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The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
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Without prolonged fasting, healthy individuals maintain blood glucose levels above 3.5 mM due to a well-adapted neuroendocrine counterregulatory system that effectively prevents acute hypoglycemia, a potentially life-threatening condition. The primary clinical scenarios for hypoglycemia encompass diabetes treatment, inappropriate production of endogenous insulin or insulin-like substances by tumors, and the use of glucose-lowering agents in non-diabetic individuals. Notably, hypoglycemia in the...
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Diabetes current and future translatable therapies.

Fabio Antonio Gonzalez-Sanchez1, Triana Mayra Sanchez-Huerta1, Alexandra Huerta-Gonzalez1

  • 1Tecnologico de Monterrey, Escuela de Ingenieria y Ciencias, Departamento de Bioingeniería y Biotecnología, Av. General Ramon Corona No 2514, Colonia Nuevo Mexico, CP 45201, Zapopan, Jalisco, México.

Endocrine
|July 6, 2024
PubMed
Summary

Diabetes treatments are evolving beyond insulin injections. Cell-based therapies offer potential for glucose-sensing, in situ insulin secretion, aiming to improve life for type 1 diabetes patients and some type 2 diabetes patients.

Keywords:
Cell therapyDiabetesInsulin producing cellsIslet transplantationOrganoidsPancreatic islets

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Area of Science:

  • Endocrinology
  • Regenerative Medicine
  • Public Health

Background:

  • Diabetes mellitus affects over 200 million globally, with type 1 and some type 2 cases involving pancreatic beta-cell depletion and glycemic dysregulation.
  • Current standard care for insulin-dependent diabetes involves exogenous insulin, posing a significant burden on patients and caregivers.
  • Cell-based therapies are being researched as a potential alternative to exogenous insulin, offering in situ glucose sensing and insulin secretion.

Purpose of the Study:

  • To review current clinical approaches for treating insulin-dependent diabetes (type 1 and some type 2).
  • To explore future potential alternative strategies to cell-based therapies for diabetes management.
  • To discuss the advantages and disadvantages of various discussed treatment methods.

Main Methods:

  • Review of existing clinical trials and research on cell-based therapies for diabetes.
  • Analysis of donor islet isolation and implantation protocols.
  • Exploration of alternative strategies to overcome donor shortage and immunosuppression.

Main Results:

  • Pancreatic islet transplantation has been tested clinically but faces challenges with donor availability and immunosuppression.
  • Cell-based therapies aim to provide a more autonomous system for glucose control and insulin delivery.
  • Ongoing research focuses on overcoming limitations of current cell-based approaches.

Conclusions:

  • Cell-based therapies represent a promising avenue for managing insulin-dependent diabetes, potentially eliminating the need for exogenous insulin.
  • Addressing donor scarcity and immunosuppression are critical for the clinical success of cell-based diabetes treatments.
  • Further research and development are essential to realize the full potential of these advanced therapeutic strategies.