Can Type 1 Diabetes Be Reversed?

Individuals with Type 2 diabetes are fortunate in that it's possible, with diet and lifestyle changes, to actually reverse the course of the disease. Even if they're unable to reverse Type 2, it's possible for them to avoid going on insulin by losing weight, watching carbs, and getting moderate exercise.

Those with Type 1, however, can't change the reality that they'll always need to take insulin since their bodies no longer make it. Or can Type 1 diabetes ever be reversed?

Very preliminary experiments suggest that it might in fact be possible to reverse Type 1 with an inexpensive vaccine that keeps the immune system from attacking pancreatic cells, reports the Los Angeles Times. Studies in mice already had documented the effectiveness of the tuberculosis vaccine known as BCG in Type 1 diabetes. That vaccine was shown to prevent T cells from attacking the insulin-secreting cells in the pancreas. In mice that got the vaccine, the pancreas began to regenerate and to produce insulin once again, effectively "curing" the mice of their diabetes.

An immune system protein called tumor necrosis factor (TNF) is pivotal in the research. When blood levels of TNF are increased, studies show, the protein blocks other areas of the immune system that attack the body, particularly the pancreas.

Researchers report that humans who got low doses of the vaccine began to demonstrate transient increases in insulin production. At Massachusetts General Hospital, medical experts are getting ready to try higher doses of the vaccine in larger groups of people.

The research is intriguing: if the vaccine works, even those who've had Type 1 diabetes for awhile might have their pancreas function restored, reports the Los Angeles Times. That depends, of course, on whether it's possible to block the beta cell-destroying parts of the immune system. "It's fascinating research," says Spyros Mezitis, MD, Ph.D., endocrinology consultant at Lenox Hill Hospital in New York City. "It's changing the way we think about Type 1 diabetes."

Further experiments are needed with more individuals who have Type 1 diabetes, Mezitis says. "And higher doses of BCG tuberculosis vaccine are needed to confirm these important results," he adds.

Immunology expert Eva Mezey, MD, who directs the adult stem-cell unit at the National Institute of Dental and Craniofacial Research, called the study results "fascinating and very promising," according to the Los Angeles Times. She noted, though, that only a small number of patients had gotten good results, and that vaccinations would most likely need to be repeated on a regular basis.

Source:

Maugh, Thomas H. "Research shows promise in reversing Type 1 diabetes." 25 June 2011. Los Angeles Times.
http://articles.latimes.com/2011/jun/25/health/la-he-bcg-diabetes-20110625

RA and Cigarettes: A Dangerous Match

As if you needed another reason not to smoke, scientists have come up with yet another one: It turns out that smokers who receive treatment for early rheumatoid arthritis respond less vigorously than people who have never picked up a cigarette. Even former smokers achieve a better response than current smokers.

A 10-year study, conducted at Karolinska University Hospital and Karolinska Institute in Stockholm, Swedenlooked at data for 1,430 rheumatoid arthritis patients from ages 18 to 70, all of whom enrolled in clinical trials after being diagnosed. Twenty-seven percent were current smokers.The patients were given methotrexate or tumor necrosis factor inhibitors, common therapies for rheumatoid arthritis.

After three months on methotrexate, 36 percent of nonsmokers achieved a good response to treatment versus only 27 percent of smokers. The effects of tobacco were even more pronounced in the group taking tumor necrosis factor inhibitors: 43 percent of nonsmokers did well after three months, while only 29 percent of smokers did.

Interestingly, a past history of smoking did not seem to affect patients' responses to either therapy.

Not only does smoking interfere with rheumatoid-arthritis treatments, but past research has shown that smoking is itself a risk factor for the development and severity of the disease. A University of Iowa study questioned the smoking habits of 336 people with rheumatoid arthritis and found that people who had smoked over a long period of time were much more likely to be rheumatoid factor positive (rheumatoid factor is an autoimmune antibody that is strongly associated with a more severe course of the disease) and have more joint erosion than patients who had never smoked. A British study examined the records of thousands of Finnish children born in 1987 and determined that a mother's tobacco use during pregnancy increased the risk of juvenile rheumatoid arthritis in female children.

Since rheumatoid arthritis patients can suffer so much from the symptoms of the disease, it makes sense to put smoking cessation at the top of the treatment list. If you're a smoker with rheumatoid arthritis, talk to your doctor about getting help kicking the habit before you begin treatment. If you're already in treatment, remember that quitting smoking may help you respond to your medication more strongly.

Sources:

American College of Rheumatologist, www.rheumatology.org

U.S. National Library of Medicine, www.ncbi.nlm.nih.gov

View the original article here

RA and Cigarettes: A Dangerous Match

As if you needed another reason not to smoke, scientists have come up with yet another one: It turns out that smokers who receive treatment for early rheumatoid arthritis respond less vigorously than people who have never picked up a cigarette. Even former smokers achieve a better response than current smokers.

A 10-year study, conducted at Karolinska University Hospital and Karolinska Institute in Stockholm, Swedenlooked at data for 1,430 rheumatoid arthritis patients from ages 18 to 70, all of whom enrolled in clinical trials after being diagnosed. Twenty-seven percent were current smokers.The patients were given methotrexate or tumor necrosis factor inhibitors, common therapies for rheumatoid arthritis.

After three months on methotrexate, 36 percent of nonsmokers achieved a good response to treatment versus only 27 percent of smokers. The effects of tobacco were even more pronounced in the group taking tumor necrosis factor inhibitors: 43 percent of nonsmokers did well after three months, while only 29 percent of smokers did.

Interestingly, a past history of smoking did not seem to affect patients' responses to either therapy.

Not only does smoking interfere with rheumatoid-arthritis treatments, but past research has shown that smoking is itself a risk factor for the development and severity of the disease. A University of Iowa study questioned the smoking habits of 336 people with rheumatoid arthritis and found that people who had smoked over a long period of time were much more likely to be rheumatoid factor positive (rheumatoid factor is an autoimmune antibody that is strongly associated with a more severe course of the disease) and have more joint erosion than patients who had never smoked. A British study examined the records of thousands of Finnish children born in 1987 and determined that a mother's tobacco use during pregnancy increased the risk of juvenile rheumatoid arthritis in female children.

Since rheumatoid arthritis patients can suffer so much from the symptoms of the disease, it makes sense to put smoking cessation at the top of the treatment list. If you're a smoker with rheumatoid arthritis, talk to your doctor about getting help kicking the habit before you begin treatment. If you're already in treatment, remember that quitting smoking may help you respond to your medication more strongly.

Sources:

American College of Rheumatologist, www.rheumatology.org

U.S. National Library of Medicine, www.ncbi.nlm.nih.gov

View the original article here