Tackling type 1 diabetes

A recent discovery could change the course of type 1 diabetes prevention and treatment

August 25, 2016

There are currently 11 million Canadians living with diabetes or prediabetes, and every three minutes, another Canadian is diagnosed. More than 300,000 Canadians live with type 1 diabetes in which the body produces little or no insulin, resulting in difficulty regulating blood sugar. Source: Canadian Diabetes Association.

Diabetes is a chronic, often debilitating and sometimes fatal disease in which the body fails to properly produce insulin, a hormone that controls the amount of glucose (sugar) in the blood. Type 1 diabetes (T1D) is diagnosed when the body produces little or no insulin. Living with this disease requires constant monitoring of glucose levels, dietary changes, and lifelong insulin injections in order to survive. Even when their doctor's directions are strictly followed, T1D patients are at risk of developing serious health complications, including cardiovascular conditions, kidney, eye, and nerve damage and even amputations.

"Our immune systems are supposed to protect our bodies from threats, but for T1D patients, it mistakenly attacks and destroys the insulin-producing cells in the pancreas. This is why it is called an ‘autoimmune' disease," explains Dr. Fraser Scott, a CIHR-funded senior scientist at the Ottawa Hospital Research Institute and professor at the University of Ottawa.

The pancreas is an organ that sits behind the stomach. It releases hormones, including insulin, into the blood stream. Specialized cells, called beta cells, release insulin to keep blood glucose levels normal. This process does not occur with T1D patients and, consequently, they must inject themselves with insulin several times per day, via pen, syringe, or insulin pump.

Despite their best efforts, sometimes T1D patients suffer from complications as their blood glucose can never be completely regulated. "The pancreas is a very sensitive, glucose-monitoring machine that, when it is healthy, releases only just enough insulin to maintain normal blood glucose levels," says Dr. Scott. "In a T1D patient, even monitoring glucose levels six times a day just isn't the same."

Fortunately, hope is on the horizon for T1D patients thanks to a groundbreaking discovery made in Dr. Scott's lab.

Dr. Fraser Scott
Senior scientist, Ottawa Hospital Research Institute
Professor, University of Ottawa
Photo courtesy of The Ottawa Hospital.

A window of opportunity opens

While the exact cause of the disease remains unknown, a complex interaction between genes, diet and bacteria could play a role in T1D development. Dr. Scott's previous research suggested that a bacteria-killing protein called cathelicidin antimicrobial peptide (CAMP) might be linked to T1D, so he began examining its function in the gastrointestinal tract of animals that develop diabetes. 

That was when his team made a surprising discovery: CAMP was not only present in the gut, but also in the pancreas. What would a bacteria-killer be doing in a bacteria-free part of the body? This led to their realization that, perhaps, CAMP does more than kill bacteria. And they were right – CAMP was found to help the pancreas regenerate and produce insulin.

Intrigued, Dr. Scott and his team investigated further and learned that when diabetes-prone rats were injected with CAMP, they generated new insulin-containing beta cells potentially replacing the cells that were destroyed.

"Most existing T1D research focuses solely on suppressing the self-attacking immune system. There was a need for research that not only addresses this suppression, but also the regrowth of destroyed beta cells. Our discovery that CAMP may play a role in dampening gut inflammation and regrowing these cells is an important milestone in diabetes research," says Dr. Scott.  While this research is still in its early stages, other groups have made similar, complementary findings using a different animal model, strongly supporting the need for further pre-clinical studies.

This research breakthrough could provide insight into diabetes prevention and treatment, potentially opening the door to improving the health and quality of life of diabetes patients, and paving the way to a cure.

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