Researchers at Columbia University Medical Center have developed a way that could potentially cure type 1 diabetes by retraining gastrointestinal cells into insulin producing cells. While stem cells have been used in many of the attempts to create the necessary replacement cells, scientists have been unable to get them to function as they needed. This new research has found that changing the function of existing cells may restore the same type of insulin production expected in a healthy body. This new technique has already proven effective in lab mice and new studies using human tissue are showing promise.
Type 1 diabetes occurs when the immune system attacks the pancreatic beta cells that produce insulin. Once these cells are eliminated the body is no longer able to create the substance necessary for natural functioning, and individuals afflicted with the disease are forced to inject the required drug. In order to effectively adjust dosage, these individuals have to calculate how it will affect their body based on dietary intake, exercise amount and blood sugar levels in order to prevent dangerous drops or spikes in glucose. Scientists have been attempting to replace the lost pancreatic cells in a way that would respond to bodily changes automatically and prevent the need for injections and complex dosage calculations.
Previous experiments using stem cells have successfully generated cells that can produce insulin, but to this point they still cannot be made to function the same way as the naturally occurring pancreatic beta cells that react to changes in sugar levels. When mouse cells, or even human cells, have been retrained with this new method, research has shown that insulin is only produced in response to the presence of sugar, which corresponds with the natural functioning of the original pancreatic cells lost in the development of diabetes mellitus type 1.
The new technique that could cure diabetes deactivates the FOXO1 gene that prevents gastrointestinal cells from producing insulin and results in a cell that has been retrained to also be glucose-responsive. Once the FOXO1 gene is deactivated, it takes roughly one week for the affected cells to begin production of the hormone, but only in response to glucose levels rather than constantly as converted stem cells have done to this point. This slight difference in glucose response based insulin delivery versus constant delivery could mean the difference between curing the disease and killing the afflicted person due to hypoglycemia, commonly known as low blood sugar.
While this new research indicates great promise, the process is not yet complete. In order to turn a technique that could cure diabetes into a process that does, a drug must be developed that can effectively deactivate the FOXO1 gene in the necessary cells, so they are retrained to produce insulin. Once such a drug is created it will then have to be tested extensively to ensure both its effectiveness and a lack of dangerous side-effects. However long this process may be, though, science appears to be one step closer to winning the battle.
By David Morris