Type 1 Diabetes Research

A Step Into Freedom From T1DM

About Me

Hello

I amShivani Desai

Type 1 diabetes researcher and enthusiast

Welcome to T1DM.org! It is a platform which consolidates my work about type 1 diabetes (T1DM) and its management. This forum invites an open interaction from national and international experts to manage type 1 diabetes, share their knowledge and collaborate to work towards freedom from this painful disease.

This forum includes the papers published by the author in the journals of repute. These papers primarily involve the content related to the etiology and pathophysiology of T1DM, the application of mesenchymal stem cells to manage T1DM and improve the quality of life in patients, and the correlation of diabetes with hepatic dysfunctions. It also includes papers related to the immunological aspects in the journey to prevent and reverse the disease.

With more interaction and collaborations, we can bring an end to T1DM and give a better life to the children who are at risk to develop this immensely agonising disease.

2 Patents

Diabetec foot ulcer (DFU) treatment using stem cell, Wound healing

26 Publications

T1DM vaccine research, Regenerative medicine research, 15 under process

10 Awards

'Woman Innovator' National Award 2022 and others, for research in T1DM

Journey So Far

2016

July

Inception of Idea

Development of vaccine to prevent and reverse type 1 diabetes mellitus

2018

September

t1dm.org Launched

Platform launched to consolidate research work about type 1 diabetes and its management

t1dm.org invites an open interaction from national and international experts to manage type 1 diabetes, share their knowledge and collaborate to work towards freedom from this painful disease

2020

June

Research Publication

First review paper on type 1 diabetes mellitus “Mapping of type 1 diabetes mellitus” published in Current Diabetes Reviews

2021

December

Preclinical Model Development

Preclinical model development project using Swiss albino mice started to study type 1 diabetes

2022

April

Phase 1 Preclinical Study

Stability test for vaccine formula conducted
Allergy test and safety study for vaccine formula conducted
Efficacy study of vaccine formula to prevent and reverse type 1 diabetes mellitus

My Latest Publications

Showing posts with label diabetes. Show all posts
Showing posts with label diabetes. Show all posts

[Meta Analysis] Narrative Review of Anti-CD3 Antibody and Anti-CD20 Antibody: Immunotherapeutic Strategies to Treat and Prevent Type 1 Diabetes

Background and objective: Type 1 diabetes mellitus is a complex disease defined by the loss of pancreatic cells, which leads to complete insulin insufficiency. The Diabetes Control and Problems Trial defines the aims of Type 1 diabetes therapy as achieving adequate glycaemic control and preventing and avoiding recurrent bouts of hypoglycaemia. Despite ongoing efforts to improve insulin therapy regimens, the actual hormone substitute therapy treats just the symptoms of the disease, with no influence on disease pathology or etiopathogenesis. In recent decades, there has been a lot of interest in preventative techniques in high-risk patients, based on the theory that if a therapeutic intervention is adopted early in the disease, it can help maintain endogenous cell function by protecting the remaining cell reservoir from autoimmune attack.
Authors: Prajakta Kashalikar, Shivani Desai, Avinash Sanap, Madhura Shekatkar, Ramesh Bhonde

Journal: Recent Advances in Inflammation & Allergy Drug Discovery (Formerly as Recent Patents on Inflammation & Allergy Drug Discovery)

Keywords: Immunotherapy; Meta-analysis; Rituximab; Teplizumab; Type1Diabetes

Read Full Review Paper

[Editorial] Th1-Th2 Seesaw: An Essential Aspect in Type 1 Diabetes


Balanced Th1 and Th2 cytokines are significantly associated to maintain the immunological ecosystem in human physiology. Any imbalance can lead to either autoimmune diseases or immunodeficient diseases. This editorial highlights the immunological mechanism involved in type 1 diabetes (T1DM).

Journal: Current Diabetes Reviews

Keywords: Cytokines; T1D; T2D; anti-inflammatory; immunological processes; proinflammatory

Read Full Editorial

[Video] The Insulin Journey

The history of insulin is a 100 years story. This marvel has become a blessing for Type 1 Diabetic Mellitus (T1DM) patients. This video describes the complete journey of insulin from even before its scientific discovery. 


