The term diabetes has essentially become synonymous with type 2 diabetes, and probably with good reason: 90 percent of diabetics worldwide have that form of the disease. But there are also millions of Americans with type 1. These two diabetes types share the name and an end result but they vary greatly in several key areas. Among them is how the disease arises, and how each is treated.
A new study presented at 54th Annual European Society for Paediatric Endocrinology Meeting shows one novel way for treating type 1 diabetes, which has the potential to be a major breakthrough.
Type 1 is caused by an irreversible immune-system attack on the cells in the pancreas which secrete insulin, a hormone that signals to all the cells of the body to take up more glucose. The reason for the attack is unknown, but many studies have supported a variety of potential explanations, which include genetics, contagions and possible environmental factors. The end result is that patients have an inability to produce the hormone, which up until about 80 years ago meant certain death.
Later, mass production of insulin (derived from pancreases of cattle and pigs) became possible, and this was used to treat millions of diabetics, who in turn have been able to live relatively normal lives, provided they frequently check their insulin and glucose levels.
For the past 30-plus years, insulin has been produced from genetically modified yeast. Today, implanted insulin pumps make management of the illness easier, but the holy grail has always been finding a way to get the body to make insulin on its own, possibly through stem cells, or something similar.
Researchers working at Université Catholique de Louvain in Belguim have set their sights on a population of cells they believe could be reprogrammed into insulin-secreting cells. The cells are pancreatic progenitors, which means they are more adult than, say, embryonic stem cells, but retain some of the flexibility in final cell type that is characteristic of stem cells. Using targeted messenger RNA the researchers were able to program these cells to produce insulin inside diabetic murine models.
What's really promising is that the cells produced insulin only in response to high glucose levels in the body. This is significant, because insulin is not a hormone that needs to be secreted constantly.
In fact, taking insulin at the wrong time, or having too much of it, is deadly. Normally, the body produces insulin when glucose levels are high (for example, after eating) and the body responds by taking up the sugar and storing it. If glucose levels are low, as a result of not having eaten for awhile, a dose of insulin will knock glucose down even further. For this technique to work, the reprogrammed cells need to respond appropriately to glucose. And according to these researchers, it did.
The technique sounds a bit far-fetched, but it's closer than you may think to being a reality. The researchers already have a supply of cells that is compatible in humans, and they want to establish cell banks to soon begin implanting them in humans.