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Stem cell therapy: Diabetes is no longer an incurable disease
Stem cell therapy: Diabetes is no longer an incurable disease. Diabetes is a group of metabolic diseases characterized by hyperglycemia, which is caused by insulin secretion defects or impaired biological effects or both.
Clinical manifestations of diabetes
1. Polydipsia, polyuria, polyphagia and weight loss. The typical symptoms of severe hyperglycemia appear with three more and one less symptoms, which are more common in type 1 diabetes. When ketosis or ketoacidosis occurs, more than three and one less symptoms are more obvious.
2. Fatigue and weakness. It is more common in type 2 diabetes. Obesity is common before the onset of type 2 diabetes. If not diagnosed in time, the weight will gradually drop. Diabetes examination methods are:
3. Blood glucose: it is the only criterion for diagnosing diabetes. Patients with obvious symptoms of more than three and one less can be diagnosed with only one abnormal blood glucose level. Asymptomatic patients need two abnormal blood glucose levels to diagnose diabetes, and 75g glucose tolerance test is required for suspected patients.
4. Urine sugar: often positive. When the blood glucose concentration exceeds the renal glucose threshold (160 to 180 mg/dL), urine glucose is positive, and when the renal glucose threshold increases, the diagnosis of diabetes may be negative even if the blood glucose reaches the diagnosis. Therefore, urine glucose measurement is not a diagnostic criterion. 5. Urine ketone bodies: Urine ketone bodies are positive in ketosis or ketoacidosis.
6. Glycosylated hemoglobin (HbA1c): It is the product of the combination of glucose and hemoglobin in a non-enzymatic reaction. The reaction is irreversible and the HbA1c level is stable. It can reflect the average blood glucose level 2 months before blood collection, and is the most valuable for judging the state of blood glucose control. index of.
7. Glycated serum albumin: It is the product of the combination of blood glucose and serum albumin in a non-enzymatic reaction, reflecting the average blood glucose level 1 to 3 weeks before blood collection.
8. Serum insulin and C-peptide levels: reflect the reserve function of pancreatic β cells. In the early stage of type 2 diabetes or obesity, serum insulin is normal or increased. As the disease progresses, pancreatic islet function gradually decreases and insulin secretion capacity decreases. 9. Blood lipids: dyslipidemia is common in diabetic patients, especially when blood sugar control is poor, manifested as increased levels of triglycerides, total cholesterol, and low-density lipoprotein cholesterol, and decreased levels of high-density lipoprotein cholesterol.
10. Immune indicators: islet cell antibodies (ICA), insulin autoantibodies (IAA) and glutamate decarboxylase (GAD) antibodies are three important indicators of type 1 diabetic humoral immunity. Among them, the positive rate of GAD antibody is high and sustained It takes a long time and is of great value in the diagnosis of type 1 diabetes. There is also a certain positive rate among first-degree relatives of type 1 diabetes, which has the significance of predicting type 1 diabetes.
11. Urinary albumin excretion: radioimmunoassay or enzyme-linked methods can sensitively detect urine albumin excretion, and urine albumin is slightly elevated in early diabetic nephropathy.
The long-term high blood sugar in diabetes causes chronic damage and dysfunction of various tissues, especially eyes, kidneys, heart, blood vessels, and nerves.
Causes of diabetes
1. Genetic factors: There is obvious genetic heterogeneity in both type 1 and type 2 diabetes. Diabetes has a tendency to develop in a family, and 1/4 to 1/2 patients have a family history of diabetes. There are at least 60 genetic syndromes that can be accompanied by diabetes in clinical practice. There are multiple DNA sites involved in the pathogenesis of type 1 diabetes. Among them, the DQ site polymorphism in the HLA antigen gene is most closely related. A variety of clear genetic mutations have been found in type 2 diabetes, such as insulin gene, insulin receptor gene, glucokinase gene and mitochondrial gene.
2. Environmental factors: Obesity caused by excessive eating and reduced physical activity is the most important environmental factor for type 2 diabetes, which makes individuals with genetic susceptibility to type 2 diabetes prone to disease. Patients with type 1 diabetes have an abnormal immune system. Some viruses such as Coxsackie virus, rubella virus, mumps virus and other infections cause their own immune response and destroy insulin β cells.
