Type 2 Diabetes

Diabetes Type 2 is a chronic disease that keeps the body from utilizing its insulin for energy production. Rather, the body stores the insulin in its cells, which increases the concentration of sugar in the blood and cells. In Diabetes Type 2, patients become insulin-resistant. 

In the US, diabetes has the most cases of its Type 2. There are more than 29 million patients with these diseases in the US alone. Moreover, more than 85 million individuals are in their pre-diabetic phase and can officially become diabetic in a few years. 

In Diabetes Type 2, our body forgets to utilize its insulin against the increased glucose storage and concentration in the blood. In the initial phases of the disease, the pancreas tries to make more insulin to get glucose to enter the cells. With time, the insulin can’t keep up with the glucose, and it ends up in increased concentration or storage of the glucose in the body. 

Risk factors for diabetes are either modifiable or non-modifiable. Modifiable risk factors are changeable through effort and work, while unmodifiable factors are unchangeable.

• Genetics: Effect of DNA on stimulation of the insulin-producing gland. Obesity can cause insulin resistance if excess fat is present in the body's center (abdominal area).

• Metabolic syndromes: High blood pressure (hypertension), high concentration of triglycerides and cholesterol, high blood sugar levels, and extreme fat around the waist area

• Improper inter-cell communication: Cells can transmit the wrong signals and messages across the membranes, which lead to improper communication between the cells. When these defects take the form of a chain, they can cause a cascade of detrimental events, leading to the incidence of diabetes.

• Damage to pancreatic beta cells: Beta cells are the involved cells for insulin production. Any damage to the beta cells can affect the production of insulin hormones. Through defective insulin production, wrong signaling causes high levels of blood sugar or diabetes.

The signs and symptoms of diabetes can range from mild to severe symptoms. Blood sugar levels above 120mg/dL can cause hyperglycemia (initial stages).

The most common symptoms of Diabetes Type 2 are:

• Extreme thirst

• Blurriness in vision

• Frequent urination (specifically at nighttime)

• Numbness or tingling sensations in the hands, fingers, feet, and whole limbs (both upper or lower)

• A feeling of being worn out and fatigued

• Unhealed wounds or wounds taking more time to heal than usual

• A constant feeling of staying hungry

• Being more prone to specific yeast and microbial infections

• Rashes in the whole body, specifically in the genital area

• More incidence of acne and pimples breakout in unusual places on the body

• Extreme weight loss without putting any effort into workout or diet

• A pear-shaped body has more fat and obesity in the central abdominal area than in the other parts

Treatment of Diabetes Type 2 consists of three specific steps:

• Medications

• Dietary and lifestyle changes

• Physical activity and exercises

• Medications for diabetes include:

• Sulfonylureas

• Meglitinides

• Biguanides

• DPP-4 inhibitors

• Glitazones, TZDs, and Thiazolidinediones

• Alpha-glucosidase inhibitors

• Bile acid sequestrants

• SGLT2 inhibitors

• Dopamine receptor agonists

• GLP-1 receptor agonists

Pramlintide 

Insulin therapy is another significant approach for the treatment of Diabetes Type 2. In this treatment, insulin is injected inside the body to compensate for the levels needed for glucose control. The spots for insulin injection can be anywhere on the belly (abdomen), upper arm, butts, and thighs. In most cases, insulin therapy is a temporary treatment that may cause recurrent problems.

Stem Cell Therapy is the newest treatment option with the recent technologies and updates. Stem Cells have a vast application for creating innovations in treatment strategies. Stem Cell Therapy can regenerate neural cells, body cells, cartilages, and endocrine cells.

Stem Cell Therapy provides an approach to treatment to utilize the isolated Stem Cells of the patients from their bone marrow. Stem Cell Therapy has multiple benefits for the patients to revitalize the functioning of the human organs and cells. 

HSC (Hematopoietic Stem Cells) is the major source of cells in humans' circulating and peripheral blood in the bone marrow. Hematopoietic Stem Cells include white blood cells (monocytes) and red blood cells. According to the research studies, bone marrow-derived white blood cells (monocytes) can help in improving chronic inflammatory and other infectious auto-immune diseases or conditions. 

Other than the HSCs, MSCs (Mesenchymal Stem Cells) are also present inside the bone marrow of an individual. Researchers claim that MSCs can effectively enter the circulating bloodstream during the injury event. After entering the injury site, these cells act as a home to the inflammation of injured tissues in the body.

Once the MSCs enter the injured site, they act as an immunomodulatory and protective agent for the autoimmune conditions.  Moreover, these stem cells can replace the defective beta cells of the pancreas to replenish the need for body insulin.

According to the clinical literature, Exosomes combined with MSCs help in autoimmune diseases by regulating the inflammatory cytokines, microenvironment, and immune cells. These processes have a potent relation with both adaptive and innate immune cells. In these cells, macrophages, Treg cells, Th17, immunoregulatory miRNAs, and CD4+Th1 are the most crucial ones. 

Exosomes-combined-MSCs help in the regulation of T-Cell subsets in cases of autoimmune diseases. Moreover, the MSCs-Exosomes also aid in reducing the levels and concentration of pro-inflammatory Th17 and TH1 cytokines such as IL-17AF, IL-12p70, and IL-6. However, the same MSCs-Exosomes help in increasing the concentration of anti-inflammatory Treg. 

Therefore, MSCs-Exosomes increase the concentration of Treg cells and the related products without changing the concentration index of the lymphocytes to maintain immunoregulation in the body. Similar effects of these cells are seen in the cases of RA (Rheumatoid Arthritis) and GVHD (graft-versus-host disease). MSCs-Exosomes help improve the GVHD by suppressing the differentiation of populations of the naïve T-cells. Macrophages constitute a crucial and major portion of the innate immunity of the human body, which can be regulated through the administration of MSCs-Exosomes. According to the different microenvironments, Mo (naïve macrophages) can be polarized into anti-inflammatory (M2) or pro-inflammatory (M1) to play different roles in different conditions. Along with the autoimmune conditions, this combination therapy can also help facilitate metabolic hemostasis to attenuate obesity and adipose inflammation. Moreover, MSCs-Exosomes can also promote the M1-M2 macrophage conversion to reduce the pro-inflammatory factors or effects of the macrophage M1.