Related article: A Century-Long Journey Of Type 1 Diabetes Management: From Insulin To…??

For more videos and discussions on T1DM, visit: https://www.t1dm.org

For queries or feedback, email info@t1dm.org or simply leave a comment below.

[Video] Ongoing Research on Type 1 Diabetes Mellitus

Insulin is the only available treatment for Type 1 Diabetes Mellitus (T1DM) for over a century now. Globally, scientists are working on different avenues to find a permanent cure for T1DM. Clinical trials are under process, but with little success so far. So where are we today?

A short video:



For more publications and discussions on T1DM, visit: https://www.t1dm.org 

 For queries or feedback, email info@t1dm.org or simply leave a comment below.

[Video] What is Type 1 Diabetes Mellitus?

The history of type 1 diabetes mellitus (T1DM) is a longstanding story and during this 'Diabetes Month', we have designed this platform to discuss various aspects of this disease. This video is an introduction to T1DM on the occasion of Diabetes Day 2021.

For more videos and publications on T1DM, visit www.t1dm.org.

For queries or feedback, email info@t1dm.org or simply leave a comment below.

Seesaw of Th1 and Th2 in Autoimmune Disorders

Autoimmune diseases stem from imbalances within the functioning of the patient’s immune system. This imbalance is witnessed due to many factors, such as stress, malnutrition, vitamin and mineral deficiencies, inappropriate gut flora, and allergies. These are the common etiologies that are considered while diagnosing any autoimmune disease. 

However, this article describes the basic explanation about the mechanism of T-helper (Th) cells disturbing the immune system, as well as the factors causing this imbalance.

What are Th1 and Th2?

T-helper cells (Th) are an important part of the immune system. They are lymphocytes that recognize foreign pathogens or normal tissues in autoimmune diseases. Cytokines are produced as a response. These Th cells are divided into subgroups:

Th1

Th2

Involved in “cell-mediated” immunity

Involved in “humoral-mediated” immunity

Usually deals with infections by viruses and certain bacteria

Usually deals with infections by bacteria, toxins, and allergens

Body’s first line of defense against pathogens that get inside our cells

Stimulating the production of antibodies in response to extracellular pathogens (those found in blood or other body fluids)

Tend to be pro-inflammatory

Tend to be anti-inflammatory

Involved in the development of organ-specific autoimmune disease

Involved in systemic autoimmune disease and other chronic conditions


In a well-functioning immune system, both groups of these T helper cells work together to keep the system balanced. One side might become more active to eradicate a threat, then settling back to a balanced level. 

Effect of Th Responses in Autoimmune Disease


An alteration in Th1-Th2 balance causes various autoimmune diseases. This is described in the figure.


When the Th1 cells of the immune system are overactive, they can suppress the activity of Th2 and vice versa. This can be problematic, because these two components of the immune system function in a delicately balanced relationship. In the case of autoimmune disease, an imbalance can further the attack on healthy tissue, thereby worsening symptoms. 

Maintaining a balance between Th1 and Th2 immunological responses is paramount to healthy immune functionality.

[Review Paper] Type 1 Diabetes and Covid-19: Managing the Difficult Duo


Coronavirus disease 2019 (COVID-19) has stimulated health concerns globally, especially in diabetes where it has been accompanied by severe outcomes.

Type 2 diabetes mellitus (T2DM) is a chief worry; though, there are a considerable population of patients with type 1 diabetes mellitus (T1DM) also, that too with incomparable concerns during the current COVID-19 pandemic. Some children experience significant complications related to this disease and paediatric deaths have also been reported.

This article describes some key points related to the complications and management of concomitant T1DM and COVID-19.

Read Full Article

Source: Dr. D. Y. Patil Institute of Pharmaceutical Sciences & Research Blog

Keywords: Blood Glucose, Diabetes, COVID-19, Insulin    

A Century-long Journey of Type 1 Diabetes Management: From Insulin to …???



Can you answer this question mark in the title? What is the next product coming in the market for reversing or managing type 1 diabetes? 

