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NEWS

DISCOVERY OF TYPE 1 SUBTYPES

Researchers have found that young

children diagnosed with Type 1 diabetes

appear to have a different form (or

'subtype') of the condition to those

diagnosed as older children and adults.

This discovery could lead to new and

more tailored treatments.

The JDRF-funded research found

that children diagnosed under the age of

seven have beta cells that don't process

insulin properly. The researchers led by

Dr Pia Leete at the University of Exeter,

also found that the immune system

rapidly destroyed most of these cells. In

contrast, people who were older than

13 when diagnosed had beta cells that

could process insulin normally. While they

lost most of their beta cells, these people

often continued to make small amounts

of their own insulin after diagnosis.

Children who are diagnosed between

seven and 13 could fall into either group,

and the researchers are working on ways

to distinguish between them, which

could make a big difference to the way

scientists develop treatments to cure or

prevent Type 1.

The team made the discovery when

studying pancreas samples from people

newly diagnosed with Type 1 diabetes,

some of which came from the JDRFfunded Network for Pancreatic

Organ

donors with Diabetes (nPOD).

In samples from children who were

younger than seven at diagnosis, the

researchers found fewer beta cells capable

of producing insulin, and more immune

cells invading the pancreas. These

samples also showed that the beta cells

weren't functioning correctly, releasing

both insulin and another molecule called

proinsulin, which is broken down by beta

cells when they make insulin. Usually,

beta cells don't release both insulin and

proinsulin simultaneously.

Pancreas samples from people

diagnosed older than 13 did not show

signs of proinsulin being released

alongside insulin. Instead, these cells

were producing insulin normally, although

only in tiny amounts.

This suggests that testing for insulin

and proinsulin could be a way to check

which of the subtypes of Type 1 diabetes

a person has when diagnosed between

seven and 13 years old, and determine

different treatments, eg the two groups

may respond differently to different

immunotherapies. Also, the younger age

group would likely need replacement

beta cells, while the older age group may

benefit from a treatment to kick-start their

dormant beta cells.

Other JDRF-funded researchers are

now exploring both of these approaches.

Professor Noel Morgan, one of the

authors of the research, said: "The

significance of this could be enormous

in helping us to understand what causes

the illness, and in unlocking avenues to

prevent future generations of children

from getting type 1 diabetes.

"It might also lead to new treatments

if we can find ways to reactivate dormant

insulin-producing cells in the older age

group. This would be a significant step

towards the holy grail to find a cure for

some people."

The research is available in

Diabetologia.

DIGITAL HEALTH FOR T2S

A new digital healthcare subscription

service aimed at people with Type 2

diabetes and pre-diabetes, is preparing

for launch in the US.

proBEAT is expected to be available

without the need for a prescription and

appeal to a broad range of adults to help

them improve their knowledge of how

a variety of lifestyle, dietary and health

and wellbeing factors impact their blood

glucose levels by acting as a black box

flight recorder.

Big data about the multitude of factors

that affect glucose levels will be gathered

from all users and employed in developing

and subsequently 'fine-tuning' predictive

algorithms and artificial intelligence-based

feedback and prompts. These will then

be able to both educate and provide

motivational tools to the user to encourage

them to lead a healthier lifestyle.

Dr Faz Chowdhury, CEO of Nemaura

Medical, which is based in Loughborough

UK, comments, "There are more

than 85m people in the US with prediabetes and more

than 24m with Type

2 diabetes. We believe proBEAT will

be the first service of its kind offering a

digital solution combined with predictive

glucose profiling, developed using realtime data from

a vast pool of people using

our non-invasive continuous glucose

monitor. Chronic disease conditions

such as diabetes are best tackled before

they manifest as full-blown medical

conditions requiring intense treatment and

management and we are very excited by

the prospects of initially addressing the

US market and potentially benefit many

millions of people."

Nemaura Medical Inc, the company

behind the service, is now prioritising the

launch plans and considering various

options, including potential partnering

with multi-national companies.

www.nemaura.com

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