SA JOURNAL OF DIABETES & VASCULAR DISEASE RESEARCH ARTICLE VOLUME 19 NUMBER 1 • July 2022 9 28. Ogbera, A. Prevalence and gender distribution of the metabolic syndrome. Diabetol Metab Syndr 2010; 2: 1–5. 29. Third National Health and Nutrition Examination Survey. Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. J Am Med Assoc 2002; 287: 356–359. 30. Azizi F, Salehi P, Etemadi A, Zahedi-Asl S. Prevalence of metabolic syndrome in an urban population: Tehran Lipid and Glucose Study. Diabetes Res Clin Pract 2003; 61: 29–37. 31. Hwang L, Bai C, Chen C. Prevalence of obesity and metabolic syndrome in Taiwan. J Formos Med Assoc 2006; 105: 626–635. 32. Lobo RA. Metabolic syndrome after menopause and the role of hormones. Maturitas 2008; 60: 10–18. 33. Jouyandeh Z, Nayebzadeh F, Qorbani M, Asadi M. Metabolic syndrome and menopause. J Diabetes Metab Disord 2013; 12: 1. 34. Lindström J, Louheranta A, Mannelin M. The Finnish Diabetes Prevention Study (DPS): Lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care 2003; 26: 3230–3236. 35. Tuomilehto J, Lindström J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343–1350. 36. Karmali KN, Lloyd-Jones DM. Adding a life-course perspective to cardiovascularrisk communication. Nat Rev Cardiol 2013; 10: 111–115. New research holds big promise for a type 1 diabetes cure An implant containing insulin-producing stem cells An experimental implant containing stem cells designed to mature into insulin-secreting cells passed its first human trails. The studies reported the implant (designed to replace the missing insulin cells) to be mildly effective, offering promising signs of a ‘functional cure’ for diabetics with type 1 diabetes. The implanted stem may mature and become islet tissue that includes the beta-cells that produce insulin when needed so that normal blood sugar levels may be maintained. An open-label, first-in-human phase 1/2 study is being conducted to evaluate the safety and efficacy of pancreatic endoderm cells (PECs) implanted in non-immunoprotective macro-encapsulation devices for the treatment of type 1 diabetes. We report an analysis on one year of data from the first cohort of 15 patients from a single trial site that received subcutaneous implantation of cell products combined with an immunosuppressive regimen. Implants were well tolerated with no teratoma formation or severe graft-related adverse events. After implantation, patients had increased fasting C-peptide levels and increased glucose-responsive C-peptide levels and developed mixed meal-stimulated C-peptide secretion. There were immunosuppression-related transient increases in circulating regulatory T cells, PD1high T cells, and IL17A+CD4+ T cells. Explanted grafts contained cells with a mature β-cell phenotype that were immunoreactive for insulin, islet amyloid polypeptide and MAFA. These data and associated findings are the first reported evidence of meal-regulated insulin secretion by differentiated stem cells in patients. ‘Because of this initial success, we are now implanting larger numbers of cells in additional patients and we hope that this will result in a significant reduction or even elimination of the need for patients to take insulin injections in the near future,’ says David Thompson, a researcher working on the trial from the Vancouver General Hospital Diabetes Centre. Published in Cell Stem Cell 2021; 28(12): 2047–2061. A new pill that could help treat and even prevent type 1 diabetes Yale researchers have developed a pill that controls insulin levels while simultaneously reversing the inflammatory effects of the disease. The pill addresses three issues: • it helps control immediate blood glucose levels • restores pancreatic function • re-establishes normal immunity in the pancreatic environment. Developer Tarek Fahmy, associate professor of Biomedical Engineering and of Immunobiology: ‘What excites me about this is that it’s a two-pronged approach. It’s facilitating normal metabolism as well as correcting immune defects in the long term.’ The nanoparticle or nanocarrier, made from polymerised bile acid, protects the insulin while carrying it to the pancreas. Published in Yale Biomedical Engineering J 2021; 5(11): 1403.
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