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January 22, 2003

Research: Causes and Prevention

Question from New Zealand:

I just wanted to know where the research into a cure is at. Is there any light at the end of the tunnel?

Answer:

Broadly, there are three main thrusts to finding a ‘cure’ for type�1A (autoimmune) diabetes — all are being vigorously pursued. The first has been to define in a population who is most at risk genetically. To a large extent, this has been done and the search is now on for the environmental factors that trigger the destruction of the islets. in this group. There were great hopes that very early detection of diabetes could make it possible to defer insulin dependence, but this has been disappointing.

For those who already have overt diabetes, I think the next big step will be the development of a glucose sensor that can be safely connected to an insulin pump by radio using a rechargeable implanted battery. This seems on its way, but in the long run the best hope is for a pancreas transplantation technique that gets around the two problems of lack of donors and the need for lifetime immunosuppression. Surrogate cells could be stem cells, cultured normal human islet cells or perhaps suitably protected porcine cells. This has a long way to go, but ways of producing permanent immunological tolerance in the very short term is already at the stage of having permission to begin human trials.

DOB