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Advantageous Treatment Alternatives For Diabetes
The Potential of Two New Technologies
Jonathan RT Lakey
Associate Professor
Department of Surgery and Biomedical Engineering
Director, Clinical Islet Program
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Type 1/ Type 2 Diabetes
Overview
Type 1
Type 2
Age of onset
Usually during
childhood or puberty
Commonly over age
35
Nutritional status at
times of onset
Commonly
undernourished
Obesity usually
present
Prevalence
5 to 10 percent of
diagnosed diabetics
90 to 95 percent of
diagnosed diabetics
Genetic
predisposition
Moderate
Very strong
Defect or deficiency B cells are destroyed,
eliminating the
production of insulin
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Inability of B cells to
produce appropriate
quantities of insulin;
insulin resistance other
defects
Diet Replacement
Tri-Betic
Conclusion
Type 1
• Type 1 diabetes is an autoimmune disease
• Pancreas stops producing insulin
• Body’s immune system attacks and destroys insulin-producing cells,
beta cells
• There is not a cure; Insulin is not a cure
• Insulin manages symptoms but does not halt the disease or protect the
individual from serious complications
• Kidney failure, blindness, nerve damage, heart attack, stroke, and
pregnancy complications
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Type 1
• As many as three million Americans may have T1D
• Each year, more than 15,000 children and 15,000 adults—approximately 80
people per day—are diagnosed with T1D in the U.S.
• Approximately 85 percent of people living with T1D are adults, and 15 percent of
people living with T1D are children.
• The prevalence of T1D in Americans under age 20 rose by 23 percent between
2001 and 2009.
• The rate of T1D incidence among children under age 14 is estimated to increase
by three percent annually worldwide.
• T1D accounts for $14.9 billion in healthcare costs in the U.S. each year
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Type 1- pathophysiology
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Type 1- pathophysiology
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Type 1- pathophysiology
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Type 2
•
•
•
•
Impact
Type 2 diabetes is the most common form of diabetes.
Body does not produce enough insulin
The cells ignore the insulin
Complications arise when glucose builds up in the blood
• Cells are starved; lack of energy
• Damage to eyes, kidneys, nerves, and heart
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Type 2
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Impact of Diabetes
Impact of Diabetes
Impact
Economic Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT Diet Replacement
Tri-Betic
Conclusion
Impact of Diabetes in the US
•
Type I: 18,436 people younger
than 20 years in the US were
diagnosed with type 1 diabetes
annually. (2008-2009)
•
Type 2: 5,089 people younger
than 20 years were diagnosed
with type 2 diabetes
annually.(2008-2009)
•
•
•
Estimated direct costs in 2007 at
$116 bn
3rd common disease; 4th leading
cause of death
Total direct costs ~$240 billion
in 2012
$58 billion to
treat diabetesrelated chronic
complications
50%
•
Incidence: 371 million diabetics
worldwide, 5 M deaths
•
Complications: Leading cause of
blindness and amputation
Type 1/ Type 2 Diabetes
23%
27%
>$481 billion worldwide
annually
Impact
$27 billion for
care to directly
treat diabetes
Role of Antioxidants
RDDT
Diet Replacement
$31 billion in
excess general
medical costs
Tri-Betic
Conclusion
Impact of Diabetes
1 in 10
health care dollars is spent treating
diabetes and its complication
1 in 5
health care dollars is
spent caring for
people with diabetes
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Role of Antioxidants
Antioxidants
• Antioxidant: a molecule that inhibits the
oxidation of other molecules
• Oxidative stress is a cause for many
complications in diabetes
• Antioxidant defense mechanisms involve
both enzymatic and non-enzymatic
strategies
Mechanisms of action:
1) enzymes that degrade free radicals
2) proteins such as transferrin that can bind
metals which stimulate the production of
free radicals
3) antioxidants such as vitamins C and E
that act as free radical scavengers
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Nutraceuticals and Management of Diabetes
Need to look and cite papers that specifically
Demonstrate reversal of
-
Impact
Dyslipidemia (derangement of lipid levels)
Atherosclerosis (narrowing of blood vessels)
Liver dysfunction
Kidney dysfunction
Nerves & eyes
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Nutraceuticals and Reversal of Diabetes
Need to look and cite papers that specifically
demonstrate reversal – reversal of what ??
Islet function ? Pancreas function ??
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Research Development Diabetic
Technologies
Luteolin
Can be found in:
celery, broccoli, green pepper, parsley, thyme,
chamomile tea, carrots, olive oil, peppermint,
rosemary, navel oranges, and oregano.
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Luteolin
Through advancing activity in the NOS-NO
pathway and, thus, decreasing oxidative stress,
luteolin was found to protect endotheliumdependent relaxation against high glucose
injury
Inhibits the increase in Reactive Oxygen
Species (ROS) and free hydroxyl radical(OH-)
levels and enhances the activity of the NOSNO(Nitric Oxide Synthase-Nitric Oxide)
pathway.
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Luteolin
Lowered cholesterol and triglyceride
levels in diabetic rats, and thus could be
potentially useful in improving the lipid
profile in diabetic patients
Protects against the development of
Kidney dysfunction (nephropathy) – could
be indispensable in arresting the decline of
kidney function in long-term diabetics.
