1:55
As mentioned, diabetes primarily comes in two major types.
Type 1, as I mentioned five to ten percent.
And Type 2 is the rest, 90 to 95
percent and diabetes prevalence is increasing everywhere in the world.
So it is a real burden and a threat to the world's health economy because
of the astronomic numbers of patients that are
affected worldwide, and particularly in the poorer countries.
Such as China and India, which together account for more than 40% of
the world's diabetic populations, and we can see that today more
than 382 million people with diabetes have been diagnosed.
2:42
And an expectation of as much as 592 million by the year 2035
can be found on the IDF's webpage.
So, it is really astronomic in numbers and the major issue in diabetes,
is, that it is, it's association with high risk of developing
devastating late complications, that actually lead to, premature death.
In fact, one diabetic patient dies every six seconds while at
the same time, in the same period, two new patients are diagnosed.
9:11
There is also a group of patients that are residing in between the two types where a
slow engagement with the immune system is some unknown way is
further involved in eliminating beta cells in the so called Type 1 and half diabetes.
It's also called latent autoimmune diabetes of the adult, or LARA.
So it's a slow progression from might, what might have been diagnosed as a Type 2
diabetes that moves towards the Type 1 diabetes
that eventually becomes entirely dependent on exogenous insulin injections.
So the major challenge going forward,
as I mentioned is to interfere, block or
revert these red arrows and I, I wanted to
highlight the for, that for Type 2 diabetes,
phenomenally, promising data have very
recently been published from a clinical
trial called the Dual Trial that illustrates
that when you combine therapies of using long
acting insulin, known here is IDeg and a long
acting GLP-1, known here as Liraglutide
actually leads to the normalization of hemoglobin A1C over time.
And glycosylated or glycated hemoglobin reflects the long-term control
of glucose control and you could say glycosylation of
proteins, or glycations of proteins, is sort of an
directly proportional with the levels of glucose in the blood.
So if you have high glycosylated, gly, glycated levels of hemoglobin A1C, you
will also have an indication that you have had hyperglycemia for the past period.
When you look at the lower curve.
It is all the way
into the normal
area which is a,
below the 6.5
horizontal line
on the slide.
So it, in these patients, you could
say it glycosylated insulin, oh, sorry, glycosylation of
hemoglobin A1C levels all the way back to approach to normal levels and one could
speculate that if, although this is a
clinical trial, one could speculate that if these
patients were continued in this, therapy that
they may actually be, prevented from developing complications.
So in conclusion there maybe a window of prevention by the combined use
of long acting insulin and GLP1, and we know from beta cell biology studies,
that this cocktail of two of these two drugs, is actually possibly optimal
to nurse, and protect, and enhance the
apparent functionality of the beta cell mass.
Possibly one of the explanations, to restart
on normal glycemic levels, in Type 2 diabetes.
Also, now [UNKNOWN] the drugs,
to interfere with obesity,
may in the long term, be the most
effective tools to actually prevent
progression to once diabetes.
For the reversal of the arrow regarding Type 1 diabetes
cell replacement therapy, as illustrated by organ donor islets transplantation's
from the Edmonton protocol, has proven effective in attempts to establish and
normalize blood glucose regulation when combined with immunosuppression.
This pioneering work of Dr. Shapiro at the University of
Edmonton has led us to very, to very strong worldwide
commitments in trying to make alternative sources to possibly replace
this [UNKNOWN] organ donors and providing the islets of Langerhans.
This is the focus of the remaining talk.
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