Researchers move closer to a cure for diabetes

Karakose abstract

Graphical abstract of the work.  Credit Mount Sinai Health System

Diabetes researchers and bioinformaticians from the Icahn School of Medicine at Mount Sinai have developed a new understanding of how human beta cell regenerative drugs work. These drugs, developed at Mount Sinai, may hold promise for more than 500 million people with diabetes worldwide.

Diabetes develops when cells in the pancreas, known as beta cells, cannot produce insulin, a hormone essential to regulating blood sugar levels. While significant progress has been made toward discovering a durable therapy, none are scalable therapeutic options for millions of diabetics worldwide.

For more than 15 years, researchers at the Icahn School of Medicine at Mount Sinai have worked tirelessly to find a solution to cure diabetes by identifying a drug that could make human beta cells regenerate.

In 2015, Mount Sinai researchers discovered the first such drug, called harmine. Harmine is a member of a class of medications called DYRK1A inhibitors. In 2019 and 2020, the researchers reported that DYRK1A inhibitors could synergize with TGF-beta signalling as well as GLP-1 receptor agonist (GLP-1RA) drugs such as semaglutide (e.g., Ozempic) and exenatide (Byetta) to induce more robust levels of human beta cell regeneration. Finally, in July 2024, they showed that harmine alone increases human beta cell mass by 300 per cent, and if a GLP-1RA is added, by 700 per cent. 

A key question has been how harmine causes beta cells to regenerate. In the newest study, the research team reports that the new, regenerated beta cells may be coming from an unexpected source: a second pancreatic cell type called alpha cells. Since alpha cells are abundant in people with type 1 and type 2 diabetes, they may be able to serve as a source for new beta cells in both common types of diabetes.

“This is an exciting finding that shows harmine-family drugs may be able to induce lineage conversion in human pancreatic islets,” says Esra Karakose, PhD, Assistant Professor of Medicine (Endocrinology, Diabetes and Bone Disease) at the Icahn School of Medicine at Mount Sinai and corresponding author of the study. “It may mean that people with all forms of diabetes have a large potential ‘reservoir’ for future beta cells, just waiting to be activated by drugs like harmine.”

“A simple pill, perhaps together with a GLP1RA like semaglutide, is affordable and scalable to the millions of people with diabetes,” said Dr. Stewart.

Empathetic telephone calls improve diabetes control in low-income adults, study shows

Empathy-focused phone calls made by trained, nonmedical community members led to significant improvements in blood sugar control for low-income adults with diabetes, according to a new study from Dell Medical School at The University of Texas at Austin in collaboration with Lone Star Circle of Care. Published today in JAMA Network Open, the study suggests this approach could provide a simple, cost-effective model for managing chronic conditions, particularly for patients with limited access to traditional mental health and support services.
A recent study conducted by Dell Medical School at The University of Texas at Austin, in collaboration with Lone Star Circle of Care, found that empathy-focused phone calls made by trained community members (who are not medical professionals) led to significant improvements in blood sugar control among low-income adults with diabetes. Published today in JAMA Network Open, the study suggests that this approach could serve as a simple and cost-effective model for managing chronic conditions, especially for patients who have limited access to traditional mental health and support services.

In a six-month clinical trial, 260 patients with uncontrolled diabetes were randomly divided into two groups. One group received standard care, while the other received standard care and regular phone calls that emphasized listening and empathy. These calls were made by community members who were trained to provide compassionate support, allowing participants to share their experiences and challenges related to living with diabetes.

“This approach starts by recognizing the real and everyday challenges of living with diabetes,” said Maninder “Mini” Kahlon, Ph.D., the study’s lead author and an associate professor in the Department of Population Health at Dell Med. “By providing sincere and empathetic support, we achieved a health impact equivalent to taking medication. This is because emotional well-being serves as the gateway to the lifestyle changes that enhance the management of the condition—an area where traditional healthcare often falls short.”

Key findings include:

  • Improved Blood Sugar Control: Patients who received empathy-based calls saw an average HbA1c reduction of 0.7%, compared with no significant change in the control group.
  • Greater Impact for Patients With Mild or Greater Depressive Symptoms: Patients reporting mild depressive symptoms saw even larger reductions, with average HbA1c improvements of 1.1%.
  • High Satisfaction: Nearly all participants receiving the calls rated them as very or extremely beneficial to their well-being.

