New strategies to detect and stop diabetes

Diabetes is the fastest growing widespread disease in the world. About 465 million people around the world are living with diabetes today. Modern medicine has led to better health and longer life, but research still faces many challenges.

Per-Ola Carlsson, senior physician and professor

in medical cell biology. Photo: Cecilia Yates

Diabetes, both type 1 and type 2, are chronic diseases for which there is no cure yet. Current research is dominated both by finding strategies to halt the progression of the disease in affected patients and by finding methods for the early detection of people at risk of developing diabetes to halt its course before the onset of diabetes mellitus. disease breaks out.

“Studies are now underway with mesenchymal stem cells (MSCs) to prevent the progression of type 1 diabetes,” said Per-Ola Carlsson, senior physician and professor of medical cell biology, who works both experimentally and clinically in diabetes research. “With treatment, the remaining insulin-producing cells, which are about 25-50% at the onset of diabetes, can hopefully be preserved and the patient can therefore manage on very low insulin doses.”

Reduced risk of complications

In this way we can in the long run reduce the risk of complications and ensure better living conditions and a longer lifespan.

“In the future,” Carlsson says, “we can envision identifying individuals who begin to show signs of immune activity against insulin-producing cells and treating them to prevent the destruction of the cells before so many of them are lost that it results.” with a high blood sugar level.’

Another research project is transplantation with stem cell-derived insulin-producing cells. This treatment is aimed at type 1 diabetes patients who have already lost their insulin-producing cells.

Increase in type 2 diabetes in the younger population

Problems such as weight gain and obesity have led to an increase in type 2 diabetes in society, especially at a younger age. The main treatments are diet and exercise. Many new drugs have a good impact and reduce the risk of consequences, but currently no drug can stop the progressive course of the disease in type 2 diabetes.

‘Of course,’ Carlsson says, ‘there is hope for developing drugs that target the disease mechanism itself, that is, stop the course of the disease. These may be the ones that influence the free radical stress against the insulin-producing cells. It would mean a lot if we could intervene in the disease process.’

Influence of the immune system on diabetes

Diabetes research is also being conducted at Uppsala University to advance our understanding of the immune system and its function at an early age to determine what influences the risk of developing diabetes later on.

Mia Phillipson, professor of physiology at the

Department of Medical Cell Biology.

Photo: Cecilia Yates

Like many of the greatest discoveries, the idea for the new study came about unexpectedly. Along with her research team, Mia Phillipson, professor of physiology in the Department of Medical Cell Biology, has had several successful research projects over the years. The team is studying what the cells of the immune system do in different tissues, both healthy and diseased, and has discovered new functions for the cells of the immune system. One discovery is that certain types of cells in the immune system, called macrophages, are important in wound healing, something that is now being tested clinically in patients with diabetic foot ulcers.

‘Basic research involves quite a few random discoveries,’ explains Mia Phillipson, ‘and it is important that these can be secured and germinated in a creative and tolerant research environment. In our mouse models with stained macrophages used in completely different projects, we found a very high accumulation of these cells in other healthy tissues, for example in the pancreas.’

‘We found that these macrophages have completely different functions than they do later in life, and that they are important for the insulin-producing pancreatic islets to mature and become functional after birth. We now want to investigate how these macrophages will play a role in the risk of developing diabetes later in life.’

Infections can affect the development of diabetes

The research focuses on discovering new functions in immune cells, then developing drugs that use these functions to heal damaged tissue, or to treat inflammatory bowel disease, diabetes or cancer.

‘We now want to understand,’ says Phillipson, ‘whether, for example, infections in the first year of a child’s life affect the pancreatic macrophages and thus increase the risk of diabetes later in life, and how we can counter this. More knowledge about why we have different risk levels for diabetes will eventually allow us to tailor advice and treatments for different subgroups, so that we can stay healthy.’

Cecilia Yates

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