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Newly Discovered Hormone May Provide Treatment of Type II Diabetes
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Diabetes mellitus is a condition in which the body is not able to properly utilize sugar. There are two types of diabetes mellitus, Type I and Type II. Type I diabetes mellitus is an autoimmune disorder, in which the body’s immune system attacks and destroys insulin producing β cells in the pancreas. Patients with Type I diabetes mellitus require daily insulin injections in order to help their cells take in glucose, and are normally diagnosed with the disease as juveniles. Type II diabetes mellitus is an inability of the body to either make sufficient insulin, or to use it properly. Type II diabetes mellitus usually develops later in life, and may or may not require daily insulin injections to control blood sugar levels.

Long term treatments for diabetes mellitus involve proper nutrition, exercise, daily insulin injections, and medications. In addition, daily monitoring of blood glucose levels is required. This can be necessary many times a day, depending on the severity of disease and how well the patient is controlling his or her blood sugar. While these methods can help a patient control blood glucose levels and stay healthy, there is no treatment available that can replace the defective pancreatic β cells or improve insulin production and usage by the patient. Long term effects of uncontrolled blood glucose can result in heart disease, kidney disease, neuropathy, and circulation problems, and can be life threatening.

Recently, however, a research team at the Harvard Stem Cell Institute, discovered a hormone being produced in the liver that they named betatrophin. The team induced insulin resistance in mice, which caused increased replication of β cells in the pancreas. They searched for upregulated genes in these mice, and found the gene for betatrophin. The betatrophin hormone appeared to help increase the proliferation of β cells to make up for the insulin resistance in the mice. The researchers are particularly excited because the hormone is very specific for β cells, and is very efficient at inducing replication of these cells.

The research team hopes that by injecting volunteers with human betatrophin, they can induce similar replication of β cells in patients with Type II diabetes mellitus. This would increase the amount of insulin being produced, which could help ease some of the symptoms of the disease, and make glucose uptake by other cells more efficient. The betatrophin injections would be required less frequently than insulin injections, possibly as infrequently as once per year. This would be a simple way to improve patient compliance, and decrease the amount of medication needed. The researchers want to begin clinical trials once they have been able to produce sufficient quantities of human betatrophin. Ideally, patients with Type II diabetes mellitus would still continue with a proper diet and exercise regimen, in addition to any treatments, including betatrophin. Combining multiple methods of controlling blood glucose levels would almost certainly be more effective than any one method alone.

The research team also suggested betatrophin as a possible treatment for Type I diabetes mellitus. However, this seems like it might not be as effective as a treatment for Type II diabetes mellitus. Since Type I diabetes mellitus is an autoimmune disorder, the β cells in the pancreas are attacked and destroyed. If there are any β cells present to reproduce after betatrophin treatment, they would all most likely be targeted again by the immune system. The most plausible long term treatment for Type I diabetes mellitus would require the generation of β cells that are not recognized by the host’s immune system. They would have to be free of whatever markers the host immune system is recognizing. In order for this strategy to work, researchers would need to determine how the immune system is recognizing β cells and find a way to engineer cells that are not detected by the immune system. Another option would be therapy to decrease the immune response against β cells, but this could leave the patient susceptible to infection.

While there is still much work that needs to be done to find effective, long term treatments for both Type I and Type II diabetes mellitus, the discovery of betatrophin is very exciting. By teaching the body how to replace β cells in the pancreas, many patients with diabetes and pre-diabetes could be able to better control their blood sugar levels and prevent the harmful long term effects of diabetes.


References:

http://www.nature.com/news/liver-hormone...nt-1.12878
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Newly Discovered Hormone May Provide Treatment of Type II Diabetes00