All study participants, who were patients of the Lone Star Circle of Care, had the flexibility to choose how often and for how long they wanted to engage in calls. During the initial stages, they could select between one and five calls per week, gradually tapering as they made progress. This patient-driven approach empowered individuals to receive support at a pace that met their needs and schedules. It helped foster a strong connection with their callers while reinforcing their self-care routines.

“At a time when workforce shortages challenge health care delivery, this study underscores the profound clinical impact nonclinical staff can make,” said Jon Calvin, CEO of Lone Star Circle of Care. “By leveraging trained laypeople, we’re demonstrating that empathy, connection and intentional engagement can lead to measurable health improvements. In a world where medicine is increasingly fast-paced and technology-driven, this work reminds us that human connection remains at the heart of effective care. Empathy not only enhances patient engagement but empowers individuals to take meaningful steps toward better health outcomes.”

This research builds on previous studies highlighting the benefits of empathetic phone calls. In 2021, Kahlon and her team published a study that found “Sunshine Calls”—a series of regular, genuine phone calls made by individuals who were not healthcare professionals—showed promise in alleviating loneliness, depression, and anxiety, as well as improving overall mental health among mainly homebound older adults.

Both studies were funded by the Episcopal Health Foundation, which focuses on person-centered, nonmedical approaches to health.

Looking ahead, researchers hope to explore the long-term effects of empathy-based support on both diabetes control and broader mental health. They also plan to scale this model, aiming to make holistic, empathetic support more widely available to those in need.

Jabuticaba peel improves nutritional characteristics of bread and lowers glycemic peaks 

Consumption of bread supplemented with jabuticaba peel flour, which is rich in fiber and antioxidants, lowers glycemic peaks and prolongs satiety.
Consumption of bread supplemented with jabuticaba peel flour, which is rich in fibre and antioxidants, lowers glycemic peaks and prolongs satiety.

Researchers at the State University of Campinas (UNICAMP) in São Paulo, Brazil, have developed a sourdough bread formulation enriched with jabuticaba peel. This bread may serve as an alternative for individuals with diabetes and others who need to manage their blood sugar levels. The research findings and test results are published in the journal Foods.

The article highlights that bread’s high carbohydrate content can significantly increase blood sugar levels, risking hyperglycemia. As a result, there is a growing demand for healthier bread options. Artisanal bakers are responding by diversifying their products with recipes that offer added nutritional value and utilize fermentation methods that promote a milder glycemic response.

According to the article’s data, adding jabuticaba peel flour increased the bread’s fibre content by more than 50%. It raised its antioxidant capacity by between 1.35 times and 3.53 times, depending on the proportion of jabuticaba peel flour added to the formulation. This supplementation increased nutrients’ bioavailability and enhanced the final product’s nutritional composition.

The researchers conducted a crossover trial to assess the glycemic peak (the highest blood sugar level reached) after consumption of regular bread made by the long fermentation method (which tends to induce a lower glycemic peak) and consumption a week later of bread containing jabuticaba peel flour. Blood sugar peaked 30 minutes after ingesting the regular bread without jabuticaba peel flour, remaining high for another 15 minutes and then trending down. In the case of the bread supplemented with jabuticaba peel flour, the peak was lower, occurring 45 minutes after ingestion, and blood sugar fell slowly for two and a quarter hours.

Metabolism

Blood sugar rises after ingestion of bread and other carbohydrate-rich foods. Digestion releases glucose, telling the pancreas to secrete insulin, which induces a return to prior blood sugar levels. Flaws in this process lead to health problems, and it is essential to observe the extent to which blood sugar spikes in response to eating.

“If we can lower the spikes in sugar and insulin levels that occur after meals, we reduce the likelihood of developing diabetes and metabolic syndrome. For individuals already experiencing hyperglycemia, managing these post-meal spikes can decrease the risk of heart disease. Additionally, this approach can help extend the lifespan of insulin-producing cells,” said Bruno Geloneze.

The thesis supervisor, who formed the basis for the article, noted that the main challenge in producing the bread for the trials was effectively deploying the technology while preserving its nutritional and functional value. Jabuticaba peel flour has unique sensory characteristics, and its inclusion needs to be evaluated carefully.”

“Jabuticaba peel flour has particular sensory characteristics, and its inclusion had to be evaluated concerning both the technological characteristics of breadmaking and the processing and conservation of the bioactive compounds involved,” she said.

