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A turning point in the fight against type-1 diabetes

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Type 1 diabetes
 
In October 2014 Harvard professor Douglas Melton announced a breakthrough in the treatment of type-1 diabetes by creating stem cells that produce insulin.

Melton demonstrated that mice treated with transplanted pancreatic cells are still producing insulin months after being injected. Testing in primates is now underway at the University of Chicago, and clinical studies in humans should begin in just a few years.

"Most patients are sick of hearing that something's just around the corner," says Melton, but he's convinced that his research represents a significant turning point in the fight against diabetes.

Type-1
Type-1 diabetes, which usually occurs in children, is an autoimmune disease in which the body attacks its own beta cells of the pancreas and destroys their ability to make insulin. It's a devastating lifelong chronic condition, which affects some three million Americans and 400,000 English people. Treatment is daily insulin doses, a healthy diet and regular physical activity.
 
Increasing incidence
For reasons not completely understood, the incidence of type-1 diabetes has been increasing throughout the world at about three to five per cent a year, and is most prevalent in Europe. This is troubling, because type-1 diabetes has the potential to disable or kill people early in their lives.

The search to discover why type-1 diabetes is increasing resembles the penultimate chapter of an Agatha Christie mystery, where there are many suspects, but no prime candidate. The last chapter to explain the increasing incidence of type-1 diabetes is yet to be written.  
 
Parents unaware of symptoms
A 2012 UK report suggests that parents are unaware of the warning signs of type-1 diabetes: thirstiness, tiredness, weight loss and frequently passing urine. As a consequence 25% of children with the condition are diagnosed once they are already seriously ill with diabetic ketoacidosis (DKA). DKA occurs because a severe lack of insulin upsets the body's normal chemical balance, and leads to the production of poisonous chemicals called ketones. This build-up can be life threatening, and needs immediate specialist treatment in hospital.
The challenge of cell production
Making industrial quantities of the insulin-producing cells of the pancreas has been a Holy Grail of diabetes research. All previous attempts have failed to achieve scalable quantities of the mature beta cells that could be of practical benefit to people living with diabetes.

Just over 20 years ago when Professor Melton's son Sam was diagnosed with type-1 diabetes Melton promised that he would find a cure. He was further inspired when his daughter at 14 was also diagnosed with type-1 diabetes.

According to Melton, it should be possible to produce 'scalable' quantities of beta pancreatic cells from stem cells in industrial-sized bioreactors, and then transplant them into a patient to protect them from immune attack. This would result in an effective cure.

"The biggest hurdle has been to get glucose-sensing, insulin-secreting beta cells, and that's what our group has done," says Melton.

In addition to offering a new form of treatment, and possibly a 'cure' for type-1 diabetes, Melton believes his discovery could also offer hope for the 10% of people living with type-2 diabetes who have to rely on regular insulin injections.

Takeaway
If Professor Melton is successful, not only will his discovery honour a promise to his children, but also it'll be a medical game-changer on a par with antibiotics and bacterial infections.
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