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  • Re: Stem cells
    method could never produce any treatment on a scale of practical significance An alternative would be to use the human embryonic pancreas as a source and even though ethical concerns in most jurisdictions would prevent deliberately harvesting human embryos for transplant many embryos are lost spontaneously or discarded in ordinary medical procedures for other reasons so these represent a more realistic option However since immature pancreatic islets do not yet function normally the procedure up to now has been to attempt a step by step differentiation of them in the laboratory to render them more functionally mature before transplanting them This is not fully effective unfortunately and after transplant they often exhibit features of immature beta cells releasing glucagon and insulin together for example Kieffer and colleagues have explored a way around this problem which is to start not with immature pancreatic cells but with pancreatic precursor cells which they then transplant into the patient This allows their development to be guided more naturally by the patient s own biochemistry producing a more normal mature end product Since the implanted tissue would be subject to both ordinary host immunity and the host s own autoimmunity to pancreatic beta cells immunological

    Original URL path: http://islet.org/forum/messages/55802.htm (2016-04-29)
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  • Psoriasis drug alefacept shows promise in preserving pancreatic
    hours after eating C peptide levels increased by 0 015 nmol L for those in the alefacept group whilst C peptide levels fell by 0 156 nmol L for those in placebo group C peptide is a measure of how much insulin is being produced by the pancreas The increase in C peptide levels for the alefacept group shows that patients in this group were able to produce slightly more of their own insulin as a result of the treatment Similar results were noted for 2 hour C peptide levels however the difference between groups was not large enough to meet the study targets This measure was set as the primary target to be achieved Other results showed that patients in the alefacept group were able to 25 less insulin worked out as units of insulin per kg of weight of participants The number of hypoglycemic events also reduced for those receiving the treatment Participants on alefacept recorded 10 9 hypos per year compared with 17 3 amongst the placebo group The research team noted that each participant in the alefacept group experienced an adverse event as a result of the treatment however none of these were serious By comparison

    Original URL path: http://islet.org/forum/messages/55794.htm (2016-04-29)
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  • Re: Psoriasis drug alefacept shows promise in preserving pancreatic
    side effects of such interventions which makes it of questionable cost benefit Efforts to stop the progression of type 1 diabetes in newly diagnosed patients with immunosuppressives began in the 1980s when cyclosporine then a new drug was used but because this could not specifically suppress diabetic autoimmunity and caused a general immunosuppression with all its negative side effects it was dropped Since then research has focused on anti CD3

    Original URL path: http://islet.org/forum/messages/55796.htm (2016-04-29)
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  • New Research on C-Peptide
    least two separate causes insulin deficiency and c peptide deficiency with only insulin controlling the long term glucose utilization may explain some of the disconnect observed between diabetic complications and glucose control For example while patients who have survived 50 years or more with type 1 diabetes have been reported to have an HbA1c value above 10 in some studies they often have only very mild complications 3 Significantly the Joslin Clinic Report on its Gold Medalist survivors 50 years disease duration and more notes that 66 of them still have residual c peptide production which is undetectable in the majority of type 1 diabetics 5 years post diagnosis or longer 4 Since there is independent evidence that inflammation in diabetics correlates with their degree of complications it could be that the same persisting immunological response to pancreatic beta cells which causes this inflammation also causes patients to have a lower c peptide production from their correspondingly small number of surviving beta cells so that what inflammation apparently causes might in fact be caused by a lack of c peptide 5 A recent study has interestingly shown that even a very small amount of residual c peptide production in a patient can have enormous benefits with respect to the development and progress of complications Even though in healthy individuals the normal c peptide level is on average around 0 5 nmol L with fasting levels at 0 42 nmol L and glucose challenge levels at 0 6 nmol L this study has shown that in type 1 diabetics a c peptide level of even just 0 04 nmol L a mere 8 4 of normal levels can have dramatic benefit 6 Even improvements to this level from extremely small to merely very small levels showed real clinical benefit to the patients as long as they were above a lower threshold of 0 08 nmol L 7 Benefits included reduced risk of severe hypoglycemia lower HbA1c values lower risk of retinopathy and reduced nephropathy risk 8 The most interesting implication of this study is that even the small increases in patient internal output of c peptide which can be achieved with various islet encapsulation devices now being developed or tested can probably be of significant benefit even if the reduction in required insulin dose they can achieve is small While it might logically seem simpler just to inject enough c peptide to bring the patient up to normal levels this proposal has been under review for a very long time without being translated into a clinical application so islet encapsulation may present a faster route Cebix is now starting phase 2 studies to win FDA approval for their c peptide injection but islet encapsulation might beat them to it Also islet encapsulation would have a more physiological response increasing the c peptide output during meals and decreasing it during fasting which could possibly increase its benefit while Cebix s product which is just a long acting c peptide would not have

    Original URL path: http://islet.org/forum/messages/55781.htm (2016-04-29)
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  • Re: New Research on C-Peptide
    Some evidence yes some no What other complications has it been found to help with A recent study has interestingly shown that even a very small amount of residual c peptide production in a patient can have enormous benefits I don t agree at all In these studies C peptide is measured as a marker for insulin production It is the insulin production which is thought to have the enormous

    Original URL path: http://islet.org/forum/messages/55783.htm (2016-04-29)
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  • Re: New Research on C-Peptide
    HbA1c versus its major effect on complications suggesting an independent role for c peptide It states in the Abstract that for a 50 higher stimulated C peptide HbA1c decreased by 0 07 HbA1c i e a lowering of blood sugar by 1 4 of its normal value which is clinically insignificant t he risk of sustained retinopathy was reduced by 25 i e a nearly 36 fold greater retinopathy risk reduction than blood glucose reduction On pp 3 4 of Lachin s study a c peptide level of 0 04 nmol L only just above the limit of detection with the latest technology at 0 03 nmol L which was just 8 4 of the c peptide levels in a healthy patient was nonetheless significantly related to a reduced risk of both retinopathy and nephropathy The core result of Lachin s study and the one I wanted to highlight as significant for the small improvements in blood sugar control and c peptide output which can be achieved by various islet encapsulation devices in the present state of technology is stated on p 15 of his report which is that even small incremental increases in C peptide particularly those measured below the previously established cut point of 0 2 nmol L i e 5 times greater than the levels he and his colleagues demonstrated to be significant are shown to be clinically beneficial This supports the general conclusion of another group of researchers which is that far from just measuring the benefit of residual insulin production in the patient with type 1 diabetes the e vidence shows that C peptide is a biologically active peptide in its own right 5 This is why the CEBIX Corporation has invested so much time and effort in bringing its c peptide for injection product

    Original URL path: http://islet.org/forum/messages/55785.htm (2016-04-29)
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  • Re: New Research on C-Peptide
    wise to be skeptical GKGK All we need to consider are type 2 diabetics whose C peptide levels are through the roof as a result of insulin over production trying to combat insulin resistance Despite their high C peptide levels type 2 diabetics suffer the same complications as type 1 diabetics The common denominator is elevated average blood glucose NOT diminished C peptide High blood sugar likely does its damage

    Original URL path: http://islet.org/forum/messages/55786.htm (2016-04-29)
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  • Re: New Research on C-Peptide
    cause of diabetic complications On the contrary they are claiming that there are two independent causes hyperglycemia and c peptide deficiency each acting by different mechanisms As a result type 1 diabetics will have two sources of complications operating while type 2 diabetics will initially only have hyperglycemia as a cause and later only gradually as a result of a decline in c peptide output many of them particularly those

    Original URL path: http://islet.org/forum/messages/55787.htm (2016-04-29)
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