Research reveals more on insulin production changing slowly after type 1 diabetes diagnosis

Posted on 08 June 2018

Woman injecting insulin to manage a hyper in type 1 diabetes

Scientists have revealed new insights into how the body’s destruction of insulin-producing cells in type 1 diabetes is a lengthy process – and can be left incomplete.

The researchers – partly funded by JDRF – found the insulin produced by people living with type 1 diabetes drops for seven years after diagnosis, before then stabilising.

The finding offers the hope that if we can work out what causes this stablization, new strategies could be developed to preserve the insulin-producing beta cells in people diagnosed with type 1 diabetes.

Why did they do this research?

Historically, scientists thought that the autoimmune attack in type 1 diabetes wiped out all of the beta cells in the pancreas. Recent evidence however has shown that although there is a sharp drop in insulin production following diagnosis, many people continue to produce tiny amounts of insulin many years after diagnosis.

If we can understand when and how beta cell numbers decline as the condition progresses, it could help us to develop treatments to protect the beta cells and preserve insulin production for as long as possible. The researchers from the University of Exeter therefore set out to understand how insulin production changes over the course of many years following a diagnosis of type 1 diabetes.

What did they do?

Beta cells make a molecule known as C-peptide at the same time and in the same quantities as insulin. This means that researchers can use C-peptide levels in urine to measure how much insulin a person is producing from their beta cells, even after starting on insulin treatment.

The team therefore tracked insulin production in over 1,500 people living with type 1 diabetes in England and Scotland by tracking changes in C-peptide levels.

What did they find?

The researchers identified two clear periods of insulin production. In the first seven years following diagnosis, insulin production halved each year for seven years, followed by a more stable period afterwards where insulin levels declined much more slowly or plateaued.

What does this mean for type 1?

Dr Beverley Shields, who led the research, described the findings as “really exciting.” The results of her team’s work will open the door for further research into preserving beta cells.

Calling for further research, Professor Andrew Hattersley – who also worked on the study – said: “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.”

Blood glucose levels testing

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