December 2010 eUpdate Newsletter
December 21, 2010
RESEARCH NEWS
UCSF Islet Transplantation Research Studies Launched
Significant progress has been made in improving the results and clinical applicability of pancreatic islet transplantation as a treatment for type 1 diabetes.
UCSF is a member of the Clinical Islet Transplant (CIT) Consortium, an international collaborative effort that is conducting several multicenter trials examining the outcomes of pancreatic islet transplantation in patients with type 1 diabetes. Our transplant team led by Andrew Posselt, MD, PhD, and Peter Stock, MD, PhD, has announced three CIT clinical trials that may be of interest to those with type 1 diabetes who experience severe hypoglycemia unawareness.
- Trials CIT-03 and CIT-07 - intended for patients with type 1 diabetes and no other transplant of any kind (EXCEPT a previous failed pancreas transplant).
- Trial CIT-06 - examines the outcome of islet transplantation in patients with type 1 diabetes who have received a kidney transplant and have stable renal function.
To learn more about our program, visit the UCSF Pancreas and Islet Cell Transplantation website, or contact 415-353-8893 or islettransplant@ucsfmedctr.org.
CLINICAL NEWS
Improving Insulin Management for Hospitalized Patients
Robert Rushakoff, MD, Mary Sullivan, RN, DNP, ANP-BC, CDE, and other UCSF clinicians are focused on improving diabetes management for both hospitalized patients and patients transitioning both into the hospital and then back to their homes.
In a recent journal article, Dr. Rushakoff and his colleagues reported how an online educational module completed by 283 pediatric nurses helped to reduce the hospital's insulin error rate from nearly 15% to less than 2%. [Diabetes Care]
In another journal article, Dr. Rushakoff and his team identified diabetes specific post-hospital discharge issues by conducting a telephone survey administered one week after hospital release. On the positive side, they found that nearly100% of patients had been successfully trained in use of insulin, home glucose monitoring and understood the discharge orders. The team learned that even though 79% of patients felt their blood sugars were in good control, only 53% were considered in good control based on predefined criteria. Approximately 21% of the patients had trouble obtaining diabetes medications and supplies, and many had challenges managing their blood sugars when steroids and other drugs were prescribed to reduce inflammation or as part of post-transplantation treatment. By making simple changes to hospital pre-discharge instructions, these post-discharge issues may be minimized for the patient. [Endocrine Practice]
Working with a group of UCSF anesthesiologists, Dr. Rushakoff has developed an internet based program that with just a few clicks will allow any health care provider to prepare patient specific instructions for preoperative management of their diabetes medications. These instructions can then be printed or emailed to the patient. The program is now undergoing clinical testing.
Save The Date - Pediatric Diabetes Symposium & Kids Kamp
We're proud to announce the date of our very popular Pediatric Diabetes Symposium & Kids Kamp -- Saturday, March 12, 2011. This event will be held from 8:30 a.m. until 3 p.m. at the UCSF Mission Bay Conference Center in San Francisco.
During the program, parents will hear informative presentations on both diabetes management and cutting-edge research. Children with diabetes and their siblings will be educated and entertained at Kids Kamp.
Stay tuned...program details will be announced in early 2011. If you have any questions regarding this program, please contact Kathleen Fraser.
In the meantime, we invite you to review our online Pediatric Diabetes Teaching Materials developed by the UCSF Pediatric Diabetes Program led by Steve Gitelman, MD, and Saleh Adi, MD.
DIABETES CENTER NEWS
Diabetes Center Recruits Inflammation Expert
Suneil Koliwad, MD, of the Gladstone Institute of Cardiovascular Disease has joined the faculty of the UCSF Diabetes Center to continue his research involving inflammation and the role it plays in diabetes.
Dr. Koliwad, a practicing endocrinologist, is an expert in understanding how the cellular balance of fat cells - called adipocytes, and macrophages - the body’s scavengers of dead cells, contributes to the development of inflammation in chronic obesity. When individuals become overweight, their adipocytes fill up with dietary fat and die. When the macrophages dispose of these dead cells, they become inflamed and secrete immune factors called cytokines. These cytokines over time help to cause insulin resistance, diabetes and heart disease.
By increasing the amount of an enzyme called DGAT1 through bone marrow transplantation in mice, Dr. Koliwad and his colleagues are able to generate mice with macrophages that can store more fat. These altered macrophages are not only protected from the inflammatory response to a high fat diet, they protect obese mice from developing serious complications, including insulin resistance. Because humans possess DGAT1 in microphages and adipocytes quite similar to that seen in mice, these results provide a new avenue in which to explore new ways to prevent type 2 diabetes in obese people.
