Beta Cell Replacement Therapy: A New Frontier in Diabetes Research

Philipson350A promising new approach to stem cell research brings together research groups at the University of Chicago with other collaborators to apply their complementary expertise in stem cell and developmental biology, genetics and genomics and beta-cell physiology to address the problem of generating mature human beta-cells that can be used therapeutically in patients with type 1 diabetes (TID).  In particular, Dr. Philipson and Bell have been working with James Wells, PhD of the University of Cincinnati and his lab to continue the momentum of this research.

As Kovler scientists continue their research in this area- with generous support from Friends United- they are thinking through the idea that cells made from adults can be taught to make insulin and might be used to treat diabetes. The technical term for these cells is induced pluripotent stem cells (iPSCs), and Dr. Philipson thinks they can help teach all of us how insulin-secreting cells (beta cells) are properly made. These adult stem cells are made from skin biopsies of adults, not embryos, and using genetic methods can be turned into stem cells that can do almost anything.

According to Dr. Philipson, the next phase of this collaborative project is to “send blood samples to Dr. Wells and his team to start the process of making adult-stem cells from white blood cells. Our specific research initiative is to take advantage of our expertise in unusual, genetic forms of diabetes called monogenic diabetes.” Using iPSCs derived from patients with monogenic forms of diabetes due to a mutation in key genes affecting beta-cell development or maturation of the insulin secreting cells, Drs. Philipson, Bell and others hope to learn how to create improved beta cells.

Continue to stay in the know–connect with Kovler Diabetes Center!


Introducing Emily: a Kovler Summer Intern

Hello, my name is Emily and I have been working here at Kovler for a little over a month and a half now.  Each day when I walk into work, I am astonished at how awesome this institution is and cannot believe I am able to work here.  Coming into this internship, I was very nervous about the types of things I would be doing and the people I was going to be working with.  Not having diabetes myself and with only a small amount of experience, I was nervous yet excited to begin.

Being a Nursing major my understanding of diabetes has mostly come from my textbooks, and the clinicals I have completed.  This pasted spring I worked on a Cardiac-Pulmonary floor and received the opportunity to care for numerous patients with diabetes.  I was able to assist them in managing their blood glucose levels within the hospital in addition to promoting healthy lifestyles once these patients were discharged.  With what felt like an abundance of knowledge I decided to take the opportunity to come work for Kovler.  But little did I know that I would become even more acquainted with diabetes.

Throughout my time here, I have found a deeper respect for patients with diabetes and the care that these patients need.  I also have so much admiration for the doctors working within Kovler, who have made ground-breaking discoveries through their research.  It’s so incredible and interesting!  Lastly, working with the members of Kovler has shed a new light on proving care.  The people here at the Kovler Diabetes Center are so passionate about what they do and it is incredible to see how they can make a difference for each individual they care for, educate, and support.  I hope to do the same in my own career.

While working close with these members, especially Peggy Hasenauer, I have helped to launch two substantial programs for Kovler this summer: Kovler Krew and the Diabetes All-Star Peer-to-Peer Program.  Both new projects have made great progress so far and we are excited to see where they are headed!

Kovler Krew, a volunteer program, provides members of the community a chance to offer their time, support, and knowledge to assist the Kovler Diabetes Center in expanding its community presence, and helping educate and support patients all throughout Chicago.  Volunteers play a large role in the Kovler team and we are very thankful for those that choose to do so.

The second program, Diabetes All-Star Peer-to-Peer Program is a peer-to-peer mentoring program for Kovler patients from the south side of Chicago who have type 2-diabetes. We believe that through this mentorship our patients, who have struggled in the past, will achieve confidence and stability in managing their diabetes and continue to live healthy lifestyles.

Working with these volunteers and patients, I hope to strengthen the Kovler Team and to build the Kovler connection throughout the Chicago-land area. It has been great seeing the progression of these programs so far, and I am eager to see what else the rest of the summer has to offer.


Guest Blog: Diabetes Prevention Program Outcomes Study

I am the Program Coordinator for the Diabetes Prevention Program Outcomes Study, a multi-center study which has been ongoing since February 1996.  We ended recruitment in February, 1999.  There are two staff members working on the DPPOS here – myself and Rina DeSandre.  We have worked together since the study’s inception!

