Calling on the United Nations for a Diabetes Resolution

The International Diabetes Federation (IDF) is leading a worldwide campaign by the global diabetes community to have the United Nations and its member countries recognise the global burden of diabetes by adopting a UN Resolution on diabetes. Currently, the UN Millenium Development goals are the United Nation's primary focus, and rightly so. But diabetes is a problem in developing nations, much more of a problem then previously thought. I believe that the UN will rely on World Health to drive the issue. However, it is honourable that diabetes organizations across the globe are calling for the consideration of such a resolution.

IDF's press/web page states:

IDF has assembled a global coalition of interested parties to promote the Resolution. Momentum is picking up speed with support for the initiative coming from IDF industry partners and member associations, as well as community, consumer, professional and philanthropic organisations from around the world. These include the European Society for the Study of Diabetes (EASD), the American Diabetes Association (ADA), the Juvenile Diabetes Research Foundation (JDRF), Rotary International and Lions Clubs International. The aim is for the UN Resolution to be declared on World Diabetes Day 2007 (November 14). The IDF-led campaign and the encouraging response received so far has the potential to change the face of diabetes and help bring this life-threatening condition out of the shadows.

What I find particularly useful is the IDF's eAtlas where current global diabetes data and forecasts can be found.

Tomorrow is American Diabetes Alert Day(28 March 2006) an outreach campaign to find the undiagnosed - a significant problem around the world. World Diabetes Day is 14 November 2006. I wonder what we can do to help make the UN resolution to recognize the global burden of diabetes a reality for 2007. More next time.

Realistic Next Step? Islet Transplantation

A friend traveling between the UK and Minneapolis (she is a pumper and a continuous glucose monitor user!) submitted this news flash to the UK pumpers group. I remember hearing about the Edmonton Protocol first in the 1990’s, and was asked by my former (and well missed) doctor in NYC to think about participating. My doctor wanted me “in,” but my husband and I decided it was too risky, and I declined. Read about how the group started here.



Researchers at the University of Alberta in Edmonton, Canada, use this procedure (named the Edmonton protocol) to transplant pancreatic islets into people with type 1 diabetes. The lead researcher, founder and current Director is James Shapiro, MD. A multicenter clinical trial of the Edmonton protocol for islet transplantation is currently under way. According to the Immune Tolerance Network (ITN), as of June 2003, about 50 percent of the patients have remained insulin-free up to 1 year after receiving the transplanted islets. A clinical trial of the Edmonton protocol is also being conducted by the ITN, funded by the National Institutes of Health and the Juvenile Diabetes Research Foundation International. The article above refers to this particular arm of the trial.

What is interesting to note is:

-researchers remove the islets from the pancreas of a deceased donor. Because the islets are fragile, transplantation occurs soon after they are removed, much like any organ transplantation, with all the similar barriers and failures
-a typical transplant requires about 1 million islets, extracted from two donor pancreases
- the recipient needs to take immunosuppressive drugs that stop the immune system from rejecting the transplanted islets and this doesn’t always work. The side effects are tough, including mouth sores and gastrointestinal problems, increased blood cholesterol levels, decreased white blood cell counts, decreased kidney function, and increased susceptibility to bacterial and viral infections – the drugs may also increase the risk of cancer.
-One setback is the shortage of islet cells. The supply available from deceased donors is not sufficient to offer this treatment to all T1’s. As this article states they are looking at other means to increase supply and demand such as cloned cells produced on a large scale in computer-controlled bioreactor which would eventually could be given through booster shots.

Read about the clinical trials or one person’s personal experience before you decide if the risks outweigh the benefits? And who qualifies? Diabetes UK initiated the Islet Transplantation Consortium (Diabetes UKITC) which was formed in 2001 in the hope of replicating the ‘Edmonton’ protocol in the UK and carrying out collaborative research on the domestic and international arena. The Consortium is made up of medical researchers interested and/or involved in islet cell research in the UK. But it isn't clear how far they have progressed. Last year, Dr. Stephanie Amiel of Kings College lead the team that performed the first successful islet transplantation. This was funded by Kings College, I believe. Here is a study which is currently recruiting for the procedure.

Infections, Vaccines and Diabetes: What is the Connection?

Lately, I have been thinking a lot about vaccines. I thought about the flu vaccine I was given last October which did not protect me from getting the flu last week. I have thought about the threat of the Bird Flu H5n1 and the Pandemic Flu of 1918 that killed 50 million people across the globe, and how protected we will be if the Bird Flu today mutates and crosses over to the human race. I have also been thinking about a comment that I received last week in response to my post on TEDDY. I was given a vaccine for Chicken Pox at age 5. I then became infected with chicken pox. Go figure. Then I contracted chicken pox at the age of 10 - again! The doctors in 1974 decided I should have another varicella vaccine. Soonafter my chicken pox infection and vaccination, I too was diagnosed as a T1 diabetic.

In an effort to show academia's response to external factors, such as vaccines being given the blame for Paediatric T1 diabetes, I have listed a few here.

Admittedly, I have no idea whether or not, the threat of diabetes was present when I became infected with chicken pox at age 10, and the infection proved my vulnerability or if the infection itself activated my immune system to wipe out the beta cells present in my pancreas. Others have suggested that vaccinations carry the threat themselves. One scientist has been studying whether time of vaccination is responsible. The author, Claussen, believes that any vaccination given after 2 months old, increases the risk for diabetes. This article refutes this hypothesis:

The results of our study and the preponderance of epidemiologic evidence do not support an association between any of the recommended childhood vaccines and an increased risk of type 1 diabetes.

Claussen (as before) disagrees:

Exposure to HiB immunization is associated with an increased risk of IDDM. (insulin dependent diabetes mellitus)

An altogether different article sets out to study whether viruses induce T1 diabetes in children. This study focuses on the evaluation of some infectious diseases as risk determinants of type I. The study assessed whether children who had become infected by one or two of the following viruses posed a threat: morbilli, parotitis, rubella, pertussis or varicella (chicken pox!). Their conclusion?

Contracted infections can be considered potential accelerating factors of clinical manifestation of type I DM. Therefore multiple exposures might speed up the onset of diabetes in children

Lastly, there is this paper that investigates perinatal
data, early nutrition, growth and development, infectious
diseases, atopic diseases and vaccinations. The group that collected the data was/is called the EURODIAB collaborative group (established in 1988) and consisted of 44 European centres covering about 30 million children.
They found incidence rates were highest in northern and north-western Europe and lowest in southern and eastern Europe. They found incidence in northern
Europe to be the highest in the world.
(What is your cultural background? I just happen to be Norwegian, and Dutch with a sprinkling of French and English)
Here is what they found to be significant risk factors for T1 diabetes:
Perinatal risk factors:
Older maternal age (high risk in children born to mothers 25 years +)(YES for me)
Maternal preeclampsia (YES for me)
Neonatal respiratory disease
Jaundice caused by blood-group incompatibility (YES for me)

Childhood
prediabetic children were taller than their peers for up to 5 years
of age. (YES for me)
Even higher differences were seen for weight
Association between accelerated growth and risk (YES for me)

Vaccines
no evidence to support vaccinations
(against rubella, morbilli, varicella, pertussis, poliomyelitis,
diphtheria, tetanus, parotitis and haemophilus
influenza B) increasing the risk of childhood
Type 1 diabetes.

This last paper definitively relates to me. Obviously, most papers cannot correlate vaccinations and incidence of T1. What are your thoughts? Do any of these factors relate to you or your children?