Stem Cells For Diabetes Treatment

About Diabetes

Diabetes is a chronic condition that affects how the body processes glucose, a type of sugar that comes from the carbohydrates we eat. Normally, glucose is carried by the bloodstream to cells, where it’s used for energy. In diabetes, this process doesn’t work properly, causing glucose to build up in the blood.

But why are high glucose levels harmful?

Too much glucose in the bloodstream can deposit in blood vessels and nerves over time. This can lead to serious complications affecting the eyes, kidneys, heart, liver, and limbs. In advanced cases, diabetes may result in vision loss (retinopathy) , kidney failure (nephropathy), or even limb amputation.

Note: Major studies like the Diabetes Control and Complications Trial (DCCT) for type 1 diabetes and the UK Prospective Diabetes Study (UKPDS) for type 2 diabetes have shown that consistent treatment of the disorder reduces the risk of complications and early death in diabetic patients.

What is the difference between type 1 and 2 diabetes?

Both types of diabetes show elevated blood glucose levels, but type 1 diabetes occurs due to a lack of insulin, whereas type 2 diabetes results from the body’s inability to utilize insulin. These underlying pathways also change their management methods. Insulin injections become mandatory in type 1 diabetes, whereas it is only prescribed in severe cases in type 2 diabetes. Type 2 diabetes is manageable by lifestyle changes, which is impossible with type 1 diabetes.

Diagnosis

The diagnostic criteria essentially measures glucose levels via different methods:

Fasting Blood Glucose Level: It measures blood glucose levels without any food intake for at least 8 hrs. According to the American Diabetes Association (ADA), Normal fasting glucose level is 100mg/dL and prediabetic level is 100-126 mg/dL. Diabetes is confirmed when fasting blood glucose is over 126 mg/dL.

Random Blood Glucose Level: It estimates blood glucose level at any random time of the day. Level equal to or higher than 200 mg/dL is an indicator of diabetes.

HbA1c: It evaluates the glucose attached to hemoglobin to provide an average of glucose level over a period of 2-3 months. Normal HbA1c is 5.7% or lower. The value of HbA1c ranges from 5.7% - 6.4% for prediabetes and is 6.5% or higher for diabetes.

Oral Glucose Tolerance Test (OGTT): It determines blood glucose levels every two hours before and after drinking a sweet drink. The normal, prediabetic, and diabetic levels of blood glucose for OGTT are less than 140 mg/dL, 140-199 mg/dL, and 200 mg/dL or higher, respectively.

Some additional tests also aid in detecting diabetes:

Urine Tests: Glucose, ketones, or proteins in urine indicate diabetes and diabetes-induced nephropathy.

C-peptide Level: C-peptide is a byproduct of insulin. Its low amount in blood indicates diabetes and also distinguishes between type 1 and 2 diabetes.

Autoantibody Test: It measures GAD65, IA-2, ZnT8, and IAA antibodies that attack pancreatic cells. This test is used for confirmation of type 1 diabetes.

Early and accurate diagnosis of diabetes is vital to prevent complications. Testing should be repeated if initial results are borderline or inconclusive. A combination of these tests often provides the most accurate picture. Once diagnosed, regular monitoring helps guide treatment decisions and assess risk for complications.

Early Signs & Symptoms of Diabetes

The symptoms of diabetes are as under:

• Unexplained weight loss/gain
• Increased appetite
• Weakness
• Headaches
• Excessive sweating
• Frequent urination
• Frequent thirst
• Dry mouth
• Urinary tract infections
• Blurry vision
• Slow healing of wounds
• Gum bleeding
• Recurrent skin infections

In the long-term, higher glucose in blood accumulates in blood vessels and nerves that triggers more complications in other organs. Diabetic foot ulcer, diabetic neuropathy, diabetic retinopathy, and diabetic nephropathy are complications arising in foot, nerves, eyes, and kidney due to diabetes.

Available Types of Diabetes

Type 1 Diabetes: This form occurs when the immune system mistakenly attacks the pancreas, destroying cells that produce insulin. Insulin is the key hormone that promotes the cellular uptake of blood glucose. Its lack causes higher glucose levels in blood and mandates the use of insulin injections for treatment.

Type 2 Diabetes: It is the most common form of diabetes where the pancreas produces sufficient quantities of insulin, but the body cells cannot use it effectively. It is often managed with lifestyle adjustments and medications to lower blood sugar.

Gestational Diabetes: Diabetes that develops during pregnancy is referred to as gestational diabetes. Although the cause is still not clear, it is believed that maternal hormones might affect the functioning of pancreas. Excessive amounts of proinsulin and HLA molecules are also thought to play a role in gestational diabetes.

