Diabetes researchers from across the world shared their latest breakthroughs at this year’s annual European Association for the Study of Diabetes (EASD) conference. Here we share a few of the conference highlights.
Genetic engineering to develop new type 2 treatments
People living with type 2 diabetes usually have insulin resistance. This means that their bodies can’t use the insulin they produce properly, so cells can’t remove glucose, or sugar, from the blood as easily. Normally this is treated with tablets or by eating well and getting active, but these don’t work for everyone. So scientists have been looking for different ways to help people with insulin resistance.
A team in Israel has been genetically engineering human muscle cells to help them take up greater amounts of sugar from the blood. They made the cells make more of a protein called GLUT4, which helps to open ‘doors’ in the cell surface more easily, letting more sugar into the cells.
The team presented their latest findings at EASD. In tests on the cells themselves, they found the genetically engineered cells could take up 50% more sugar than normal muscle cells. They grew these cells into clumps, known as tissue, and transplanted this into mice with diabetes. The mice who’d had the transplant had around 20% lower blood sugar levels for up to 4 months, compared to mice without the transplant.
Transplants can sometimes be quite invasive, so the team also developed a successful way of injecting the tissue instead.
New and improved treatments would mean better care for people with type 2 diabetes, improving their health and reducing the risk of diabetes-related complications in the future .The early stage results of this innovative new technique are exciting, but there’s still a way to go before we know is this approach would be safe and effective for people with type 2. The next steps are to move the treatment into clinical trials in humans.
One of the researchers, Ms Hagit Shoyhet, said:
"In the future, a single injection of engineered tissue could provide long-lasting glucose control, significantly improving quality of life and life expectancy."
Viruses and type 1 diabetes: Closing in on a Link?
Type 1 diabetes happens when the immune system attacks insulin-making beta cells in the pancreas. But researchers still don’t know why the immune system attacks in this way. It’s thought that a combination of both our genes and our environment play a role. Viruses have been studied as one potential environmental trigger.
Although several have been linked to type 1, one group in particular called enteroviruses have the strongest evidence behind them.
Enteroviruses can cause infections including hand, foot and mouth disease, meningitis, polio, while others cause milder, cold-like symptoms.
Studies looking at the possibility of preventing type 1 diabetes by vaccinating against enteroviruses are already underway. But evidence on the role they might play in triggering type 1 is mixed and we can’t make firm links yet between viruses and type 1.
Researchers from University of New South Wales, Australia, who presented their work at EASD set out to take a deeper look at the existing evidence around enteroviruses and type 1.
The team – led by Ms Sonia Isaacs – combined findings from 60 existing studies, involving 12,077 people.
They found that people living with type 1 diabetes were eight times more likely to have had an enterovirus infection than those without the condition. They also found evidence of a link between the virus and new diagnoses of type 1. People with type 1 had a 16 times greater chance of having an infection in the month after their type 1 diagnosis compared to those without diabetes.
The team also showed that people with type 1 diabetes who started off at a higher risk of type 1, because they carried genes that are linked to the condition, were 29 times more likely to have had an enterovirus infection.
There are several possible theories about how enteroviruses could increase the risk of type 1 diabetes. For example, it’s thought enteroviruses might look similar to parts of insulin-making cells, causing the immune system to mistakenly attack them. Continued research will be crucial to unravel this.
This study adds to building evidence that enteroviruses could be a culprit involved in the complex process that leads to type 1 diabetes. But for now, there are still question marks over whether the virus is directly involved or if there are other factors at play.
Predicting weight loss
There are huge benefits to losing weight if you’re living with type 2 diabetes and carrying extra weight. But getting to a healthy weight is easier said than done. Community weight loss management programmes – like WW or Slimming World – can be a helpful way to support people on their weight loss journey. But is there a way to predict early on your chances of losing weight?
Researchers, Ms Lulwa Al-Abdullah, of the University of Glasgow, and Professor Jennifer Logue, of Lancaster University, studied health records from 1,658 adults living with type 2 diabetes and obesity in Scotland who attended a weight management programme to explore this. They found that people who lose at least 0.5% of their body weight after their first three sessions are more likely to reach their weight loss goal of more than 5% of their bodyweight by the end of the programme, and to maintain this going forward.
The first few weeks are likely to be so important because this is when people are adapting how they shop, eat, cook and get active. Other factors such as age, sex, socioeconomic status, ethnicity, diabetes medication and HbA1c (average blood sugar level), weren’t found to predict weight loss in either the shorter or longer term.
Dr Lucy Chambers, our Head of Research Communications, said:
“This study suggests that there are ways to predict within the first few weeks of a weight loss programme whether it is likely to be effective for a particular individual. Providing people with this information would give them the opportunity to ‘stick or switch’, and the best chance of finding an approach that works for them. We now need more research to develop a predictive tool that could be used by healthcare professionals, giving more people with type 2 diabetes the best chance of a healthier future.”
Type 1 diabetes differences in girls and boys
Type 1 diabetes affects over 1 million children and young people worldwide. It’s caused by the immune system attacking insulin-producing cells in the pancreas. People living with type 1 diabetes need support in carefully managing the condition, to live well and avoid complications.
Scientists have found that women living with diabetes can be more at risk of heart problems. But we don’t know much about the differences between girls and boys with the condition.
Researchers in the Netherlands shared their latest discoveries at EASD. They drew together results from 90 studies to see if and why sex might play part in type 1 diabetes care and management in girls and boys under the age of 18, and how it affects their quality of life.
The team found that girls were more likely to experience diabetic ketoacidosis, or DKA, a dangerous complication caused by blood sugar levels going too high. Girls also tended to need more insulin and they were more likely to have higher average blood sugar levels than boys. Girls were also more likely to use insulin pumps.
When they looked at impact on emotional wellbeing, the team found that girls with type 1 diabetes generally experience a lower quality of life, and are more vulnerable to diabetes-related distress and fear of hypos.
The exact reasons why there are differences between girls and boys living with type 1 diabetes aren’t clear, but physical differences in their bodies, along with hormonal changes that happen in girls’ bodies when they go through puberty might go some way to start explaining this.
More research is urgently needed to pinpoint why these differences exist, and crucially how to address them.
One of the researchers, Silvia de Vries, said:
“All young people with type 1 diabetes should be offered care that is tailored to their individual needs so they are able to manage their condition effectively.”
Shedding light on the link between type 2 diabetes and depression
Diabetes can cause serious physical harm, but the psychological impact of living with this relentless condition is often overlooked. Professor Sanjoy Paul and his team from the University of Melbourne in Australia presented new research suggesting that living with type 2 diabetes can put you more at risk of depression.
Professor Sanjoy Paul looked at medical information of 1.4 million people living with type 2 diabetes from the UK and US databases. They looked at the prevalence of depression over an 11-year period from the time of a type 2 diagnosis.
They found that depression in people with diabetes is common and rising. In the UK in 2006, 29% of people living with type 2 diabetes had depression. But this rose to 43% in 2017. They also saw that risk of depression wasn’t the same for all age groups. Younger people had a greater risk of depression compared to those diagnosed with type 2 later in life.
The research serves as a reminder that emotional and psychological support must be a core part of diabetes care.
