Beta cell function and autoimmunity in longstanding type 1 diabetes

There is recent evidence that, in contrast to what was previously thought, some people with type 1 diabetes still have functioning beta cells in their pancreas even many years after diagnosis. Protecting these cells against attack by the immune system offers a possible approach to ‌prolonging insulin production and improving blood glucose control, as well as perhaps ultimately contributing towards a cure for the condition.

We have completed a pilot study and found 16% of participants still have functioning beta cells with tiny amounts of insulin being produced.

We want to try to find out why insulin production is preserved in some people with type 1 diabetes but not others, and how it relates to activity of the immune system. We think that differences in immune cell memory may play a part in determining whether beta cells survive and continue to produce insulin. This research is continuing as part of cellular immune studies.

What factors might prevent people developing type 1 diabetes?

Although islet autoantibodies are very important for identifying family members at increased risk of type 1 diabetes, there is a very interesting, small group of people who have had multiple islet autoantibodies for many years, but have not yet progressed to symptoms of type 1 diabetes or diagnosis.

We will examine in cellular immune studies how this group are protected by their immune system compared with two other groups 1) people who continue the more usual faster progression towards diagnosis and 2) people with no islet autoantibodies.

Because the group of people in BOX with multiple islet autoantibodies for many years is small, we are collaborating with researchers running family studies worldwide in a project called SNAIL to collect larger numbers in support of our research.

This project is funded by the Juvenile Diabetes Research Foundation (JDRF).