Monogenic Diabetes: It typically manifests at a younger age (<35 years) including infants and teenagers. This type of diabetes does not affect insulin but involves single gene modifications. For example, changes in the gene encoding the glucokinase enzyme disrupt the sensing ability of glucose levels, thereby causing dysregulation of glucose uptake.

Prediabetes: Prediabetic individuals do not show symptoms of diabetes, nor do they fit in the diagnostic criteria. However, they have increased blood glucose levels, which put them at a higher risk of developing diabetes in the future.

What Causes Diabetes?

The causes of diabetes include the following:

Obesity: Excess body weight and limited physical activity can reduce the body’s sensitivity to insulin, making it harder for glucose to enter cells, leading to higher glucose in blood.

Genetics: Diabetes can occur due to genetic alterations. There is a higher possibility that a type 2 diabetic person has at least one parent suffering from type 2 diabetes.

Hormonal Imbalance: Hormonal disturbances such as acromegaly, Cushing’s syndrome, hyperthyroidism, etc., also cause diabetes. The hormonal secretion induce glucose synthesis resulting in higher glucose levels.

Aging: As people age, the body experiences more oxidative stress, chronic inflammation, and cellular damage, which can impair glucose regulation and increase the risk of diabetes.

What are available treatments for Diabetes?

Once diagnosed, diabetes should be treated as early as possible. The current therapeutic interventions normalize the insulin and blood glucose levels. Additional medications are prescribed to treat diabetes-related complications such as high blood pressure, high cholesterol, etc. However, these treatment options are linked to several complications such as gastrointestinal disturbances, respiratory disorders, cardiovascular issues, etc. These constraints have urged the need for alternative therapy.

An effective therapy should integrate the treatment of the disorder from its core pathways without any complications. Stem cells for diabetes treatment fits into the criteria by acting on the following pathways:

• Stem cells differentiate into beta islet cells that produce insulin.
• They promote regeneration of pancreatic islet cells by secreting growth factors such as VEGF, IGF1, PDGF, etc.
• These cells also suppress the immune cell proliferation, thus attenuating the autoimmunity that destroys insulin-producing cells.
• They promote the survival of islet cells against oxidative stress and inflammation.
• Stem cells produce anti-inflammatory cytokines and reduce free radicals to combat inflammation and oxidative stress, respectively.
• They alleviate insulin resistance by reprogramming macrophages from M1 to M2 phenotype.
• They increase the expression of GLUT4 gene and decrease the gene expression for IL6 and PAI-1, which enhance the glucose uptake by cells.

Frequently Asked Questions

Q1. Is stem cell therapy effective for diabetes treatment?

Numerous clinical trials have estimated the effectiveness of stem cell therapy in diabetes. They have shown stabilized glucose levels, improved insulin production, and reduced insulin resistance. The need for drugs dramatically decreased after the therapy. Many patients even went insulin-free for months. Scientists have reported potential reversal of diabetes through stem cell therapy. These studies indicate that diabetes stem cell treatment is indeed effective.

Q2. How are stem cells better than medications?

Medications require prolonged use, which could cause toxicity to other organs. Furthermore, they only manage glucose levels on a daily basis without working on the underlying mechanisms. On the other hand, stem cell therapy offers long-lasting results and treats the disorder at a deep cellular level by targeting all the pathways of the condition. It does not cause any toxicity to other organs, proving it as a better alternative.

Q3. Is stem cell treatment for diabetes safe?

Q4. Can stem cell therapy treat both Type 1 and 2 diabetes?

Yes. Scientists have evaluated the stem cell treatment for diabetes type 1 and 2 as well as its working mechanism. Type 1 diabetes stem cell treatment acts on cell regeneration and modulation of immune response. On the other hand, stem cell therapy for diabetes type 2 changes the signaling pathways for insulin resistance. In both cases, the results of diabetes stem cell therapy have been positive, thus establishing stem cell therapy as the next generation treatment strategy for diabetes.

Q5. Can stem cells also treat diabetic neuropathy?

Glucose deposition on nerves causes nerve damage leading to diabetic neuropathy. Diabetic neuropathy stem cell treatment exerts its therapeutic effects by secreting neuroprotective factors and neurotrophic factors that prolong nerve cell survival and regeneration.

Q6. Why opt for stem cell treatment for diabetes in India?

India is becoming a major hub for medical tourism. Its cost-effective treatment procedures integrated with world-class infrastructures and facilities have made it a preferred choice for obtaining treatment. Both the private and government sectors have made huge investments in research for diabetes stem cell treatment in India. For example, Advancells delivers high quality stem cells to facilitate stem cell therapy for diabetes type 1 and 2 in India. Therefore, India has become an ideal destination for stem cell treatment.