Type 2 diabetes is a self-inflicted medical condition for the vast majority of sufferers. You get it by consistently eating too much and accumulating a large amount of visceral fat tissue, thereby suffering all of the unpleasant metabolic consequences that it brings. The more you do this, the greater your risk. The path to diabetes is a gradual increase in metabolic disarray that first passes through what is known as metabolic syndrome before becoming full blown diabetes. Some people are susceptible than others as a result of genetic differences, but the road is basically the same for everyone: eating yourself into sickness takes years of effort, but in a wealthy society nearly everyone has the resources to do it.

Here is the interesting thing: at almost any point along the way, right up until either morbid obesity or later stage diabetes, this can all be reversed. A person can step off the path of increasing disability and head back to a healthier lifestyle, turning back the progression of diabetes. This can even be accomplished in a fairly drastic way by enlisting calorie restriction:

An extreme eight-week diet of 600 calories a day can reverse Type 2 diabetes in people newly diagnosed with the disease .... the low-calorie diet reduced fat levels in the pancreas and liver, which helped insulin production return to normal. Seven out of 11 people studied were free of diabetes three months later.

Not that I'm suggesting that it's smart to eat gluttonously for half your life and then rely on having your fat pulled from the fire this way - there are other consequences to being overweight for an extended period of time, as shown by risk levels of suffering age-related diseases in later life. But here is another more recent study to illustrate the point that cutting back and changing lifestyle is very powerful when it comes to diabetes, as it restores some of the brain's activity with respect to food that becomes disarrayed in diabetics.

Short-Term Caloric Restriction Normalizes Hypothalamic Neuronal Responsiveness to Glucose Ingestion in Patients With Type 2 Diabetes:

The hypothalamus is critically involved in the regulation of feeding. Previous studies have shown that glucose ingestion inhibits hypothalamic neuronal activity. However, this was not observed in patients with type 2 diabetes. Restoring the energy balance by reduction of the caloric intake and weight loss are important therapeutic strategies in patients with type 2 diabetes. We hypothesized that caloric restriction would have beneficial effects on the hypothalamic neuronal response to glucose ingestion.

Functional magnetic resonance imaging was performed in 10 male type 2 diabetic patients before and after a 4-day very low calorie diet (VLCD) [to measure] neuronal activity in the hypothalamus in response to an oral glucose load.

...

Post-VLCD scans showed a prolonged signal decrease after glucose ingestion. The results of the current study demonstrate that short-term caloric restriction readily normalizes hypothalamic responsiveness to glucose ingestion in patients with type 2 diabetes.

Source:
http://www.longevitymeme.org/newsletter/latest_rss_feed.cfm

Other than calorie restriction, regular exercise is the most potent presently available method available to maintain health and extend life expectancy - which is actually more of a criticism of our lack of advanced biotechnology than praise for the merits of exercise. Exercise is beneficial even for the elderly, however, and one part of the downward spiral that comes with age is that loss of strength and increasing frailty constrain the ability to exercise sufficiently vigorously to obtain its benefits. This is true even for the longest-lived humans: "Ageing is a continuum of biological processes characterized by progressive adaptations which can be influenced by both genetic and physiological factors. In terms of human maturation, physically and cognitively functional centenarians certainly represent an impressive example of successful healthy ageing. However, even in these unique individuals, with the passage of time, declining lung function and sarcopenia lead to a progressive fall in maximal strength, maximal oxygen uptake, and therefore reduced exercise capacity. The subsequent mobility limitation can initiate a viscous downward spiral of reduced physical function and health. Emerging literature has shed some light on this multi-factorial decline in function associated with aging and the positive role that exercise and physical capacity can play in the elderly. Recognizing the multiple factors that influence ageing, the aim of this review is to highlight the recently elucidated limitations to physical function of the extremely old and therefore evaluate the role of exercise capacity in the health and longevity of centenarians."

Link: http://www.ncbi.nlm.nih.gov/pubmed/22883374

Source:
http://www.longevitymeme.org/newsletter/latest_rss_feed.cfm

Many research groups are working on building blood vessels. Here is one: scientists "have developed [an] artificial functioning blood vessel outside of the body, made from reprogrammed stem cells from human skin. The team also saw the cells develop into a blood vessel inside the body for the first time. The new technique could have real potential to treat patients with heart disease [by] either injecting the reprogrammed cells into the leg or heart to restore blood flow or grafting an artificially developed vessel into the body to replace blocked or damaged vessels. ... this new study demonstrates that a new type of partial stem cell developed from fibroblasts (skin cells) can be reprogrammed into vascular cells before going into the body, which have no risk turning into tumours. The [team] introduced four genes to human fibroblasts in the laboratory to reprogramme them into partial stem cells so they could become vascular cells. When these newly created cells were injected into an ischemic leg (a leg with restricted blood flow) in an animal model, the function of the leg was improved. The process of developing vascular cells from skin cells took two weeks, which makes a personalised approach of turning a patient's own skin cells into vascular cells feasible for treatment of vessel-blocking related diseases. The researchers say the next step is to test this approach in cells from patients with vascular disease."

Link: http://www.kcl.ac.uk/newsevents/news/newsrecords/2012/08-Aug/pioneering-heart-disease-treatment.aspx

Source:
http://www.longevitymeme.org/newsletter/latest_rss_feed.cfm

At root, medicine is driven by the urge remain alive. It is a process of engineering the means to prevent death, and so setting out to deliberately create greater longevity by tackling the root causes of aging - rather than addressing named diseases, one by one - is no more than the logical next step in this process. We know more than enough to get started down this path, and there are some few organizations working on it even today, though far from enough and with far from enough funding.