Our study is looking at how to prevent diabetes in people at high risk.  It was a very stringent screening process, but finally after three years we finished recruitment and randomized 153 people.  There are three treatment groups now.  One is using the medication metformin, which is currently indicated for treatment of diabetes, one group is the placebo and the other group is intensive lifestyle.  Those in the intensive lifestyle group have a goal to lose 7% of their weight and do at least 150 minutes of moderate exercise (like a brisk walk) each week.

Since our study has been going on so long, we actually have some results initially published in the New England Journal of Medicine in 2001.  It was found that lifestyle was almost twice as effective (a 58% reduction in risk) at preventing diabetes as taking metformin for prevention. However, the metformin did have a 31% reduction in risk of getting diabetes.

Our participants are quite loyal – with a greater than 90% retention rate.  They see us twice a year now.  We also have classes on a quarterly basis and all are invited and can bring a guest as well.  There are various topics ranging from stress reduction to resistance training to eating a Mediterranean based diet.

We are planning on continuing the study until 2014.  However, we are also in the process of planning for another extension.  We still have many questions to be answered and our participants are also eager to continue. (What a great job I have!)

Thank you,

Margie Matulik
Program Coordinator,  DPPOS


Making Healthy Choices at the Taste of Chicago

This was my second year on the Humana Healthier Choices panel for the Taste of Chicago and it is always a thrill to take part–I have grown up attending the Taste and it is an honor to help in any small way.

The panel of four healthcare professionals were asked to review a list of foods submitted by various Taste of Chicago vendors to be included as a “Healthier Choice.”

In order to obtain the Humana Healthier Choice logo for the Taste, the items must to meet the following requirements:

Meals/Entrees
:

Less than 500 calories (25% Daily Value)
Less than 4 grams saturated fat (20% DV)
Less than 480 mg sodium (20% DV)

Appetizers/Snacks/Dessert:

Less than 250 calories
Less than 2 grams saturated fat
Less than 240 mg of sodium

Here is a complete list of the foods we selected: Healthier Choices Guide

The most important thing for Taste of Chicago attendees to remember is that the foods that are chosen certainly are healthier choices, but it is the cumulative amount consumed throughout their day at the that contributes to overall health.

Some tips for making healthy choices at the Taste of Chicago:

  • Stick to 500-600 calories per meal
  • Limit the caloric beverages
  • Stick to Taste portions (and possibly share that with family and friends) to get the most bang for your calorie intake
  • Take advantage of the surrounding area during the Taste–walk along the lakefront or through Millennium Park and Lurie Gardens to get more physical activity to burn some of the calories consumed at the Taste
  • Eat smaller meals surrounding your visit to the Taste to reduce your overall calories for the day
  • Enjoy more of the fresh fruits and vegetables when you arrive to fill up on lower calorie foods
  • Be sure to visit the non-food vendors at the Taste — there is always something interesting showcasing Chicago

Have a fun (and healthy) weekend at the Taste of Chicago!

Amy Hess-Fischl
Registered Dietitian and Certified Diabetes Educator
The University of Chicago Kovler Diabetes Center


Introducing Megan: A Kovler Summer Intern

I’m Megan Miniat and this is my first summer interning at the Kovler Diabetes Center.  I am currently studying Psychology at Miami of Ohio University and plan on pursuing my Masters of Science to fulfill my goal of becoming a nurse.

Diabetes has always been a part of my life as my brother was diagnosed with Type 1 when he was six years old. I hope that my experience at Kovler will enable me to learn more about diabetes so that I can increase awareness and educate others. I am especially interested in how social media can be used as a tool for diabetes education, awareness, and support. I am eager to apply this knowledge as I move forward in my nursing career.


Guest Blog: Humana Healthier Choices at Taste of Chicago

You Can Eat at a Food Festival and Be Healthy, Too.

By Fredrik Tolin, M.D., medical director and vice president for Humana of Illinois

It’s officially summer – time to get outdoors and have fun! If you live in the Windy City or are planning a trip here, you’ll want to experience the annual Taste of Chicago – the biggest food festival in the U.S. For those of us who need to watch what we eat, though, food festivals can seem a bit scary. The temptations are endless and generally high in fat and calories.

Well, there is good news for Taste-goers. Health and wellness company, Humana, has again published the Humana Healthier Choices guide – and is bringing many health and well-being activities to the Taste of Chicago to help everyone enjoy the festival in a healthful way.

For the past two years, we have had the privilege of working with Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDE, advanced practice dietitian and coordinator for The University of Chicago Kovler Diabetes Center, to determine which foods made the cut to be listed as a Healthier Choice.