Additional information on Dr. Koliwad’s exciting research may be found at the following links: [USA Today] [Gladstone Release]
In Case You Missed It...Our 10th Anniversary Tribute Video
This fall, we celebrated our tenth anniversary when diabetes research, clinical care and education were all united into one organization to more rapidly improve the quality of life of those living with diabetes. In these past ten years, we’ve accelerated our basic research efforts and have aggressively pursued promising clinical research to help generate new treatments for this disease.
Thanks to a generous benefactor, a video was created to capture the story of the Diabetes Center. We invite you to watch this special tribute that celebrates our partnership of researchers, clinicians, and patient families -- all of whom help to make the Diabetes Center a very special place. [View Video]
Holiday Wishes From Our Center Director
It is truly an honor to lead the Diabetes Center, not only because of the strength of our diabetes research, clinical care and education programs, but because I have the pleasure of working with some of the world’s most accomplished and dedicated diabetes research and medical professionals, collectively focused on improving the lives of those impacted by diabetes.
This past year, the Diabetes Center continued to make significant progress through our pursuits in basic and clinical research to: understand the autoimmune attack of the insulin-producing beta cells and identify new ways to re-educate the immune system; generate functional beta cells for possible replacement in the body; and investigate the causes of type 2 diabetes and how inflammation and central regulation of food intake affect the development of the disease.
In this season where friends and family are so important, it is only fitting that we acknowledge the tremendous support of our extended family – patients, volunteers, and all of our supporters throughout the world. It is through the unwavering generosity of so many of you that 2010 has been a year to remember at the Diabetes Center.
On behalf of the faculty and staff of the Diabetes Center at UCSF, we wish you the healthiest and happiest holiday season.
Matthias Hebrok, PhD, Director, UCSF Diabetes Center
CLINICAL TRIALS
The Diabetes Center at UCSF is among the premier institutions for clinical trials of emerging therapies in diabetes. Numerous clinical trials in type 1 and 2 diabetes are now underway.
Interested in participating? A sample of our trials currently enrolling patients:
Type 1 Diabetes: Thymoglobulin Intervention Study Seeking volunteers, 12 to 35 years of age, within 100 days of diagnosis [JDRF story link]
Type 1 Diabetes: TrialNet Natural History Study [Antibody Screening] Seeking relatives of people with type 1 diabetes, 1 to 45 years of age
Type 1 Diabetes: An Oral Insulin Preventative Study Seeking relatives of people with type 1 diabetes, 3 to 45 years of age
Type 1 Diabetes: Treatment with Thymoglobulin + Neulasta Seeking volunteers newly diagnosed at least four months but not more than 2 years, 16 to 44 years of age
Type 1 Diabetes: Treatment with Polyclonal Tregs Seeking volunteers newly diagnosed within 2 years, 18 to 35 years of age
Type 1 Diabetes: Effects of Canakinumab on the Progression of Type 1 Diabetes Seeking volunteers within 3 months of diagnosis, 6 to 45 years of age
Type 1 Diabetes: Islet Transplantation Seeking volunteers 18 - 65 years of age
Type 1 Diabetes: Efficacy of Islet After Kidney Transplantation Seeking volunteers 18-65 years of age
Type 1 Diabetes: Peritransplant Deoxyspergualin in Islet Transplantation Seeking volunteers 18-65 years of age
Type 2 Diabetes: The Effects of Co-administration of Colesevelam HCI and Sitagliptin on Glucose Metabolism Seeking volunteers 18 - 80 years of age and not currently on any antidiabetic medications
Type 2 Diabetes: Paleolithic-Type Diets and Metabolic Control Seeking volunteers 18 years of age and older with type 2 diabetes
Bone Study for Postmenopausal Women With or Without Type 2 Diabetes Seeking volunteers between 50 and 75 years old
APS1 and Autoimmune Disease Seeking volunteers at least 6 weeks old who have either autoimmune disease, have evidence of autoimmunity, have a family member with autoimmunity, or do not have autoimmune disease (healthy volunteer control)
For more opportunities, visit the Clinical Trials section of our website, or contact Kathleen Fraser, our Clinical Trials Recruitment Coordinator.
Diabetes Center at UCSF
If you wish to receive more information about the UCSF Diabetes Center’s clinical and research programs, or would like to financially support one or more of these efforts, please contact Suzanne Ritchie at 415-476-6334. You may also visit our donation website and designate your gift to “The Diabetes Center."