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524 Cardio Diabetes Medicine 2017

Integrated Management of

Diabetes Through Novel Therapies

Dr. Dina Nagodra, MBBS

MSc Public and Tropical Health, UMST, Sudan
Certified in Regenerative Medicine, Utrecht University, Netherlands
Certified in Diabetes, IDF, Belgium

1.Introduction: • Bring blood glucose levels under control with oral
According to the International Diabetes Federation, hypoglycemics
diabetes currently affects 7% of the world’s popula-
tion — nearly 250 million individuals worldwide. This 2.1 Mesenchymal Stem Cells
total is expected to rise to 380 million by 2025 as Mesenchymal stem cells (MSCs) harbor differentia-
a result of aging populations, changing lifestyles, tion potential, immunosuppressive properties, and
and a recent worldwide increase in obesity. DM is anti-inflammatory effects, and they are considered
a major risk factor for ischemic heart disease and an ideal candidate cell type for treatment of DM.
stroke, which collectively account for high rates of MSC-related research has demonstrated exciting
morbidity and mortality among adult patients. In ad- therapeutic effects in glycemic control both in vivo
dition, DM is the most common underlying cause of and in vitro, and these results now have been trans-
chronic kidney disease and blindness among adults. lated into clinical practice. The richest source for
Improvement in glycemic control is the key to pre- MSCs, however, is the bone marrow. MSCs are niche
vention of complications of DM. Type 2 diabetes mel- cells. (2).
litus (T2DM), which accounts for 90–95% of all DM Several recent studies in rodents have indicated that
cases, results from a combination of insulin resis- the adult pancreas contains some type of endocrine
tance and dysfunction of insulin-producing pancre- progenitor cells that can differentiate toward b-cells
atic beta cells. It is the major cause of amputations (3,4).
in the United States, accounting for 50% to 70% of
all nontraumatic amputations, and diabetic neuropa- During pregnancy, pancreatic islet cells normal-
thy accounts for more hospitalizations than all other ly expand in number to meet increased metabolic
diabetic complications combined. demands. Researchers have found that the protein
HNF4-alpha helps increase b-cell mass and also en-
2.Why Stem Cells? able b-cell proliferation. Furthermore, various reports
have also described putative stem cells in the liver,
As such, stem cell therapy would directly benefit per-
sons with diabetes by replenishing b-cells that are spleen, central nervous system, and bone marrow
destroyed by autoimmune processes, although it that can differentiate into insulin-producing cells.
would still be necessary to mitigate the autoimmune Once a population of these cells has been gener-
destruction of b-cells (1). ated, they could either 1) be induced to differentiate
into insulin-producing cells in vitro and then be trans-
Stem Cell Treatment can be used for both, Type 1
and Type 2 Diabetes. The long-term goals of are to: planted, or 2) be injected into the circulation along
with stem cell stimulators, which differentiate into a
• Prolong life permanent self-renewing b-cell population.
• Reduce symptoms Even in advanced cases of diabetes mellitus, the hu-
man pancreas retains its ability to restore the func-
• Prevent diabetes-related complications such as
blindness, heart disease, kidney failure and am- tional possibilities of its tissues as well as their re-
putation of limbs generation, specifically the insulin-producing β-cells

GCDC 2017