Type 1 diabetes could be reversible

Constant blood sugar monitoring could become a thing of the past Keystone

Researchers from the University of Geneva have discovered that before puberty, the pancreas is capable of self-healing though a previously unknown mechanism. The study was done on pre-pubescent mice and opens up interesting possibilities in fighting Type 1 diabetes.

Approximately 40,000 persons in Switzerland suffer from Type 1 diabetes (also known as juvenile diabetes). It is caused by the loss of so-called pancreatic beta cells that produce the hormone insulin, that in turn regulates the use of sugar in the body.

Since beta cells do not regenerate, scientists have traditionally assumed that the loss of these cells is irreversible; indeed, diabetic patients require insulin injections for life. However, that could change.

The research team led by Pedro Herrera discovered a new mechanism in pre-pubescent mice through which the pancreas is capable of compensating for the loss of insulin-producing beta cells. The study, published in the journal Nature, revealed that another group of pancreatic cells called delta cells play a key role in this process.

Delta cells normally produce another pancreatic hormone called somatostatin that inhibits the production of insulin. Massive beta cell loss stimulates these delta cells to revert back to a precursor state. Then they proliferate and reconstitute the population of beta cells.

This new mechanism involving delta cell fate change by far the most efficient way of offsetting the loss of beta cells and thus diabetes recovery However, the ability of delta cells to rescue the pancreas in this manner does not extend beyond puberty.

But the mechanism can be artificially induced in adults as well.

“We were able to mimic what is happening in juvenile mice by blocking the Foxo 1 (the candidate gene implicated in the mechanism) in adult individuals,” Fabrizio Thorel, research team member, told swissinfo.ch. This triggered a kind of artificial rejuvenation of the system to induce delta cell conversion in adults.

Several observations in diabetic patients suggest that the human pancreas is capable of transformation, too. It is something the research team is also investigating.

“We’re using human pancreatic samples and trying to play with the various genes and signals to identify whether or not they will respond and if this will trigger the reconversion of beta cells,” shared Thorel.

There is still a long way to go before diabetes patients might be able to benefit from these findings, but the discovery that delta cells have a high degree of plasticity points to a hitherto unsuspected option for therapeutic intervention.