find a genetically matching donor and the problem of immune system rejection, two limitations associated with donated adult and ES cells.
Indications that ES cells could benefit diabetes patients have been provided by a number of recent studies. For example, researchers at Stanford University have successfully turned mouse ES cells into insulin-making tissue that kept diabetic mice alive.
Other research has shown that insulin-producing islet cells can be transplanted into patients with Type 1 diabetes and that such transplants could potentially provide a cure. However, the only current source of replacement islet cells is from human cadavers and not enough donated islet cells are available from this source to treat the many children and adults who have Type 1 diabetes. In addition, because donated islet cells are not a perfect genetic match with the patient’s DNA, patients who receive donated islet cells must take powerful drugs to prevent rejection. These drugs have severe and potentially fatal side effects and rejection often occurs despite the medication.
SCNT could help overcome these limitations and revolutionize the treatment of juvenile diabetes by providing a way to make virtually unlimited supplies of transplantable islet cells that match a patient’s DNA.
In the future, transplants of ES cells could also help people who suffer from Type 2 diabetes. For example, ES cells could be used to help repair tissues and organs that are damaged by effects of Type 2 diabetes and alleviate some of the health problems associated with this disease.
SCNT could also play an important role in developing future “gene therapy” treatments for inherited diseases like Type 1 diabetes, which develop because the patient has an abnormal or malfunctioning gene. If the gene that causes a disease can be identified, scientists could take a patient’s somatic cell, such as a skin cell, and replace the defective gene with a normal gene inserted using recombinant DNA techniques. The “corrected” cell could then be used in the SCNT procedure to generate stem cells with normally functioning genes. These could then be directed to develop into islet cells and put back into the patient’s body, potentially providing a cure. This technique would overcome some of the most difficult hurdles facing gene therapy today.
In addition, SCNT has given medical researchers a method of growing cells that have the defects associated with a disease in a laboratory setting. This use of SCNT provides new ways to study how a disease like diabetes progresses at the cellular level and to test the effectiveness of new drugs or other treatments that may cure or slow the progress of the disease.
The consensus of the medical and patient community is that all types of stem cell research should be pursued in the effort to find cures for diseases like diabetes, and that ES cells can play an important role in this effort.
That’s why ES cell research is strongly supported by the overwhelming majority of medical researchers; medical organizations like the American Medical Association; and disease and patient advocacy groups like the American Diabetes Association, Juvenile Diabetes Research Foundation and Diabetes Research Institute Foundation.
LINKS TO MORE INFORMATION:
“All About Diabetes.”
American Diabetes Association
- http://www.diabetes.org/about-diabetes.jsp
The Juvenile Diabetes Research Foundation: Stem Cell Advocacy
- http://www.jdrf.org/index.cfm?page_id=103932
Missouri Department of Health and Senior Services - http://www.dhss.mo.gov/diabetes/
American Diabetes Association supports Somatic Cell Nuclear Transfer (SCNT)
- http://www.diabetes.org/advocacy-and-legalresources/state-legislation/stemcell.jsp
“Economics of Diabetes.”
DiabetesLiving.com
- http://www.diabetesliving.com/basics/bsc_econ.htm
“Making Insulin Out Of Stem Cells.”
CBS News
- http://www.cbsnews.com/stories/2002/11/19/health/main529925.shtml
Stem Cell Network.
- http://www.stemcellnetwork.ca/library/entries/diabetes.php
National Institutes of Health paper on the difference between SCNT and human reproductive cloning, discussing the potential benefits of SCNT for diabetes patients
- http://ospp.od.nih.gov/policy/cloning.asp
“Study Shows SCNT Stem Cell Research Could Benefit Over 500,000 Missouri Patients and Reduce State Health Care Costs by Billions.”
- News2Admin?page=ArticleEditor&id=5173
“Researchers Uncover the Remaining Critical Insulin Gene Regulatory Factor.”
Joslin Diabetes Center
- http://www.joslin.harvard.edu/news/insulin_gene01.shtml
“Cloned Stem Cells Could ‘Reboot’ Immune System.”
- http://www.uklupus.co.uk/news35.html
British Medical Journal article: Islet and stem cell transplantation for treating diabetes
- http://www.myriamdiabetes.homestead.com/files/Serup_et_al_diabetes.pdf
“Autoimmune Diseases and the Promise of Stem Cell-Based Therapies.”
The National Institutes of Health
- http://stemcells.nih.gov/info/scireport/chapter6.asp
“Stem Cells and Diabetes.”
The National Institutes of Health
- http://stemcells.nih.gov/info/scireport/chapter7.asp
"Diabetes Research Institute Demonstrates New Approach to Transform Stem Cells into Insulin-Producing Cells." Stem Cell Research Foundation
- http://www.stemcellresearchfoundation.org/WhatsNew/March_2005.htm#8
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