Savvy Updates 6/5/23: Wharton’s Jelly for Newly Diagnosed T1Ds, T1D & Advanced Brain Aging, Mental Toll of Diabetes

Wharton’s jelly found to halt diabetes progression in Phase II trial by Justin Jackson for MedicalXPress.com, 2 June 2023. (This is a highly technical post!)

Research in Sweden led by the University of Uppsala has looked into using mesenchymal stromal cells to halt the progress of newly diagnosed type 1 diabetes. In the paper, “Umbilical cord-derived mesenchymal stromal cells preserve endogenous insulin production in type 1 diabetes: a Phase I/II randomized double-blind placebo-controlled trial,” published in the journal Diabetologia, researchers detail the study and results of a small sample set of 24 participants. The researchers used Wharton’s jelly-derived mesenchymal stromal cells (MSCs) that were not derived from the patients in the study (allogeneic).

Wharton’s jelly is the gelatinous mucus-like tissue surrounding the umbilical cord’s blood supply between a developing fetus and the placenta. The jelly-derived MSCs have regenerative potential, limited cell type differentiation, self-renewal properties, and signaling with other cells resulting in immunomodulation. The immunomodulatory properties of these MSCs allow them to be used in allogeneic “off-the-shelf” therapies as the body does not reject them as foreign tissue.

A selection process called ProTrans was applied in collecting the MSCs utilized. The ProTrans selection process was created by NextCell, a Swedish biopharmaceutical company associated with several researchers involved in the study.

Study Suggests Increase in Brain Aging in Those With Type 1 Diabetes by Kristen Monaco for MedPageToday.com, 1 June 2023.

Patients with type 1 diabetes (T1D) may have advanced brain aging compared with those without T1D, though this didn’t come with early signs of Alzheimer’s disease-related neurodegeneration, according to a cohort study. “These results support the hypothesis that brain morphology is associated with an accelerating aging process in middle-aged and older-aged adults with a long history of T1D,” the researchers wrote in JAMA Network Open. However, this difference in brain aging didn’t appear to lend itself to any early manifestations of Alzheimer’s disease.

A few areas of the brain were hit harder in those with T1D, showing significantly more gray matter atrophy. Interestingly, higher body weight may hold some protective properties against this more rapid brain aging.

Mapping the Mental Toll of Diabetes by Hope Warshaw for diaTribe.org, 26 May 2023.

diaTribe attended the second annual Diabetes + Mental Health Virtual Conference on May 5-6, a two-day conference featuring top-notch speakers. The conference is the brainchild of two clinical therapists who have type 1 diabetes, Allison Nimlos and Sara Adams. Nimlos, who lives in Minnesota, has had diabetes for 29 years. Her first foray into the diabetes community was as a writer. Today, Nimlos has a counseling practice and offers diabetes coaching to people worldwide. Adams has latent autoimmune diabetes in adults (LADA) and co-owns a group psychotherapy practice in New York, where she provides care in diabetes and mental health realm.

“After becoming a therapist, I spent several years speaking about diabetes and mental health. I noticed that one 45-minute talk to cover the gamut of diabetes and mental health was nowhere near enough time,” Nimlos said. “More issues need to be covered and in greater depth. Diabetes is not just a physical illness. The mental and emotional toll of management is significant,” she said.

Managing diabetes remains challenging and burdensome, despite many positive advances in care. Dana Lehman, a psychologist and person with diabetes, cited research that shows nearly 43% of people with diabetes meet the criteria for a mental health disorder at some point in their life. Lehman added that this statistic is likely a modest estimate. Some of the unique stressors of having diabetes include daily self-care requirements, common misconceptions about it, and the potential physical effects of the condition over time.

Some great take-aways:

- - Adam Brown wrapped up a healthy attitude about diabetes self-care with these words. “I don’t ‘control’ my diabetes: I influence it, manage it, balance it, hold it, and carry it.”
  - Anna Sabino, a social worker and certified diabetes care and education specialist, referred to people like herself with diabetes (and their caregivers) as “team captain, best friend, CEO, founder, feelings owner, and mistake maker,” of their diabetes.
  - Mark Heyman concluded his keynote by giving a few “marching orders” to attendees.
    - First, he encouraged people to speak up and make their needs known. He said the more glucose levels and clinical outcomes can be tied to emotional health, the better. “Make sure that every diabetes touch point you have is informed by mental health, from your healthcare providers to work, friends, partners, and even manufacturers of diabetes devices and medications,” he said. “Talk about it relentlessly until they listen and get it.”
    - Second, bring other people with diabetes into the fold of the community. Share resources to grow and cultivate it. Third, share your lived experience with diabetes – including the aspects of emotional health. “Make diabetes your biggest strength. Think about what good has come from having diabetes,” he said.

People interested in attending the third annual Diabetes + Mental Health Virtual Conference next year (date to be determined) can join the registration waitlist here.