Conservation is relevant because the improvement in blood sugar control and insulin response is associated with the phenolic compounds in jabuticaba peel, such as anthocyanins, which account for the fruit’s dark purple colour. Therefore, it is essential to avoid their “loss” during processing.

Another important finding relates to satiety. The participants felt fuller 60 minutes after eating the bread with jabuticaba peel flour than after they ate the control bread. The authors of the article note that satiety is generally found to improve when blood sugar returns to baseline more slowly, as it does with foods with a low glycemic index.

Antioxidant capacity was monitored for three hours after the bread was consumed. After the bread with jabuticaba peel flour was consumed, the neutralization of free radicals increased significantly and lasted longer. 

“This improvement in antioxidant capacity is important because the development of metabolic disorders, cardiovascular disease and cancer, and the ageing process, involve protein oxidation mechanisms in the body.  The antioxidant capacity of a food can be beneficial in all these mechanisms,” Geloneze said.

Another significant finding was the extension of shelf life to seven days, which, according to the researchers, showed that the bacteria in jabuticaba peel and metabolites formed during the fermentation process can act as natural preservatives in long-fermentation products, inhibiting the growth of pathogenic microorganisms.

Jabuticaba

The article notes that researchers have focused in recent years on the inclusion of ingredients with high biological value in food products, especially agroindustrial byproducts, given the large quantities produced, their nutraceutical potential, and the environmental impact associated with their disposal.

Consumption of jabuticaba (Plinia jaboticaba) and other red and purple berries is known to help prevent or delay the emergence of non-transmissible chronic diseases. “Jabuticaba peel contains phenolic compounds and fibres that have been shown in several studies to contribute to the control of blood sugar and cholesterol,” Maróstica said.

The juice of this berry has also been shown to reduce insulin resistance and increase the production of GLP-1. This hormone helps regulate digestion, satiety and glycemia (as emulated by medications such as semaglutide and liraglutide).

The results of all this research are promising, and the group comprising scientists from UNICAMP’s medical and food engineering schools continue to investigate the fruit’s bioactive compounds. They are now conducting in vivo trials with animal models to find out whether and how these compounds can combat depression and help prevent colorectal cancer.

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Kumamoto University researchers discover groundbreaking antidiabetic compound

HPH-15: A Promising New Treatment for Type 2 Diabetes

HPH-15 offers multiple benefits for managing Type 2 diabetes, including effective blood glucose control, reduced risk of lactic acidosis, improved insulin resistance, and suppression of fat buildup and fibrosis in the liver and fat tissue, with these effects observed in studies using muscle, liver, and fat tissue models. These properties make HPH-15 a potentially more effective treatment for Type 2 diabetes. Credit Hiroshi Tateishi, Eiichi Araki, Kumamoto University

Kumamoto University scientists have introduced a new compound, HPH-15, which effectively lowers blood glucose levels and reduces fat accumulation. This represents a significant advancement in diabetes treatment.

Type 2 diabetes, a condition affecting millions worldwide, is often accompanied by complications like fatty liver and insulin resistance, which challenge current treatment methods. The research team, led by Visiting Associate Professor Hiroshi Tateishi and Professor Eiichi Araki, has identified HPH-15 as a promising alternative to medications like metformin.

The study, published in Diabetologia, a top journal in the field of diabetes, demonstrates that HPH-15 outperforms metformin by activating AMP-activated protein kinase (AMPK)—a critical protein regulating energy balance—at lower doses. HPH-15 not only improved glucose uptake in liver, muscle, and fat cells but also significantly reduced fat accumulation in high-fat diet (HFD)- induced obese mice. Unlike metformin, HPH-15 exhibited additional antifibrotic properties, potentially addressing liver fibrosis and other complications often seen in diabetes patients.

Key findings include:

  • Enhanced Efficacy: HPH-15 activated AMPK and promoted glucose uptake at concentrations 200 times lower than metformin.
  • Fat Reduction: The compound decreased subcutaneous fat by 44% and mitigated fatty liver more effectively than metformin in preclinical trials.
  • Safety Profile: Lactic acid production, a concern with metformin, was comparable or lower with HPH-15, suggesting reduced risks of lactic acidosis.

These results suggest that HPH-15 could redefine diabetes management by combining glucose control with preventing obesity-related complications. “This compound holds transformative potential for diabetes treatment, offering benefits beyond blood sugar regulation,” said Professor Mikako Fujita from the Faculty of Life Sciences at Kumamoto University.