Individuals with type 1 diabetes (T1D) or permanent neonatal diabetes (PND) due to an INS gene mutation (INS-PND) have a marked reduction in pancreas volume by MRI compared with control individuals with no diabetes (ND). One possible explanation for this is loss of islet-acinar insulin signaling in these forms of severe insulin deficiency. To test […]
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Codelivery of NGF R100W and VEGFA mRNA Enhances Vascular and Neural Repair in Diabetic Peripheral Neuropathy
Diabetic peripheral neuropathy (DPN) poses significant clinical challenges due to progressive nerve degeneration and vascular insufficiency. To address both neural and vascular complications simultaneously, we employed an mRNA-based protein replacement therapy. In this study, leveraging mRNA template design, structure-based screening identified NGFR100W as a variant dissociating neuroprotective and nociceptive functions, demonstrating enhanced neuritogenic activity without […]
Read MoreA Dual Stable Isotope Study of the Effect of Altitude and Simulated Flight on Glucose Metabolism in Type 1 Diabetes: A Randomized Crossover Study
The impact of atmospheric pressure changes on glucose metabolism encountered in aviation on people with type 1 diabetes is controversial. A dual-isotope study was performed in a hypobaric chamber to simulate pressure changes experienced on commercial flights. The fasting and postprandial glucose kinetics of individuals with type 1 diabetes were evaluated across simulated in-flight cabin […]
Read MoreGlucose-Dependent Insulinotropic Polypeptide Is Involved in Postprandial Regulation of Splanchnic Blood Supply
Gastrointestinal hormones are essential for nutrient handling and regulation of glucose metabolism and may affect postprandial blood redistribution. In a randomized cross-over design in 10 healthy men, the involvement of glucose-dependent insulinotropic polypeptide (GIP) in splanchnic blood flow regulation was investigated using an infusion of GIP receptor antagonist (GIPR-An) GIP(3-30)NH2 during ingestion of oral glucose […]
Read MoreSplanchnic and Leg Glucagon Metabolism in Healthy Individuals and Those With Type 1 Diabetes: First-in-Human Study Using [ 13 C 9 , 15 N 1 ]Glucagon
Circulating glucagon concentrations differ between individuals with no diabetes (ND) and those with type 1 diabetes (T1D). We combined an isotope dilution technique using stable tracers [6,22-13C9,15N1]glucagon and [6,14,19,22-13C9,15N1]glucagon with splanchnic and leg catheterization in participants with ND (n = 8; age 23.1 ± 2.9 years, BMI 26.6 ± 3.5 kg/m2, HbA1c 5.0 ± 0.2% […]
Read MoreIntrasplenic Transplantation of Islets With a Platelet Shielding System Restores Glycemic Control
Intraportal islet transplantation to treat insulin-dependent diabetes has been clinically validated. However, the hypoxic environment and sinusoidal architecture of the liver are unsuitable for the long-term survival of transplanted islets, leading to the loss of therapeutic effects within 1 year. The spleen has oxygen levels that meet islet needs, but intense instant blood-mediated inflammatory reactions […]
Read MoreDifferences in White Matter Microstructure in Children With Type 1 Diabetes Persist During Longitudinal Follow-up: Relation to Dysglycemia
Type 1 diabetes has detrimental effects in white matter microstructure. In a longitudinal study, we investigated whether these reported findings change as children grow and enter puberty. At study entry, there were 143 children with type 1 diabetes and 71 control participants without diabetes, 4–9 years old. Brain MRI using diffusion tensor imaging, neurocognitive, and […]
Read MoreTherapeutic Targeting of the GIP Receptor—Revisiting the Controversies
Current and emerging strategies to therapeutically target weight management include pairing agonism of the glucagon-like peptide 1 receptor (GLP-1R) with either agonism or antagonism of the glucose-dependent insulinotropic polypeptide receptor (GIPR). On the surface, these two approaches seem contradictory, yet they have produced similar effects for weight loss in clinical studies. Arguments that support the […]
Read MoreA Contemporary Rationale for Agonism of the GIP Receptor in the Treatment of Obesity
In combatting the obesity crisis, leveraging mechanisms that lower body weight is critical. The finding that treatment with tirzepatide, a glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) receptor agonist, produces profound weight loss highlights the value of activating the incretin receptors. Supporting this, recent studies have revealed mechanisms by which GIP receptor (GIPR) […]
Read MoreGIP Receptor Antagonists in the Pharmacotherapy of Obesity: Physiologic, Genetic, and Clinical Rationale
Obesity is a prevalent disease that also contributes to the incidence and severity of many other chronic diseases and health conditions. Treatment approaches include lifestyle intervention, bariatric surgery, and pharmacological approaches, with glucagon-like peptide 1 (GLP-1) receptor agonists approved specifically for weight loss having changed the treatment landscape significantly in the last 5 years. Targeting […]
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