Mechanism of stem cell treatment of diabetes:
Stem cells have been proven to promote the regeneration of β cells and can safely replace lost pancreatic β cells. Therefore, the use of stem cell therapy can control blood sugar well. Through multiple sets of clinical experiments and long-term studies, stem cell therapy can significantly reduce diabetes patients Fasting blood glucose FPG and HbA1c. The use of stem cell therapy can truly improve the quality of life of diabetic patients.
Traditional interventions for diabetes mainly include 5 aspects
Education, self-monitoring of blood glucose, diet therapy, exercise therapy and medication for diabetic patients.
1. Education for diabetic patients: It is necessary to educate diabetic patients to understand the basic knowledge of diabetes, establish confidence in overcoming the disease, how to control diabetes, control the health benefits of diabetes, and formulate appropriate treatment plans according to the characteristics of each diabetic patient.
2. Self-monitoring of blood glucose: With the gradual popularity of small quick blood glucose meters, patients can adjust the dose of blood glucose lowering drugs at any time according to their blood glucose levels. When type 1 diabetes is undergoing intensive treatment, monitor blood glucose at least 4 times a day, and monitor 8 times when blood sugar is unstable. During intensive treatment, fasting blood glucose should be controlled below 7.2 mmol/L, and blood glucose should be less than 10 mmol/L two hours after a meal. HbA1c is less than 7%, and the frequency of self-monitoring blood sugar in type 2 diabetic patients can be appropriately reduced.
3. Drug therapy, insulin therapy, exercise therapy and diet therapy. However, these treatment methods in the prior art either have a large side effect on the body or have an unsatisfactory therapeutic effect. Therefore, a new type of treatment method for diabetic patients needs to be developed to improve the quality of life of diabetic patients.
Progress in clinical research on stem cell treatment of diabetes
As of February 2020, there are 211 clinical research projects related to stem cell treatment of diabetes registered in the largest clinical trial registry of the American Research Institute. The stem cells involved mainly include: mesenchymal stem cells, embryonic stem cells, induced pluripotent stem cells, etc.
In recent years, mesenchymal stem cells have received more and more attention due to their easy preparation, high activity and outstanding immune regulation function. Mesenchymal stem cells have also been confirmed to play a role in reducing blood sugar and improving insulin resistance in the treatment of diabetes.
In 2015, Chinese researchers performed mesenchymal stem cell transplantation on 6 patients with type 2 diabetes and followed up for at least 24 months. After the treatment, the fasting blood glucose and the blood glucose level 2h after the meal of the 6 patients became relatively stable, and no immediate or delayed adverse reactions occurred during the entire treatment.
In 2009, the Indian research team published the results of a trial using bone marrow mesenchymal stem cells to treat type 2 diabetes. Ten patients with type 2 diabetes were treated with bone marrow mesenchymal stem cells. After treatment, the amount of exogenous insulin in 7 patients was reduced by 75% (3 of them stopped using exogenous insulin). In 2014, the researcher again treated 11 cases of type 2 diabetes with bone marrow mesenchymal stem cells. Among them, 9 cases of insulin were reduced by 50%, and insulin consumption was reduced by 66.7% on average (32.1% in the control group).
In 2015, the Swedish team randomly divided 20 newly diagnosed adult type 1 diabetes patients into two groups. They were treated as the mesenchymal stem cell treatment group and were given autologous mesenchymal stem cell transplantation plus insulin therapy, while the control group was given insulin therapy only. Follow-up The mixed meal glucose tolerance experiment was conducted for one year, and it was found that the plasma C-peptide level of the control group decreased significantly, while the treatment group did not decrease or even increased. During the study period, the mesenchymal stem cell treatment group had no obvious side effects.
With the development of various studies, more and more scientific researches have confirmed the effectiveness of stem cell therapy to intervene in diabetes. Stem cell therapy can bring more convenient benefits to diabetic patients.
(sourceinternet, reference only)