For a food to be considered, restaurants participating in the Taste of Chicago submit nutritional information including: calories, sodium content, saturated fat and the list of ingredients. Each submission is reviewed by a panel of top Chicago-area physicians with expertise in nutrition and diet, including Amy Hess-Fischl. The panel evaluates each submission to ensure they meet specific criteria:  appetizers and desserts must contain less than 320 calories, 300 mg sodium and 2 g saturated fat; main dishes must contain 500 calories or less; 500 mg sodium or less; and less than 4 g saturated fat.

We’re thrilled to announce that this year’s guide boasts a record number of 27 healthier options – from salads to spicy sausage, flatbread to sorbet – offered from 15 Chicago restaurants! You can check out the full listing of Humana Healthier Choices online at www.humana.com/tasteofchicago, and if you feel compelled, please “like” our Facebook page, where you can receive updates on the various health and wellness events and activities Humana is offering at the festival July 11-15.

Dr. Tolin with Humana’s Apple Man

At the Taste of Chicago, the Humana Healthier Choices items will be indicated by a green apple on the menu boards at participating restaurant booths. While you’re enjoying all that Taste has to offer, take a minute to check out the Humana Dining Pavilion at Buckingham Fountain and the Humana Well-Being Tour for innovative, fun and healthy activities, including free dance lessons, exercise classes and even a sock-hop. And, of course, keep an eye out for the Humana Apple Man mascot to snap your picture!

I’d like to personally thank Amy Hess-Fischl and Kovler Diabetes Center for their continued support of our Humana Healthier Choices program. For more information about Humana’s offerings at the Taste of Chicago, please see our press release. We hope to see your there!

Enjoy the summer and stay well.


Do Insulin Pumps Effect Body Image & Self-Esteem?

We are proud to announce that, after years of hard work, new Kovler Team Member Ashley Tullman just successfully defended her doctoral dissertation on the effects of insulin pumps on body image and self-esteem. Ashley’s passion for treating the psychosocial implications of chronic illness in children, adolescents and their families make her a fantastic addition to Kovler’s Individual and Family Wellness Program.

Congratulations, Ashley, and welcome to the Kovler Team!

Here Ashley shares with us the basics of her fascinating research.


Doctoral Dissertation:

A Phenomenological Study of the Psychosocial Effects of Insulin Pump Therapy on the Body Image and Self- Esteem of Female, Adolescent Insulin Dependent Diabetics

Ashley J. Tullman, M.A.

The recent increase in prescription of insulin pumps for daily diabetes care has lead to an increase in control and positive medical advancements. “[Insulin pump] use has increased dramatically, from 15,000 patients in 1993 to over 81,000 patients in the US at the end of 2000” (Bode, 2002, p.S14). It has been well researched and documented that the insulin pump provides better glucose level control in type 1 diabetes when compared to injection therapy. This being said, there is limited research to this point as to how the expanding prescription of insulin pumps to the adolescent population, specifically females, may be affecting their psychological development at this crucial period. Research has shown the female adolescent population to be highly prone to body image and self-esteem issues regardless of compounding factors such as wearing an insulin pump (Battaglia, 2005).

The specific objective of this study is to produce a partial life course description of the meaning and experience of wearing an insulin pump for adolescent women. Further information as to their struggles, their needs and their own priorities were assessed. The three main research questions were: (1) What are the psychosocial effects of wearing an insulin pump on adolescent girls? (2) What specific struggles are there as they relate to the body image and self-esteem of this group? (3) Are primary care physicians and endocrinologists addressing the psychological impact on day-to-day life?

12 participants between the ages of 12-28 were given a semi-structured interview which provided the solid grounding needed to ensure a common basis to the interactions but allowed for additional knowledge to be gained through personal interaction with each individual. The hope was to gather not only an understanding of each individual, but also an overall group experience, essentially, “how human beings make sense of experience and transform experience into consciousness, both individually and as a shared meaning” (Patton, 2002, p. 104). Meaning units were interpreted from the results and major and minor themes emerged. The major themes were an increased level of maturity seen among all participants, increased awareness of one’s body, and a positive reflection on increased flexibility in their daily lives gained through wearing an insulin pump. The minor themes included: more control afforded by the pump, struggles with relationships, varied self-esteem, and a lack of societal awareness. The results of this study suggest that the insulin pump is an overall positive addition to diabetes care for adolescent females in terms of their psychosocial health. However, the results also reflect an overall lack of and need for social and psychological support for this cohort. While there were some negative and concerning factors present, the overall reflection on daily life with an insulin pump was positive.


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