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Verapamil: an effective therapy for type 1 diabetes

To promote the functioning of beta cells and insulin in patients with type 1 diabetes, researchers have developed a novel strategy that minimizes the requirements of insulin and the incidence of hypoglycemia. These researchers have worked at the Comprehensive Diabetes Center at the University of Alabama in Birmingham, USA.

The journal Nature Medicine published these findings recently. Verapamil is the most commonly used drug for controlling blood pressure; it was approved for oral administration in the year 1981. Following the administration of verapamil, type 1 diabetes patients were able to produce greater amounts of insulin. Thus, their daily requirement of insulin was reduced substantially and their blood sugar levels were also in control.

The drug verapamil is not just safe and effective for type 1 diabetes but also a promising therapy that provides new hope to people living with this life-threatening condition. These were positive results confirmed in a human clinical trial that was randomized and double-blinded in nature; the clinical trial was controlled by placebo.

Verapamil has shown promising results in improving the function of beta cells in pancreas; the functioning of beta cells is related to the control of insulin production. Optimum levels of insulin ensure a good quality of life in patients. Under such a scenario, type 1 diabetes patients have new hope. It is otherwise difficult to control such a life-threatening condition that offers no hope.

Although this drug does not sound like a complete cure for type 1 diabetes, it is however a promising therapy for altering a life-threatening condition: type 1 diabetes. Such patients need to boost the production of insulin in their body in order to have better disease control.

A clinical trial was conducted on animal models in the year 2014. In this clinical trial, it was reported that the condition of type 1 diabetes could be completely reversed by administering verapamil. Then, they conducted a human clinical trial to determine the effects of this drug.

For more than three decades, the drug verapamil has been approved by the FDA for the treatment of high blood pressure. Current research findings are path-breaking in the sense that the drug is quite safe and effective in the treatment of type 1 diabetes patients. In patients with type 1 diabetes, the body’s immune system attacks beta cells of the pancreas.

These beta cells are responsible for the production of insulin. Insulin is the hormone that controls blood sugar levels in the patient. The production of insulin decreases substantially when the beta cells of pancreas are destroyed in the human body.

Consequently, blood sugar levels would rise in the human body and the patient would become extremely dependent on external sources for insulin. The function of beta cells can be preserved effectively when a patient is administered verapamil.

This drug induces the body to produce more insulin. In various clinical trials, it has been proved that the participants’ dependency on external insulin decreases substantially. Several individuals with type 1 diabetes can effectively regulate their blood sugar levels with this strategy.

In the human clinical trial, the drug verapamil was administered to 24 patients. These patients were in the age group of 18 to 45 years. Over the course of one year, verapamil was administered to 11 patients while a placebo drug was administered to 13 patients.

Only patients with type 1 diabetes were included in this clinical trial. They received insulin therapy to manage their condition throughout the duration of this clinical trial. The total daily dose of insulin was monitored in both the groups, that is, the group that received verapamil and the group that received placebo.

Moreover, we also monitored the amount of insulin produced in these groups. Factors such as the percentage of change in insulin and HbA1C levels were also monitored. There were patients who experienced hypoglycemic events; all such events of each patient were recorded in our human clinical trial.

A continuous glucose monitoring system was used to determine the healthy blood glucose levels of each patient. Patients with type 1 diabetes do have therapeutic options for hope. In fact, such patients should be able to deal with the illness in a promising way following the successful administration of verapamil.

Insulin dependency was substantially reduced in patients with type 1 diabetes following the administration of verapamil. The quality of life was significantly improved in these patients. The risk of comorbidities would be improved when the overall blood sugar levels was controlled in patients. Thus, a patient with type 1 diabetes would not develop several other comorbidities, such as kidney disease, blindness, and heart attack.

 

 

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Pancreatic stem cells can regenerate beta cells and respond to glucose

Within the human pancreas, scientists stimulated progenitor cells and developed them into beta cells that were responsive to glucose. These findings were published in the journal Cell Reports, which paved the way for developing novel cell therapies, which is an important breakthrough for type 1 diabetic patients. This addresses a major obstacle that blocks the way for discovering a complete cure for type 1 diabetes.

Pancreas contains progenitor cells and has the potential of regenerating islets. This hypothesis has been established since many decades, but it has not been proven conclusively. Scientists identified the exact location of stem cells anatomically. They validated their proliferative ability to transform into beta cells, which were responsive to glucose.

A detailed study of stem cells was conducted in the human pancreas, and the results were used to tap into the cell supply ‘bank’ of beta cells. These events occurred endogenously and were used for regeneration purposes. In the years to come, these stem cells could be used for therapeutic applications of type 1 diabetic patients..

In earlier studies, it was found that the bone morphogenetic protein 7 (BMP-7) could be used for clinical applications and to stimulate cells that resemble progenitors. These cells occur within the non-endocrine sections of the human pancreatic tissue. In previous studies, it was reported that BMP-7 is used to stimulate growth and to induce the transformation of stem cells into functional islets.

In a recent study, researchers further demonstrated that stem cells responding to BMP-7 reside within the network of ducts and glands of the human pancreas. Moreover, the expression of PDX1 and ALK3 is used to characterize these cells of the human pancreas. The protein PDX1 is required for the development of beta cells, whereas ALK3 is a receptor of cell surfaces and is used to regenerate several tissues.

With the help of “molecular fishing” techniques, researchers could selectively extract cells that expressed PDX1 and ALK3. A petri-dish was used to grow the cell culture, and they proliferated due to the expression of BMP-7. These cells were later differentiated into beta cells. The combined results of this study were used to develop regenerative cell therapies for both type 1 and type 2 diabetes patients.

In patients with type 1 diabetes, the cells that produce insulin in the pancreas are attacked and sabotaged by the immune system. Patients had to control their glucose levels in the blood with a daily regimen of insulin therapy. In patients with type 2 diabetes, insulin was produced to some extent but beta cells became dysfunctional over a period of time.

With islet transplantation, some type 1 diabetes patients could live without insulin injections. This is because donor cells were infused into these patients; however, enough cells are not there to treat several patients with type 1 diabetes.

Presently, research studies have primarily focused on synthesizing many pancreatic cells, which can be transplanted from embryonic (hESc), pluripotent (hPSc) and adult stem cells, and porcine (pig) islets. It would be better to regenerate insulin-producing cells in patients, which prevents the need to completely transplant donor tissue and eliminate roadblocks to other immune-related disorders.

Regenerative medicine strategies must be developed to restore insulin production in native pancreas. This would replace the need for pancreas transplantation or other cells that produce insulin. In patients with type 1 diabetes, autoimmunity abrogation must be stopped in order to prevent the destruction of immune system and newly produced insulin cells. For this purpose, efforts were made to converge immune tolerance induction that did not require anti-rejection drugs for a long period of time.