Living With Diabetes

What is type 1 diabetes?

With type 1 diabetes, your pancreas stops making insulin, a hormone that helps the body convert blood sugar into energy. Without insulin, sugar builds up in the blood and can damage your internal organs, including your heart, kidneys, eyes, nervous system, and other parts of the body. This can lead to serious or life-threatening complications over time.

Type 1 diabetes is not caused by a person’s diet or lifestyle. It is an autoimmune disorder, where the body’s immune system mistakenly attacks and destroys healthy cells in the pancreas. While it’s most commonly diagnosed in children and young adults, people can develop type 1 diabetes at any age.

How close are we to a cure?

For a century, treatment for type 1 diabetes has focused on managing the disease. Thanks to past advancements in medicine, patients are able to control their blood glucose levels with regular insulin injections or an insulin pump.

Now clinical trials are underway for treatments to reverse type 1 diabetes and restore the body’s ability to produce insulin naturally. These trials are already allowing some patients to live insulin-free, significantly improving their quality of life.

What is a biological cure?

DRI researchers are working toward a biological cure for type 1 diabetes. A biological cure means treatment that would help the body start producing its own insulin again, restoring blood sugars to normal levels without introducing other risks.

This research focuses on a process called islet transplantation. Islets are clusters of cells found in the pancreas that work together to regulate blood sugar. In an islet transplant, doctors take healthy islets from the pancreas of an organ donor, and inject them into someone with type 1 diabetes. In studies, some patients who had this procedure have been able to reduce the need for insulin injections, or stop injecting insulin altogether.

DRI scientists have already shown that islet transplantation can eliminate the need for insulin injections. Now they are working to improve the science so that more people can benefit from this treatment.

The BioHub Strategy

DRI’s BioHub strategy is a three-step approach to overcoming the current limitations of islet transplantation.

First, scientists focus on the transplant site. While the liver is the traditional site for islet transplantation, this location is not ideal. Scientists are investigating other possible transplant sites and options, including a bio-engineered platform that acts as an artificial pancreas.

Second, they are looking for ways to sustain the islets’ long-term survival and protecting them from the autoimmune attack that caused the type 1 diabetes in the first place. Some options include creating barriers to protect the cells, or adding oxygen or other agents to the transplant site.

Finally, researchers are investigating how to increase the supply of islets available for transplant. This could include finding a method to regenerate a patient’s own pancreatic cells, so cells don’t have to be taken from a donor.

Research Progress

Research has come a long way since the first islet transplant in a human was performed in 1985. Recent work by DRI scientists has included the discovery of pancreatic stem cells that can be stimulated to create insulin-producing beta cells, and a study that demonstrated that abdominal tissue called the omentum could work as a transplant site. And in 2019, a study by DRI scientists showed that a small group of patients who received islet transplants had been able to live without insulin injections for 10 years, while maintaining blood sugar levels that were in the same range as people who had never had type 1 diabetes.

Clinical Trials

A clinical trial is a study that takes treatments that have been developed in lab and pre-clinical research, and tests them in human patients. DRI scientists have a number of clinical trials currently underway, including an islet transplant study that is testing the omentum as an alternative transplant site to the liver. Other ongoing clinical trials include the POSEIDON Trial, which tests whether high doses of vitamin D and Omega-3 fatty acids can help slow or stop the progression of type 1 diabetes in newly diagnosed children and adults.

While past studies have shown that islet transplantation can reduce or eliminate the need for patients to inject insulin, so far this treatment has only been available to people with the most severe cases of type 1 diabetes. At the Diabetes Research Institute, we have one goal: a cure. With more research, our goal is to effectively reverse type 1 diabetes, restoring the body’s ability to normalize blood sugar levels naturally.