New findings could change the way you treat type 1 diabetes
Good news on the road to Diabetes Alert Day. Researchers have found that children who are diagnosed with type 1 diabetes before they are 7 years old develop insulitis, while adolescents do not. As a result, new treatments and even a vaccine could be in the pipeline to treat diabetic children and teenagers. Scientist from the University of Exeter Medical School and the University of Oslo looked at 100 pancreas samples from type 1 diabetes patients collected shortly before they died. “Those samples are extremely important because we do not understand the underlying disease process that goes on in these individuals and it's that recent diagnosis that's critical for us to actually look inside the pancreas and see what is going wrong, and the pancreas itself is an extremely inaccessible organ,” co-lead researchers Dr. Sarah Richardson said.
Insulitis is an aggressive form of diabetes in which most of the insulin-producing beta cells in their pancreas are destroyed. Conversely, teenagers diagnosed with type 1 diabetes have malfunctioning beta cells, but quite a high number of them nevertheless. “The significance of these findings is that we find that the individuals who are diagnosed young have a very different disease profile to those that are diagnosed older, and that has important implications for potential treatments in that those individuals that are diagnosed young might benefit more from immunotherapeutic therapies,” Richardson said, “whereas those that are diagnosed older we might need to look at different therapies that reactivate their sleeping beta cells at the same time as applying immunotherapeutic drugs to prevent any reactivation of an immune response.”
Additionally, co-lead researcher Professor Noel Morgan told Reuters that “it’s always been thought that when people get type 1 diabetes they've lost as many as 90 percent of their insulin producing cells from their pancreas. What we've found is that while that might be the case for the younger children it certainly doesn't appear to be true for those that are older. They have quite a considerable reserve of cells left. That's a new insight and it might mean that if we could reactivate those cells we could help them to cope better with their illness.” He added that “we might even be able to stop people getting the illness who otherwise might. That's our real hope, that we might have a way of stopping children from becoming diabetic by understanding the process and targeting it more specifically.”
JDRF – a type 1 diabetes charity formerly known as Juvenile Diabetes Research Foundation, which partially funded the research – says that up to 19,000 insulin injections and 50,000 finger-prick blood tests await a child diagnosed with this condition by age 18. Thanks to these findings, though, a different kind of prick might be in store. “We're trying to understand what the trigger is and it may be possible to use a vaccine to stop the triggering process, but it might also be able to use a different kind of vaccine to target the specific immune cells that are causing the illness, and that's where the excitement lies,” Morgan said.