Delaying Type 1 Diabetes

B-Lymphocytes May Hold Key to Delaying Type 1 Diabetes

Nov. 25, 2009 -- Researchers may have found a new way to delay, or perhaps prevent, type 1 diabetes.

Type 1 diabetes usually begins early in life, when the T-lymphocyte arm of the immune system attacks insulin-making beta cells in the pancreas. Researchers hoping to slow or stop this process have targeted T lymphocytes or T cells.

But recent research suggests that B lymphocytes play a role in T-lymphocyte immunity. In non-obese mice with diabetes, depleting B cells inhibits the disease. Can it work in humans?

Yes, find Indiana University's Mark D. Pescovitz, MD and a team of diabetes experts from 12 U.S. and Canadian diabetes centers.

Pescovitz and colleagues report data from 78 newly diagnosed type 1 diabetes patients who completed a double-blind, randomized, placebo-controlled trial of the arthritis and cancer drug Rituxan. Rituxan, a man-made antibody, attacks B cells via the CD-20 molecule on the surface of the cells.

Patients got a single four-infusion course of Rituxan and then were followed closely for a year. Over the course of the year, patients who received the drug had slower loss of insulin-producing cells as measured by C peptide (during insulin production in the pancreas, proinsulin molecules are split into insulin and C-peptide).

Unfortunately, a single course of Rituxan wasn't enough to stop diabetes. After a year, B cells in treated patients increased to 69% of their original values.

But the study does show that a treatment targeting B cells can preserve beta-cell function in early type 1 diabetes.

"It is unlikely that treatment with [Rituxan] as administered in this study would be optimal," Pescovitz and colleagues note. "Given our results, we believe that other anti-B-lymphocyte agents should be tested -- for example, anti-CD20 antibodies."

The study was funded by the National Institutes of Health, the Juvenile Diabetes Research Foundation, and the American Diabetes Association. Pescovitz and colleagues report their findings in the Nov. 26 issue of the New England Journal of Medicine.

Answer:

Your level is currently NormalHigh (hyperglycemia).Low (hypoglycemia).

If the level is below 70 and you are experiencing symptoms such as shaking, sweating or difficulty thinking, you will need to raise the number immediately. A quick solution is to eat a few pieces of hard candy or 1 tablespoon of sugar or honey. Recheck your numbers again in 15 minutes to see if the number has gone up. If not, repeat the steps above or call your doctor.

People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.

Your blood sugar level is slightly high. You should call your health care provider and ask if laboratory tests to check for diabetes are needed. If you are pregnant always consult with your health care provider.

Congratulations on taking steps to manage your health.

However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.

Your level is currently normal. However, if you are concerned about diabetes speak with your physician. There may be other risk factors that increase your risk for diabetes.

Your level is high if this reading was taken before eating. Aim for 70-130 before meals and less than 180 two hours after meals.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

Your blood sugar level may be high, depending on when you last ate. If you have not eaten for at least 8 hours, your blood sugar should be less than 100. If you've eaten within the last 2 hours, your blood sugar should be less than 140. You should call your health care provider and ask if you need laboratory tests to check for diabetes. If you are pregnant always consult with your health care provider.

Blood sugars consistently above 180 warrant prompt medical attention.

Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.

One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.

Your blood sugar level is high. You should call your health care provider and ask if laboratory tests to check for diabetes are needed. If you are pregnant always consult with your health care provider.