Consider a world with the means to prevent aging - say, though a package of therapies that a person undergoes every twenty years or so. Infusions of fresh stem cell populations, engineered enzymes to degrade metabolic waste products that build up in and around cells to impair their function, some form of mitochondrial DNA repair, culling excess memory T cells, and so on. These therapies prevent and reverse the build up of damage, allowing a body to continue in good health indefinitely. There is no good reason for them to be any more expensive than your average run of clinical treatments today: they would require little time from a physician, and would operate in much the same way for everyone, allowing economies of scale in production and distribution.

In such a society, all of the pressures associated with the short span of life we presently enjoy evaporate. We are so steeped in that omnipresent pressure of time that it's somewhat hard to envisage what a society without it would look like. Every strategic decision that we make in the course of our lives is based on time - that we have ever less of it remaining, the clock is ticking, and have only a few shots at getting anything significant accomplished. It requires a decade to become truly talented in any particular profession or skill, for example, and at least a few years to figure out whether not we can follow through to that level. That is a vast investment of time when we only have a few decades in which we are at our prime. The same goes for careers and relationships of any significance. We are pressured and choices have great weight precisely because we must forever give up an ocean of possibilities in order to swim in any particular pool.

There is a related school of thought among those opposed to engineering longevity: they say that the pressures of time created by the fact that we age to death due to our inadequate medical technology are a good thing. To me this has the look of rushing to justify what is, regardless of what might be, but they argue that the industry of individuals and humanity as a whole requires the deadline of dying; that without it, no-one would accomplish anything. They look upon the unending holocaust of death and destruction caused by aging - 100,000 lives every day, all they knew, all they could accomplish in the future, all they might have done, erased - and say it is necessary.

This is a hideous nonsense, serving to illustrate that little but a veneer separates us from the barbarians who actively slaughtered millions in past decades. It is true that rapid progress is very necessary in today's world - but we need it because we are dying, and the only way to save ourselves is through technological progress. The faster the better, every increment of speed representing countless lives that might be saved on some future date. If more people were more aware and more interested in doing something about this, we might move faster yet towards the biotechnologies of rejuvenation. Unfortunately, for all that each and every human life is shaped completely by the foreknowledge of future disability and death, all too few are willing to help change this state of affairs.

But so what if the medical technologies that can prevent death by aging make our societies slower-paced, more considered, less energetic? I'm not of the mind that this is a terrible thing - free-wheeling use of a resource is characteristic of wealth, and when we are wealthy in time, we will have the luxury to use it in ways that presently make little sense, or are called wasteful. Caring about waste is a sign of poverty, a sign that we don't have enough of whatever we worry about wasting, which in turn suggests we should do all we can to accumulate more of it. Besides, I don't for one moment believe that the slowing of economic engines and technological progress will in fact happen as feared by those who advocate for the continuation of mass death and suffering. There are all sorts of economic pressures upon human action that have next to nothing to do with aging and our current all-too-short span of life: consider the shifting desires for security, food, property, knowledge, and novelty, for example. The timescales on which those urges operate will not much change in an ageless society, as people will still have the same human nature as exists today. There will continue to be dynamic and ever-changing industries devoted to keeping people fed, clothed, and entertained.

These responses to irrational fears are, at the bottom line, unnecessary to some degree. 100,000 people died today of a cause that we can do something about. Tens of millions die every year, and hundreds of millions more suffer terribly on their way to that end. There is no argument that can possibly outweigh the need to address what is by far the greatest cause of death, suffering, and loss in the world - yet, for some strange combination of reasons, many people keep trying to find one.

Source:
http://www.longevitymeme.org/newsletter/latest_rss_feed.cfm

Another branch of targeted therapies is the design of nanofactories that can be steered to specific locations in the body and there produce proteins and other drugs in response to local conditions or external commands. Early work in this field is underway: "Science is one step closer to producing drugs in the right place at the right time in the body, avoiding the collateral damage of untargeted treatments. Researchers [have] designed nanoparticles that can be stimulated via UV light to produce proteins on demand in vivo. The new method, which involves packaging the molecular machinery for making proteins into a membraned capsule, allows the researchers to spatially and temporally regulate protein production ... The scientists created the nano-sized 'protein factories' by using lipids to encapsulate polymerase and other machinery necessary for protein production from E. coli, along with a DNA plasmid containing a gene of interest. To block transcription until the right moment, they added a DNA 'photo-labile cage' to the plasmid - a small chemical that inhibits transcription but is cleaved by exposure to UV light. To test the principle in vivo, the researchers used luciferase as the reporter protein and injected mice with the nanovesicles. After zapping them with UV light at the site of injection, they were able to measure a local burst of luminescence. ... We have a long way to go still before we have a drug factory that will land in a target tissue to produce a drug of interest ... The study has proved the principle of the first step - getting the protein expressed on signal - but future research will need to ensure that the nanoparticles and the proteins they produce aren't toxic in the wrong place, and that they get to the right location. Targeting the nanoparticles to the appropriate tissues might be achieved by 'decorating' the surface of the vesicles with specific proteins."

Link: http://the-scientist.com/2012/08/13/next-generation-in-vivo-drug-factories/

Source:
http://www.longevitymeme.org/newsletter/latest_rss_feed.cfm