The history of type 1 diabetes (T1DM) is a longstanding story. However, its management became possible only after the discovery of insulin by Frederick Banting and Charles Best in 1921. With this, scientists started developing hopes to cure this disease. Unfortunately, this goal is yet to be accomplished. This article gives a tour of the various advancements in managing T1DM and how still there is no cure for this perilous disease.

Insulin: The First Weapon to Fight T1DM

The discovery of insulin was not by chance, it was a very well-thought science. The cascade goes as follows:

1889: Joseph von Mering and Oskar Minkowski observed that removing the pancreas from dogs developed diabetes in them, followed by their death shortly.

1910: Sir Edward Albert Sharpey-Schafer projected that the lack of a specific chemical produced by the pancreas is responsible for the development of diabetes. He then named it 'insulin'.

1921: Frederick Banting and Charles Best extracted the pancreatic islet cells from healthy dogs and presented them to the dogs with diabetes which reversed the diabetic condition. This was a stepping stone towards the management of T1DM by the discovery of the hormone, insulin.

Then with the help of two other scientists, they purified insulin extracted from the cow’s pancreas and marked the first treatment option for diabetes.

Finally, in January 1922, this research was translated to humans when 14-year-old Leonard Thompson received an insulin injection to treat his diabetes. This helped him survive for 13 more years and eventually, he died of pneumonia.

And the journey continues this way…

1930s: Introduction of Insulins with longer duration of action.

1936: Sir Harold Percival Himsworth published his research which helped to understand the difference between type 1 diabetes and type 2 diabetes.

1978: Development of Humulin, the first human-based insulin, identical to human insulin in structure.

1986: Insulin pen (prefilled syringes) delivery system was available. This lead to a safe and convenient way to deliver the required dose of insulin.

1990s: Invention of external insulin pumps, which could provide healthier results, more flexibility, and easier treatment management.

1996: Lispro, the first short-acting insulin (onset of action = 15 minutes and duration of action = 2-4 hours), entered the market.

Where We Are Today

Insulin is still the only therapy used to manage type 1 diabetes. Islet transplant is also considered; however, it has to be accompanied with immunosuppressant drugs and still there is difficulty in maintenance of insulin independence; plus, Cadaveric islet transplantation needs multiple donors and is non-affordable to the common man. Extensive research is going on for immune-related therapies; unfortunately, with nothing in the market yet for the patients.

We are working towards a permanent solution to prevent and reverse type 1 diabetes and looking forward to eradicating this disease.
Type 1 to Type None!

References
  1. Vecchio I, Tornali C, Bragazzi NL, Martini M. The Discovery of Insulin: An Important Milestone in the History of Medicine. Front Endocrinol (Lausanne). 2018; 9:613.
  2. Subramanian S, Baidal D, Skyler JS, Hirsch IB. The Management of Type 1 Diabetes. [Updated 2016 Nov 16]. In: Feingold KR, Anawalt B, Boyce A, et al., editors. Endotext [Internet]. South Dartmouth (MA): MDText.com, Inc.; 2000-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279114/
  3. Raz I., Ziegler A.G., Linn T. et al. Treatment of Recent-Onset Type 1 Diabetic Patients With DiaPep277: Results of a Double-Blind, Placebo Controlled, Randomized Phase 3 Trial. Diabetes Care. 2014; 37:1392-1400.
  4. Kühtreiber W.M., Tran L., Kim T. et al. Long-term reduction in hyperglycemia in advanced type 1 diabetes: the value of induced aerobic glycolysis with BCG vaccinations. npj Vaccines. 2018; 23:1-14.


[Review Paper] Stem Cells - A Golden Therapy for Diabetic Wound



Abstract: Diabetes mellitus is the 7th leading cause of death worldwide. Diabetes can affect the organ systems and lead to a serious complication, majorly categorized as macrovascular complications, microvascular complications, and diabetic wound. Foot ulcer develops in 15-25% diabetic patient. In diabetic wound, there is impairment in growth factor, neuropeptide, matrix metalloproteinases, angiogenesis, immune system. Many approaches are being experimented to manage this major complication of the diabetic foot, but unfortunately with lesser success rate. A stem cell is an upcoming field which is being explored in the world of diabetes. Hence, this review is designed to understand the basic pathogenesis and complications of types of diabetes and the role of stem cells in the diabetic wound and the benefits related to it.

