New year resolutions and diabetes

The New year 2016 has  greeted us with a lot of headlines and news about the “diabetes time bomb”. The statistics are indeed staggering; it is reported that in the past 10 years alone, there has been a 65% increase in diabetes cases and there are over 4 million of diagnosed diabetics in the UK alone, according to the charity Diabetes UK. As someone who teaches at a university about diabetes, I know that this has to be the case and that it is also not the full story; there are so many of us who may be already at the pre-diabetic stage but we will just not know it. Type 1 diabetes detection is easier, as the body simply stops producing enough insulin (secreted from the beta cells of our pancreas) which normally keeps glucose (sugar) levels in our blood constant. The patients will often know that they’ve got it, as they unfortunately end up in a hospital. However, type 2 diabetes is the “silent killer”and may go undiagnosed for many years. It used to be referred to as the “old age” diabetes, as it would normally be diagnosed in people in their late 50’s onwards. This is probably because they hadn’t really visited the doctor before that with any serious problems, so it would just go unnoticed. By the time blood glucose levels are detected as being increased, there may have been a decade of a build-up, which if it had been detected earlier, could have been prevented. The major risk factor for development of type 2 diabetes is obesity and being overweight, which also leads to increased cardiovascular risk and heart disease. There are now reports of young children already displaying signs of development of type 2 diabetes. With an increase in our calorie intake and decrease in physical exercise we do, it is no wonder that the time bomb is ticking.

So what can we do about it? I know that what works for me is doing some exercise and making sure I eat healthy, balanced meals. However, in many cases of already diagnosed diabetes, this may not be enough and new therapies are needed. For those of you who have read my previous blogs, we have discussed novel therapies based on our immune system, changes in our dietary requirements and the way we cook our meals, as well as stem cell therapies. At the moment, extreme type 1 diabetes cases can be treated with beta cell transplant, which involves isolating and using pancreatic beta cells from deceased human donors and implanting them into the liver of the type 1 diabetes patient. However, these cells die out after a while and a new procedure is required. In addition, due to the lack of human donors, this is currently a very limited procedure. For this reason, scientists have been working tirelessly on finding new ways to produce these beta cells, through stem cell therapy. Stem cells are the cells which are yet to become a specific cell in our body and in this way can be “exploited” to try and make them into beta cells.

In a new study published last week, the researchers used human skin cells and cultured them in the lab in order to re-programme (convert from one type into another) them into a new type of cell, the beta cell. They did this by putting a “cocktail” of chemicals with the skin cells (these chemicals would normally be needed to make the beta cells in our body become functioning beta cells, i.e. able to release insulin after eating), which allowed the cells to recognise a new type of “signal” and therefore switch from being a skin cell into a beta cell. This in itself is not completely novel, as it has been demonstrated before that by using a specific cocktail of chemicals, this can be used as a tool to  make one type of cell into a different one. However, what is novel in this story is that the authors did an additional screen first to find out if there are any new chemicals that would help the cells in their journey of conversion from one cell type into another, and they identified several more compounds which boosted the cell’s ability to convert and become functional. They first tested in the lab that these cells can release insulin when challenged by high glucose levels (as would happen after we have eaten a meal), which they did. To know if this has any therapeutic value in the future, they next used mouse models of drug-induced type 1 diabetes, which results in beta cell death and development of high glucose levels, and injected the lab-grown cells into these mice.  They found that injection of these cells into mice completely normalised high blood glucose levels, thus providing proof-of-concept data (initial evidence) that there is a therapeutic potential of this new technology which could be relevant for human diabetics in the future. This story received a lot of media attention which reported the study really well.

What does this mean for us? It’s an exciting time for research, innovation and new therapies. With each day and year passing, scientists are able to find new ways to help us fight all sorts of diseases, including diabetes. What we can do is to help out a bit while this technology is being developed and tested (which may take years), is to perhaps set some targets that will help us keep going past this January and new year resolutions; perhaps sign up for a fun run/walk for your favourite charity, walk up the stairs rather than take the lift, reduce your portion size or perhaps, switch from ready-made meals to some simple, healthy recipes that can be easy and quick to make (for simple recipe suggestions visit Diabetes UK).

Zhu, S. et al. (2016). Human pancreatic beta-like cells converted from fibroblasts. Nature Communications. DOI: 10.1038/ncomms10080