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Quercetin
Found in:
red wine, onions, green tea, apples,
berries, dill, cilantro, kale, and
broccoli
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Quercetin
As an antioxidant agent, quercetin has been
shown to relieve oxidative stress as well as
protect several major organs and types of tissue
from oxidative damage.
When administered to STZ-induced diabetic
rats, the bioflavonoid induced a significant
decrease in serum glucose levels when
compared to rats under the same conditions that
were not given the treatment.
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Quercetin
Quercetin has been found to prevent retinal
edema.
Quercetin has also been shown to be antiinflammatory through the inhibition of
inflammatory cytokines.
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Lutoelin vs. Quercetin
Luteolin: Indirect
Protection
Quercetin: Direct
Protection
Relieves the stress that
diabetes places on the
body through managing
the complications that
arise from having
diabetes.
Relieves the stress that
diabetes places on the
body through reducing
the direct effects of
diabetes
i.e lowering blood
glucose levels, managing
lipid profile
i.e protection for
nepropathy
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
A Novel Diet Replacement Regimen
Treatment for Pancreatic Recovery in Type II Diabetes, Morbid
Obesity, and Metabolic Syndrome
Diet Replacement- Current Management Techniques
Morbid obesity often times requires invasive surgery to ameliorate
the condition
• Gastric bypass
• Lap Band
• Sleeve Gastrectomy
• Gastric Stapling
These options are often permanent
and can cause a patient major
trauma and provide little resolution
to pain
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Diet Replacement – A Safe & Effective Alternative To Invasive Surgery
• Non-invasive, safe and reversible
• Low risk of morbidity & mortality
• Diet replacements/meal replacements can be extremely helpful for diabetics
• Maintenance of weight and blood sugar levels are vital and especially impactful
for Type 2 diabetes
• Protein: protein is needed but in proper amounts especially when proper
blood sugar levels must be maintained
• Carbohydrates:
needed for energy, but those that need to maintain blood sugar levels must
eat the proper types and amount of carbohydrates
• Fats: can provide slow releasing energy in proper amounts
• Amino acids: important building block for protein synthesis
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Tri-Betic
Tri-Betic
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Tri-Betic-Complete Diet Replacement System
• Tri-Meal
• meal replacement drink
• Tri-Balance
• helps manage insulin
and glucose levels
• Tri-Gest
• maintains proper digestion as well as glucose levels
• helps fully absorb nutrients; supports the detoxification of the
liver, kidney, and colon
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Tri-Meal- Meal Replacement Drink
• One part of the Tri-Betic Diabetic Support System
• Tri-Meal is a meal replacement for Type II
Diabetics and Pre-Diabetics
• Helps Diabetics and Pre-Diabetics consume the accurate
amount of protein, carbohydrates, fats, amino acids,
vitamins, and minerals
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Tri-Meal- Meal Replacement Drink
• Alpha-lipoic acid
• contains sulfur
• helps the production of gluthione, a
natural antioxidants, and coenzyme A
• Biotin
• maintains blood sugar and triglycerides
• Niacin
• helps the body deal with cholesterol;
has the potential to regulate bad
cholesterol
• Minerals (copper, zinc, manganese…etc)
• supports the body immune system
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Tri-Meal- Meal Replacement Drink
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Tri-Balance- Management of Insulin and Glucose Levels
• One part of the Tri-Betic Diabetic Support System
• Alpha Lipoic Acid
• contains sulfur
• helps the production of glutathione, a natural antioxidants, and coenzyme
• Biotin
• maintains blood sugar and triglycerides
• Acetyl L-Carnitine
• an amino acid that has been noted to promote positive cellular metabolism
• Vitamin B6
• regulates blood sugar level
• Chromium Polynicotinate
• an active component of true Glucose
Tolerance Factor
• responsible for binding insulin to cell
membrane receptor sites
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Tri-Gest-Digestive System Support
• One part of the Tri-Betic Diabetic Support System
250mg rhubarb root powder: a natural digestive aid
200 mg magnesium as magnesium oxide: helps maintain the proper
amount of water in the colon.
50 mg bentonite powder: cleans and detoxifies of the intestines
50 mg fenugreek powder: detoxification agent
50 mg marshmallow root
25 mg peppermint leaf
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Tri-Gest-Digestive System Support
10 mg couchgrass powder
25 mg fennel seed
10 mg uva ursi
25 mg black walnut hulls
5 mg irish moss
25 mg slippery elm bark
5 mg cayenne powder
5 mg ginger root
50 mg glactobacillus acidophillus (1 billion
cfu/gram)
5 mg licorice root
5 mg fos5mgcitrus bioflavanoid
complex
5 mg papaya leaf
Impact
Type 1/ Type 2 Diabetes
2.5 mg bifidobacillus bifidus (10 bil/gm) 5mg
mullein leaf
5 mg parsley leaf
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion
Conclusion
RDDT and Tri-Betic- provide safe alternatives
not only for the management of diabetes but the
potential reversal of diabetes
Through this the
effects of diabetes
on the:
Can be scaled down.
Impact
Type 1/ Type 2 Diabetes
Role of Antioxidants
RDDT
Diet Replacement
Tri-Betic
Conclusion