Pea-sized pill delivers insulin shot from inside the stomach was announced by a Massachusetts Institute of Technology-led research team on 2/7/2019 and reported by Lauran Neergaard on as well as Gina Kolata in the Health Section of The New York Times.  This is SO COOL!!! Once ingested, a tiny device called Soma positions itself against the stomach wall and injects insulin into the bloodstream!

Scientists figured out how to hide a shot inside a pea-sized pill — creating a swallowable gadget, inspired by a tortoise shell, that can inject medicines like insulin from inside the stomach. Patients usually prefer oral treatment, and comply with it better, but many compounds, including insulin for diabetes, can’t survive the harsh trip through the digestive system. This new invention has been tested only in animals so far. But if it pans out, it might offer a work-around to make not just insulin but a variety of usually injected medicines a little easier to take.

“The way this works is it travels down the esophagus in seconds, it’s in the stomach within a few minutes, and then you get the drug,” said Traverso, who worked with a team from the lab of MIT inventor Robert Langer and insulin maker Novo Nordisk.

The first challenge: How to make sure the device lands where it can poke into the right spot, even if someone’s moving around. Researchers looked to nature for ideas. A certain tortoise, the leopard tortoise from Africa, can right itself if flipped onto its back thanks to the steep curve of its shell. Researchers crafted a miniature capsule with a similar shape and a weighted bottom, so that once it reaches the stomach it automatically rolls in the right direction to latch on, Traverso explained.

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Scientists successfully transformed human stem cells into insulin-producing cells that appeared to function normally when transplanted into mice.

“We can now generate insulin-producing cells that look and act a lot like the pancreatic beta cells you and I have in our bodies. This is a critical step towards our goal of creating cells that could be transplanted into patients with diabetes,” said Matthias Hebrok, PhD, of the UCSF Diabetes Center.  The research was reported in the publication, Nature Cell Biology, 1 February 2019.The bottom line: Replicating aspects of endocrine cell clustering permits the generation of stem-cell-derived β cells that resemble their endogenous counterparts.

Read more:  Scientist discovers how to grow insulin-producing cells

One-Size-Fits-All Models Don’t Predict Postprandial Glucose Spikes was reported by Kristen Monaco of, 8 February 2019. Individual patient factors — lifestyle and microbiome — drive metabolic response to food.  As we already all know, it is COMPLICATED!  This explains why.

After normoglycemia individuals in the study ate the same food, the range of postprandial glycemic responses varied greatly, Helena Mendes-Soares, PhD, of the Mayo Clinic in Rochester, Minnesota, and colleagues reported in JAMA Network Open. For example, after the 327 individuals in the study ate a standard meal consisting of a bagel and cream cheese, glycemic excursions ranged from just 6 mg/dL up to 94 mg/dL.

Taking this a step further, Mendes-Soares and co-authors developed a novel model specifically designed to predict an individual’s glucose response to food, which incorporated 72 factors. Some of these factors incorporated the individuals’ microbiome features, meal content, and individual anthropometric factors.  LET ME REPEAT:  SEVENTY TWO FACTORS!!!

Why aren’t the current models as accurate? Study co-author Purna Kashyap, MBBS, also of the Mayo Clinic, explained that those models typically lump everything — like carbohydrates and fats — simply into one category. “With our individualized model, people no longer have to give up all foods within a certain category. It allows them to choose specific foods within certain categories that fit well with their microbiome.”

Read more: One-Size-Fits-All Models Don’t Predict Postprandial Glucose Spikes

BCG Vaccine Shows Promising Signals of T1D Efficacy was reported by Martin Hensel on, 7 February 2019.  Here’s the update on Dr. Denise Faustman’s work.

Once all these Phase II trials are complete we should have enough data to make a convincing case to the FDA that BCG vaccine can be used to restore near-normal blood glucose in people with T1D.  The Phase II trial is much bigger and includes a greater range of type 1 diabetics including patients that are younger than the Phase I patients. It will be interesting to see if these patients can regenerate some of their endogenous insulin production, which is why we are carefully tracking C-peptide as well as HbA1c.  We are also very excited to start a pediatric trial for the same reason.

Additional Phase II trials will be required to determine when to revaccinate people.

There is now global data suggesting that prophylactic use of BCG vaccine among high-risk T1D children could become an accepted practice especially because of the low risk associated with BCG’s solid safety profile.  

Read more: BCG Vaccine Shows Promising Signals of T1D Efficacy

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