Can Diabetes Be Cured? The Case for Type 1

Type 1 Diabetes makes up about 10% of all diabetes cases. It affects up to 3 million Americans mostly children and of the two most common types, Type 1 and Type 2, is the one doctors and health professionals are least optimistic about finding a cure for.

Why is this? Simply put, because in Type 1 cases the body's auto-immune system attacks the pancreas. Such an attack could be due to a genetic predisposition triggered by a virus. Whatever the case, this attack response damages the insulin producing beta cells of the pancreas thereby leaving the pancreas no longer able to produce the insulin required for normal blood sugar regulation. As a result complications arise - organs of the body; eyes, kidney, heart and limbs get affected.

The general prognosis before now was that the condition was incurable. This belief has however changed over time, metamorphosing into diabetes cure research focused on the transplantation of the insulin producing cells of the pancreas destroyed under this disease. Risks associated with the procedure however include, the failure of the transplanted cells to function, side effects of immune-suppressants used during the procedure and excessive bleeding or death.

Focus is now being placed on understanding the mechanisms of the immune attack responsible for the disease and finding ways to block it. That said though, last year, in an apparent move towards a cure, researchers claimed to have found a novel large-scale method enabling them to turn human embryonic stem cells into fully functioning beta cells capable of producing insulin. They did this by the controlled differentiation of stem cells.

Differentiation or Cellular differentiation is the process by which a cell become specialized in order to perform a specific function - as in the case of a blood cell, kidney cell, heart cell, etc. Stem cells are marked out for this ability to undergo differentiation. According to the study's co-author, Douglas Melton of Harvard University ""We wanted to replace insulin injections using nature's own solution, being the pancreatic beta cell... " Now "we are reporting the ability to make hundreds of millions of these cells," he added.

The next step then was transplantation but they also needed to see how they could prevent, as often happened in transplantation cases, the rejection of the created beta cells by the body's immune system. They achieved this by creating a device which they discovered not only protected beta cells implanted into the test mice, but left the pancreas months after, still producing insulin.

Besides being highly promising for type 1 diabetics, this procedure has equal potential as treatment for many type 2 diabetics who depend on insulin injections as part of their daily treatment regimen.

What makes this particular breakthrough special is that unlike past successes at deriving beta cells from stem cells, this development was able to create glucose sensing, insulin secreting beta cells.

In focus now, would be human trials which Melton figures could kick off in a few years' time. Ultimately he says, the final product would be a credit card-sized package of beta cells ensconced in an encapsulation device that would allow sugar and insulin to easily pass through, while preventing the reverse passage of the larger bodied immune T-cells. This package could then be safely transplanted into a diabetes patient and left in place for a year or more before needing replacement.

The other method for creating beta cells which could ultimately eliminate the need for such yearly or regular replacement would be to use pluripotent stem cells as the base cells for differentiation rather than embryonic stem cells.

Pluripotent stem cells are stem cells from specialized adult cells but which have been somehow reprogrammed to change into an undifferentiated state. An example of this is endometrial derived stem cells (hEMSCs) - cells derived from the uterine endometrium. Research shows that these can be guided to differentiate into insulin producing beta cells.

The newly differentiated cells could possibly then be grafted onto the damaged pancreas (provided the initial diabetes trigger factor is avoided), for insulin to be produced. This would be ideal, because if one were to use a diabetics own pluripotent stem cell as the base for beta cell cultivation, it should eliminate the risk of the beta cells rejection. This would in turn eliminate the need for auto-immune protective devices and in that vein interval device replacement.

Finally, scientists at the Harvard Stem Cell institute have identified another strategy towards curing early stage type 1 as well as type 2 diabetes. It involves stimulating beta cells through drug therapy to make more of themselves. Since beta cells naturally replicate themselves, however at a slow rate, inducing them to do so faster, would equally eliminate the need for transplantation and immune protective devices.

As such, with the foregoing development, it is obvious that prospects for finding a cure for Type 1 diabetes is no longer as bleak as previously thought. In fact it is feasible that within the decade, various methods for curing the disease would not only be available but become essentially routine.