Insulin cells persist in long-standing diabetes

In Type 1 Diabetes, which by definition indicates a lack of insulin production, the insulin-producing "beta" cells in the pancreas are thought to be wiped out. However, that may not be exactly the case.

The results of a new study provide some of the first evidence in humans that the pancreas continues to form beta cells even in the setting of long-standing Type 1 Diabetes, suggesting a possible new treatment strategy.

"The implication is that type 1 diabetes could, theoretically, be cured if we could stop the new insulin-secreting cells being destroyed," said Dr. Peter C. Butler from the University of California. Butler presented his team's findings at the American Diabetes Association's annual meeting in San Diego.

Type 1 Diabetes Mellitus results when beta cells are mistakenly attacked and destroyed by the body in an autoimmune reaction. Until now, the only hope of reversing the disease seemed to be replacement of beta cells by transplantation.

Butler's team has now shown that, among 42 individuals who had type 1 diabetes for decades - in some cases up to 60 years - the majority (88 percent) still had detectable insulin-producing beta cells in their pancreas.

"Most interesting," Butler said, "we note that these cells have a high death rate by autoimmune destruction, implying that there must be ongoing new insulin-producing cells being formed. Therefore, type 1 diabetes may be reversible by targeted inhibition of beta cell destruction."

A lot more work lies ahead before that becomes possible. "What we do not know yet is what rate these calls are being produced or how they are being produced," Butler said. "These questions are currently being actively addressed in studies by our group, funded by the Juvenile Diabetes Research Foundation."