Journal: Current Diabetes Reviews 

Keywords: Angiogenesis; Diabetes mellitus; Diabetic complications; Foot ulcer; Stem cells

Read Full Review Paper



[Review Paper] A Peripheral Concept On Aetiology Of Type 1 Diabetes Mellitus


Abstract: Diabetes mellitus is a common metabolic disorder affecting a wide range of populations worldwide. There are many types of diabetes mellitus, one of which is type 1 diabetes mellitus (T1DM). It is an autoimmune disorder caused in about 97,700 children in India and 490,000 children globally. Many etiological factors contribute to this disease. This review article is a collage of etiological factors causing T1DM. A better understanding of aetiology is significant for the prevention and management of the disease.

Journal: Pharmaceutical Resonance 

Keywords: Type 1 Diabetes Mellitus; Etiology; Autoantibodies; Extracellular matrix; Coxsackievirus B virus

Trigger For T1DM: A Research Map


Scientists have identified the possible trigger for type 1 diabetes mellitus (T1DM).

The T cells of the immune system do not recognise self-antigens, i.e., the body’s own cells. Therefore, they are protected from the attack of the immune system. In T1DM and other autoimmune disorders, this protective system gets disrupted1.

Dr Delong and his colleagues carried out an experiment to study the trigger in T1DM. They isolated T cells from a T1DM mouse model and determined the trigger that is recognised as a foreign body in the insulin-producing β-cells. They recognised a modified version of insulin which acted as an antigen. They also observed that the immune T cells from pancreatic islets of two organ donors with T1DM recognised hybrid insulin peptides (HIPs). This study concluded that these HIPs may have a significant role as a trigger to the immune system and hence attack the body’s insulin-producing pancreatic β-cells, thus causing T1DM1. Antibodies from the blood of T1DM patients recognised the HIPs in the mouse. This suggests that a human equivalent may also exist.

Insulin is considered to be an important autoantigen for β-cell in T1DM. However, according to a recent discovery, two more secretory granule proteins, islet amyloid polypeptide (IAPP) and chromogranin A (Chg A), are also considered to be the source of antigenic peptides in T1DM2.

Conclusion

HIPs act as key antigens for the autoreactive T cells and causes loss of self-tolerance in human T1DM. They may also form in the other endocrine tissues and could be a trigger for self-antigens in other autoimmune disorders.

References
  1. Delong T, et al. Pathogenic CD4T cells in type 1 diabetes recognize epitopes formed by peptide fusion. Science. 2017;351(6274): 676-678.
  2. Haskins, Kathryn M. Hybrid Peptides as Autoantigens for Diabetogenic CD4T Cells. National Institutes of Health. (http://grantome.com/grant/NIH/R01-DK081166-06A1).

Type 1 Diabetes Mellitus: Aetiology And Pathogenesis

T1DM is allied with the selective destruction of insulin-producing β-cells in the pancreas. The commencement of clinical disease signifies the end stage of β-cell destruction which leads to T1DM. There is marked heterogeneity of the pancreatic lesions, which makes it difficult to follow the pathogenesis of selective β-cell destruction within the islet in T1DM1.


Type 1 Diabetes Mellitus: An Alarming Condition

Diabetes mellitus (DM), a metabolic disorder, is mainly of two types. Type 1 Diabetes Mellitus (T1DM), insulin dependent DM, is an autoimmune reaction to proteins of the islet cells of the pancreas. There is a lack of insulin secretion by β- cells of the pancreas. Type 2 Diabetes Mellitus (T2DM), non-insulin dependent DM, is a combination of genetic factors related to impaired insulin secretion, insulin resistance and environmental factors such as obesity, overeating, lack of exercise, stress, ageing. There is a decreased sensitivity of target tissues to insulin1.

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SHIVANI DESAI
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Pune, India