December 2011 eUpdate
Islet Transplantation Program Continues to Evolve
The UCSF Pancreatic Islet Transplantation Program led by Andrew Posselt, MD, PhD, continues to be very active and, most importantly, very cutting edge. Not only does Dr. Posselt and his team efficiently and effectively harvest islets through their state-of-the-art islet isolation process, they are using new enzymes to ensure islet viability throughout the transplant process. Also, the team is using a number of new drugs they believe will be more effective than other historical drugs in allowing them to conduct transplants with fewer islets, fewer side effects, and better long term results through the prevention of islet rejection. Eventually they hope to utilize islets made from stem cells, plus develop a protocol that requires minimal immunosuppression.
Fortunately, a large percentage of patients who undergo islet transplantation become insulin independent. One islet transplant recipient, Alison Wesley, tells her story in an article featured on the UCSF School of Medicine’s website. The story, “Frontiers of Clinical Research: Islet Transplantation,” highlights this exciting clinical research aimed to improve and save the lives of millions of patients with diabetes.
New Type 1 Prevention Studies Moving Forward
For relatives of people with type 1 diabetes who are not yet diagnosed, but who are at risk for type 1 diabetes, there are now promising clinical trials available.
UCSF Pediatric Diabetes Program Director Stephen Gitelman, MD, suggests that all family members take a simple blood test which screens for the presence of diabetes-related autoantibodies that may appear years before type 1 diabetes develops. This antibody screening is part of a national research program called Type 1 Diabetes TrialNet and is being conducted to help understand more about the development of this disease and to look at ways to delay or prevent it.
For those found to be at intermediate risk of developing diabetes (25 percent chance of getting diabetes in the next five years), there is a trial introducing oral insulin. For those found to be at high risk (greater than 50 percent chance of diabetes in the next five years), there is a trial utilizing the anti-CD3 monoclonal antibody. [UCSF News Office Story]
For more information on these studies or other clinical research being conducted at UCSF, contact Kathleen Fraser.
Fatty Liver Research Discovery With Implications For Obesity And Type 2 Diabetes
Diabetes Center researcher Allison Xu, PhD, is focused on understanding how the central nervous system regulates body weight and glucose levels. She studies how body weight is dependent on the brain sensing and responding to changes in energy stores in the body. Her exciting research often focuses on the hormone leptin and how it works in a critically important organ of the body, the liver.
The liver is responsible for changing fats eaten in the diet to types of fat that can be stored and used by the body. Hepatic steatosis, or fatty liver, is the collection of excessive amounts of triglycerides and other fats inside liver cells which, left untreated, can contribute to numerous illnesses. It has been generally thought to develop via peripheral mechanisms associated with obesity.
This month in the scientific journal Cell Metabolism, Dr. Xu and her team from UCSF, the San Francisco VA Medical Center, and the University of Michigan discovered that the hormone leptin will help suppress the fat content in the liver by stimulating the sympathetic nervous system’s control over the liver. They discovered that leptin can play this suppressive effect, independent of feeding and body weight -- if an enzyme that is involved in various cellular functions is present. If this leptin-induced enzyme, phosphatidylinositol 3-kinase (PI3K), is impaired or reduced, it leads to decreased liver activity and increased triglyceride levels -- without affecting obesity or key insulin signaling pathways in the liver.
This study is significant because conditions such as obesity and liver fat content are strongly correlated with insulin resistance. Thus, this study provides a new view on the role of central leptin resistance in causing obesity-associated fatty liver, insulin resistance and type 2 diabetes.
Dr. Xu is a member of the UCSF's Center for Obesity Assessment, Study and Treatment (COAST). Founded in 2004, COAST is focused on reducing the prevalence and adverse consequences of obesity. This group seeks to advance knowledge and understanding of the mechanisms by which stress influences obesity, and to develop effective interventions.
New Mobile App Launched By Diabetes Teaching Center and QuantiaMD, Offers Patients $100
True or False: Your liver naturally produces sugar (glucose). If you can answer this question, you could win $100 when you download and play DiabetesIQ. Dr. Martha Nolte Kennedy and her team at the Diabetes Teaching Center have launched this FREE mobile application that lets patients explore their knowledge of diabetes. Users take quizzes that provide extensive feedback, solve visual puzzles, progress through multiple game levels and compare results with other contestants.
“Education is a fundamental part of diabetes therapy,” said Dr. Nolte Kennedy, Medical Director of the Diabetes Teaching Center. QuantiaMD, who created the application with UCSF, is holding a drawing for every user that downloads the app and completes all quizzes through Level 2. Ten $100 prizes will be given away.
