07:52am Sunday 23 February 2020

Current advances in diabetes research at Mount Sinai Hospital

Diabetes has reached epidemic proportions worldwide and is a leading cause of heart disease, stroke, blindness, kidney failure and limb amputation. Two hundred and eight-five million people worldwide are affected by diabetes. With a further seven million people developing diabetes each year, this number is expected to hit 438 million by 2030.1 Several studies have shown that lifestyle changes and appropriate pharmacologic therapy can significantly reduce the development of type 2 diabetes in people at risk of the disease.
Ongoing research at the Lunenfeld is uncovering new insights into diabetes and opening the door to better therapies and even ways to prevent to prevent the illness in the first place. Here’s what scientists at several labs in the Lunenfeld are exploring in diabetes:
Stem cell-based therapies 
Will the next blockbuster treatment for diabetes start with a stem cell? The field of regenerative medicine is rapidly advancing by the potential to reprogram one cell type into another, with implications for diabetes. For example, Lunenfeld scientist Dr. Ian Rogers is investigating the use of blood stem cells that can become cells and tissues of the pancreas, muscle and nervous system. His lab has designed and is perfecting a method to grow cells that could treat type 1 diabetes and regulate insulin levels in patients, in effect replacing the need for daily insulin injections.  
Diabetes and disease remission
The concept of disease remission is most commonly associated with cancer or arthritis—but could people with type 2 diabetes enter remission as well, and experience periods of full symptom control? To find out, Mount Sinai’s world-renowned diabetes clinician and Lunenfeld scientist Dr. Bernard Zinman is recruiting patients for a new study—the first of its kind in Canada—to assess this very idea.  Type 2 patients are being enrolled and treated with intensive insulin therapy for one month to improve beta cell function, which may put their diabetes in remission when combined with other treatments. 
Safer diabetes drugs
New therapies are greatly improving blood sugar control for people with type 2 diabetes.  The two most recently approved drug classes for the treatment of diabetes, DPP-4 inhibitors and GLP-1R agonists (both now widely used in Canada), are based in significant part on the basic science work conducted by Mount Sinai’s Dr. Daniel Drucker. But what about the safety of these medications? Dr. Drucker is now investigating the cardiovascular effects of these drugs, in parallel with seven major clinical cardiovascular outcome studies to rigorously assess the safety of new drugs in patients with diabetes and heart disease. 
Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both. Type 1 diabetes is an absolute deficiency of insulin secretion, while type 2 diabetes results from a combination of resistance to insulin action and an inadequate compensatory secretory response. Type 2 diabetes accounts for 90 to 95% of the incidence of diabetes and is associated with a strong genetic predisposition as well as age, obesity and lack of physical activity.
1. Canadian Diabetes Association.

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