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“Seven year switch” in type 1 diabetes provides better understanding

By Editor
12th June 2018
Research, Type 1 diabetes

The rapid decline in insulin production that causes type 1 diabetes continues to fall over seven years and then stabilises, according to research.

A team at the University of Exeter Medical School found evidence that the amount of insulin produced declines by almost 50 per cent each year for seven years. At that point, the insulin levels stabilise.

The study measured C-peptide in blood or in urine and the researchers were able to measure how much insulin was still being made, even if they were taking insulin injections as treatment. A total of 1,549 people with type 1 diabetes were involved in the  UNITED study.

Dr Beverley Shields, at the University of Exeter Medical School, who led the research, said: “This finding is really exciting. It suggests that a person with type 1 diabetes will keep any working beta-cells they still have seven years after diagnosis.  We are not sure why this is; it may well be that there is a small group of “resilient” beta-cells resistant to immune attack and these are left after all the “susceptible” beta-cells are destroyed. Understanding what is special about these “resilient” beta-cells may open new pathways to treatment for type 1 diabetes.”

Type 1 diabetes affects around 400,000 people in the UK. The disease commonly starts in childhood but can develop at any age, and causes the body’s own immune system to attack and destroy the insulin-producing cells in the pancreas, leaving the patient dependent on life-long insulin injections.

Professor Andrew Hattersley, a consultant in diabetes at the Royal Devon and Exeter Hospital and research professor at the University of Exeter Medical School, added: “Now we know there is a “seven year switch”, the next question is why?

“Has the immune attack stopped or are we left with “super beta-cells” that can resist the immune onslaught. Any insights into halting the relentless destruction of the precious insulin-producing cells are valuable.  We could not have made this progress without the help of over 1,500 patients. We owe it to them to try to find answers that might help patient care quickly.”

Karen Addington, UK chief executive of the type 1 diabetes charity JDRF, said: “These results provide further evidence that the immune system’s assault on insulin-producing beta cells is not as complete as we once believed – and may change over time. This further opens the door to identifying ways to preserve insulin production in people diagnosed with or living with type 1 diabetes.”

The study was supported by JDRF , the Wellcome Trust and the National Institute of Health Research (NIHR) through the Health Innovation Challenge Fund.

The full paper, ‘C-peptide decline in type 1 diabetes has two phases: an initial exponential fall and a subsequent stable phase’, is published in Diabetes Care. Authors are Beverley M Shields, Timothy J McDonald, Richard Oram, Anita Hill, Michelle Hudson, Pia Leete, Ewan R Pearson, Sarah J Richardson, Noel G Morgan, Andrew T Hattersley on behalf of the TIGI I would not expand it does not help understanding  (Type 1 diabetes Immunology and Genetic predictors of endogenous Insulin secretion) consortium.

To research has been published in the Diabetes Care journal. To read the study, click here.

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