Type 1 diabetics have ‘sleeping’ insulin cells which could be woken, say scientists

The majority of type 1 diabetics still have a large reserve of dormant insulin cells and it might be possible to switch them back on

Type 1 diabetics have been offered new hope after scientists discovered that many of their insulin-producing cells are not dead, only dormant.

Diabetes is a condition where the body stops producing enough insulin to regulate sugar levels in the blood.

Scientists thought that people developed type 1 after the number of insulin producing cells dropped by around 90 per cent.

“This is incredibly exciting, and could open the doors to new treatments”
Professor Noel Morgan of Exeter University Medical School.

But a new study suggests that is only the case for very young people. After the age of six, many of the cells are still present, they have just stopped functioning.

Researchers at the University of Exeter believe it may be possible to awaken the dormant cells and reverse the disease.

Around 400,000 people have been diagnosed with type 1 diabetes in Britain, and most did not develop the disease until after the age of six.

“This is incredibly exciting, and could open the doors to new treatments for young people who develop diabetes,” said Professor Noel Morgan of Exeter University Medical School.

“It was previously thought that teenagers with type 1 diabetes had lost around 90 per cent of their beta cells but, by looking in their pancreas, we have discovered that this is not true.

Islets of Langerhans by Sarah Richardson
Photo Credit – University of Exeter
Islets of Langerhans by Sarah Richardson

“In fact, those diagnosed in their teens still have many beta cells left – this suggests that the cells are dormant, but not dead. If we can find a way to reactivate these cells so that they resume insulin release, we may be able to slow or even reverse progression of this terrible disease.”

The British team worked with scientists at the University of Oslo to look at nearly 400 pancreas samples from people with type 1 diabetes.

The samples showed the first evidence that children who are diagnosed with type 1 diabetes at the age of six years or under develop a more aggressive form of the disease.

A condition known as insulitis, representing an inflammatory process, kills off nearly all the insulin-producing beta cells in the pancreas of the young children.

But the progression of the disease is radically different in those diagnosed as teenagers or beyond, who retain unexpectedly large numbers of beta cells at diagnosis – up to 50 per cent are still present, although they are no longer working as they should.

If the amount of glucose in the blood is too high it can seriously damage the body’s organs over time.

To survive, people with type 1 diabetes must test their blood-sugar levels throughout the day by either pricking their fingers to draw blood or using a continuous glucose monitor, and then administer insulin through multiple daily injections.

But now that scientists know that the insulin producing cells are not lost, just inactive, they can start looking for ways to switch them back on.

Professor Morgan said finding out how to reboot the cells was ‘the $64,000 question,’

“Quite simply, and sadly, I don’t know,” he said. “However there is evidence that this can happen when the (cells) are kept outside the body for a few days, so understanding how to achieve this is not a complete pipe dream.

Earlier this year MIT and Harvard University showed they could switch off type one diabetes for six months in animals by transfusions of millions of insulin producing cells.

The new research means doctors are closer than ever to ending the need for daily injections.

Karen Addington, UK Chief Executive of type 1 diabetes charity JDRF, said: “A child diagnosed with type 1 diabetes at the age of five faces up to 19,000 insulin injections and 50,000 finger-prick blood tests before they reach the age of 18.

“But research can bring us closer to the day we find the cure.”

Dr Sarah Richardson, of the University of Exeter Medical School was co-author on the study. She said: “For trials to be effective, we have to understand the underlying causes of the disease.

“Our next step is to investigate why diabetes progresses differently in younger and older children, with a view to understanding how we could treat both groups more effectively.”

The research was published in the journal Diabetes.