By Dr Ananya Mandal, MD
Type 1 diabetes is mostly a treatable but largely incurable disease. The disease is caused by damaged beta cells in the islets of Langerhans of the pancreas that fail to secrete insulin. Insulin facilitates the uptake of glucose from the blood by muscle, fat, liver and other cells of the body where it is used as the energy source for various cellular functions. Since people with type 1 diabetes lack insulin, the main approach to treatment is the exogenous injection of insulin to restore a normal insulin level.
To actually cure the condition would mean eliminating the basic pathology of type 1 diabetes and helping the beta cells secrete normal amounts of insulin. However, some such approaches that are currently in development include:
Cell encapsulation aims to replace the pancreatic function through the creation of an artificial pancreas made from bioengineered tissue that contains the islet cells of the pancreas. This implant is programmed to secrete the correct amounts of insulin, amylin and glucagon hormones that are need for the normal regulation of blood glucose.
In the case of transplant, immunosuppressant drugs are usually needed to prevent the body from mounting an immune reaction against the transplanted tissue and destroying it.
With cell encapsulation, however, a protective coating is placed over the transplanted cells to protect them from immune attack, therefore prolonging their existence in the body as well as eliminating the need for immunosuppressant drugs. Cell encapsulation has not yet been successful in humans but is thought to hold promise for the future.
Regeneration of the islet cells is another new approach where degenerating islet cells are allowed to proliferate to resume their functions.
Transplantation of pancreas from a suitable matched donor.
Stem cell research for the regeneration and creation of islet cells from a person's own body. This lowers the likelihood of the immune system reacting to an artificial pancreas. With this approach, pancreatic beta cells are grown in the laboratory using stem cells taken from the umbilical cord blood of newborns or from the person's own stem cells.
Another approach is the use of gene therapy. A virus vector or vehicle can be especially designed to carry an insulin gene that gets activated in response to high blood sugar. This is also being researched widely to find a cure for type 1 diabetes.
Reviewed by Sally Robertson, BSc