Download our new app today. Diabetes IQ works with iPhone, iPad, or iPod touch devices running iOS 4.0 or later, or Google Android 1.6 and higher - and is available on the Apple iTunes store and Google Android market.
For more information on this new, innovative resource for diabetes management, read this UCSF News Office Story.
SAVE THE DATE - Diabetes Symposium & Kids Kamp
Our very popular Diabetes Symposium & Kids Kamp is scheduled for Saturday, March 10, 2012, 8:30 a.m. - 3 p.m., UCSF Mission Bay Conference Center in San Francisco. This educational program is being held in cooperation with the Diabetic Youth Foundation and Mills-Peninsula Health Services.
This program is open to families with children and teens with diabetes, adults with type 1 diabetes, healthcare providers and the community at large.
During the program, adults will hear informative presentations on both diabetes management and cutting-edge research. Children and teens with diabetes and their siblings will be educated and entertained at Kids Kamp.
Stay tuned...program details will be announced in early 2012. If you have any questions regarding this program, please contact Kathleen Fraser.
In the meantime, we invite you to review our online Pediatric Diabetes Teaching Materials developed by our UCSF Pediatric Diabetes Program, and our educational website created by our UCSF Diabetes Teaching Center for adults, Diabetes Education Online.
Make A New Year’s Resolution To Sign Up For A Diabetes Education Class
Whether you are newly diagnosed or simply in need of more information to manage your diabetes, the UCSF Diabetes Teaching Center (DTC) can help. As one of the country’s oldest diabetes education programs, the DTC offers classes for individuals with type 1 and type 2 diabetes. Diabetes management is a lifestyle, and while we understand it is not a lifestyle that you would have chosen, it is one that you can master to stay healthy. For more information: [CLASSES] [CLASS SCHEDULE]
IN THE NEWS
Los Angeles Times: Diabetes and the Stem Cell Promise - Center Director Matthias Hebrok is featured in this story.
The Immune System Has Protective Memory Cells, Researchers Discover - UCSF scientists publish regulatory T cell study in the prestigious journal, Nature.
DIABETES CENTER NEWS
Holiday Wishes From Our Center Director
In this season where friends and family are so important, it is timely for us to acknowledge the tremendous support of our extended family – patient families, donors, and our research and clinical collaborators throughout the globe.
This year, we continued to make advancements in both our scientific endeavors and in our clinical programs. This progress would not have been possible without your continued commitment to the Diabetes Center at UCSF.
On behalf of our faculty and staff, we wish you and your loved ones the best this holiday season.
Matthias Hebrok, PhD, Director, UCSF Diabetes Center
The Diabetes Center at UCSF is among the premier institutions for clinical trials of emerging therapies in diabetes. Numerous clinical trials in type 1 and 2 diabetes are now underway.
Interested in participating? A sample of our trials is listed below. For a list of all of our trials, visit the clinical trials section of our website, or contact Kathleen Fraser, our Clinical Trials Recruitment Coordinator.
Type 1 Diabetes: TrialNet Natural History Study [Antibody Screening] Seeking relatives of people with type 1 diabetes, 1 to 45 years of age
Type 1 Diabetes: An Oral Insulin Preventative Study Seeking relatives of people with type 1 diabetes, 3 to 45 years of age
Type 1 Diabetes: Anti-CD3 mAB (Teplizumab) Preventative Study Seeking relatives of people with type 1 diabetes, 8 to 45 years of age
Type 1 Diabetes: Inducing Remission in New Onset Type 1 Diabetes Mellitus with Alefacept (Amevive) Seeking volunteers newly diagnosed within 100 days, 12 to 35 years of age
Type 1 Diabetes: Efficacy of Islet After Kidney Transplantation Seeking volunteers 18-68 years of age
Type 2 Diabetes: Diabetes Support Project (DSP) Seeking adults with type 2 diabetes, HbA1c of 7.5% or higher, can read and speak English, have a partner or spouse
Type 2 Diabetes: Paleolithic-Type Diets and Metabolic Control Seeking volunteers 18 years of age and older with type 2 diabetes
Bone Study for Postmenopausal Women With or Without Type 2 Diabetes Seeking volunteers between 50 and 75 years old
APS1 and Autoimmune Disease Seeking volunteers at least 6 years old who have either autoimmune disease, have evidence of autoimmunity, have a family member with autoimmunity, or do not have autoimmune disease (healthy volunteer control)
Diabetes Center at UCSF
If you wish to receive more information about the UCSF Diabetes Center’s clinical and research programs, or would like to financially support one or more of these efforts, please contact Suzanne Ritchie at 415-476-6334. You may also visit our donation webpage and/or designate your donation to the program of your choice.
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