Welcome back to our weekly diabetes advice column, Ask D'Mine, hosted by veteran type 1 and diabetes author Wil Dubois in New Mexico. Here, you can ask all the burning questions you may not want to ask your doctor.

Today, we're taking a reader question with an interesting tie-in to Easter.

{Got your own questions? Email us at AskDMine@diabetesmine.com}

 

Peter, type 1 from New York, writes:So the Easter season got me thinking about resurrection, only in this case—rather than a two-thousand-year-old religious miracle—I’m wondering what hope there is for the resurrection of my (insulin-producing) beta cells. What’s the latest on the cure front, Wil?

Wil@Ask D’Mine answers: There’s a metaphorical Easter Basket full of potential cures. And just like the eggs in the typical basket, each one looks pretty different from the next. Here’s a recap of a few of my favorites, just to show you how widely different the colors of possible cures are:

 

The Anti-Diabetes Drug Cocktail 

This is a holiday weekend, so let’s start with a cocktail! And in keeping with the quasi-biblical theme today, this drink is on Mount Sinai Hospital researchers. They’ve combined two classes of drugs to create a cocktail that induced “the highest rate of proliferation ever observed in adult human beta cells,” according toScience Daily. What sort of rate would that be? Well, don’t put all your eggs in one basket, but this is looking pretty good: Five to eight percent per day. At that speed it wouldn’t take long to re-grow a full complement of beta cells.

But, wait, you say. I don’t have any beta cells left! How will this super-sizing formula help me? Well, the researchers report that their cocktail works on both normal human beta cells and stem cell-derived human beta cells. Because it’s Easter, you can think of a stem cell as a beta cell egg. So if you don’t have any beta cells left, a few of these beta cell eggs can be added first, hatched into chicks, and then be turned loose to be fruitful and multiply.

So when can we order the cocktail? Well… There are some problems. Apparently, this pair of drugs affect other organs in the body, too, so the Mount Sinai team is trying to figure out how to deliver the cocktail directly to the beta cells. Or maybe they don’t have to, because on the other side of the country, the folks at Stanford may have already solved that problem… 

 

Using Zinc to Regenerate the Pancreas

I find this ironic, in that we just covered John Burd’s OTC diet supplement with zinc—which he says has the potential to stop type 2 diabetes in its tracks—but zinc is back in the diabetes news again, this time with implications for us type 1s. Instead of a cure-all, however, this time zinc is posed to serve as a unique transport medium to deliver targeted therapy to the insulin-producing beta cells in the pancreas.

Here’s the deal: apparently zinc is like cat nip for beta cells. Yep. They suck up zinc at a rate of 1,000 times more than the surrounding cells. That got Stanford endocrinologist and researcher Justin Annes thinking that zinc could be used to guide targeted regeneration meds to the beta cells. Think of it as the other side of the radioactive iodine coin, where the thyroid’s thirst for iodine is used to deliver killing radiation to thyroid tissue to wipe out cancer cells without killing everything else in the neighborhood.

And speaking of cancer, Annes’ team—who apparently haven’t talked to the Mount Sinai team—are now linking the zinc to a cancer drug called JNK inhibitor CC-401, which has been shown to help regenerate beta cells. The zinc is needed because the CC-401, as well as boosting beta cells, apparently flips on the switches of unexpressed genes throughout the body. The scientists dryly say that this could cause serious side effects. I picture Bruce Banner turning into The Incredible Hulk. There’s still a long way to go, but the stuff you spray in your throat for the common cold may someday guide beta cell fertilizer to the barren fields of your pancreas.

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Beta Cell "Seeds" Discovered

Which, of course, brings many of our readers back to bemoaning the crucifixion of all their beta cells by the immune system. What good will fertilizer do if there are no sprouts? There are two things to consider here, and the first is that just like the famous Monty Python “Bring out your Dead” scene, maybe not all the beta cells are really dead after all. Or if they are, maybe it doesn’t matter as much as we thought, because University of Miami scientists might have just over-turned the last few decades of thinking when it comes to how beta cells grow in humans. They’ve discovered beta cell seeds in the pancreas, that just need to be watered to grow. Well, OK, they didn’t call them seeds. They called them progenitor cells. But you get the idea.

 

A Vaccine to Stop Type 1 Diabetes

Or how about, instead of taking three, four, or five shots a day, you just take one and you’re done? Actually, this won’t work for those of us who already have type 1 diabetes, but as a way to eradicate T1D diabetes going forward, scientists in Stockholm are working on a diabetes vaccine. Hey, it worked for smallpox and polio.

In a pilot study by the company Diamyd Medical, their lymph node-injected vaccine Diamyd held 11 out of 12 newly diagnosed type 1s in their honeymoon period for fifteen months by preserving a portion of the endogenous insulin production. More of a partial cure than a full cure, it nonetheless greatly reduced the amount of injected insulin needed to maintain normal blood sugar, and is thus a step in the right direction. A bigger study is underway currently.

So how does the vaccine work? It’s a so-called "antigen-specific intralymphatic immunotherapy" based on the protein GAD65. Sorry you asked, aren’t you? It’s high-tech bordering on magic, but the vaccine is said to reprogram the immune cells to leave the beta cells quite safe. Right now, it’s only being investigated with recently diagnosed type 1s, but I can’t help but wonder how it would work as a preventative vaccine for those at high risk. And going forward, there may be a way this vaccine could help those of us who already have T1D.

 

True Pancreatic Resurrection

In the spirit of Easter, which is a religious holiday marking death and resurrection, we should note that in the diabetes world, there is some evidence that the dead can be raised. I’m talking about the Edmonton Protocol here, where cadaveric pancreatic tissue—that’s pancreas parts from recently dead folks—is implanted into the living to continue life. Both the life of the tissue, and of the recipient. And there’s more: Like the famous curing touch of you-know-who, these resurrected cells confer a miracle cure to the recipient. The Edmonton Protocol cures type 1 diabetes.

Of course, it comes with its own biblical plague of locusts.

To keep cells alive in a body that they weren’t born into, the recipient has to take powerful anti-rejection drugs. Permanently. And the transplant does nothing to address the underlying (and still not fully understood) causes of type 1 diabetes. There’s nothing to prevent a relapse, and in fact, most Edmonton recipients become T1 again down the road.

Still, researchers continue to dig into this approach, and if one of the other eggs in the Easter basket—maybe the vaccine, for instance—could be combined with the Edmonton Protocol in the future, our dead beta cells might have the chance to rise again, and stay alive.

 

This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences. We are not MDs, RNs, NPs, PAs, CDEs (or partridges in pear trees). Bottom line: You still need the advice and care of a licensed medical professional.