New Research Detects Beta Cell Death before Type 1 Diabetes Onset

JDRF-funded scientists are conducting new research to create a blood test that may reveal when beta cells are lost during the development of type 1 diabetes (T1D). The test, which is the first of its kind, could be used to identify individuals who have begun to develop T1D, but do not yet have abnormally high blood sugar, and to test if therapies aimed at protecting beta cells or reversing the immune attack are effective. To determine if beta cells are being destroyed, the researchers looked for DNA (which carries genetic information) that is released by dying beta cells into the blood. Specifically, they designed a test to detect DNA from the insulin gene; although all cells contain the insulin gene, beta cells possess a unique modification to the gene which allowed the researchers to specifically detect beta cell death.

“This is important because it is a method that may be able to detect the killing of insulin-producing cells—this is the process that leads to the disease, but we actually never measure it, we only know about it after it has happened,” says Kevan C. Herold, M.D., professor of immunology at Yale University and lead researcher for the study. “With further studies, this test might be useful for identifying the destruction of beta cells before diabetes occurs, so hopefully it can be stopped.”

The test was developed by studying mice, but it is now under investigation to detect the loss of beta cells in the human pancreas, which could make it applicable to people who are at risk for developing T1D—before they are diagnosed. By using the test to analyze the blood of mice as they developed T1D, the researchers found that they could detect beta cell death as soon as it began to occur, even before blood sugar began to rise, providing the first non-invasive measure of beta cell death.

Preliminary tests of stored samples from humans with recent-onset T1D were also able to demonstrate beta cell loss, suggesting promise for future use in identifying individuals at early stages of T1D and in measuring the effectiveness of therapies aimed at preventing beta cell death and T1D development.

“Dr. Herold’s work has the potential to develop a tool that will allow us to better understand the fate of beta cells in type 1 diabetes,” says Andrew Rakeman, Ph.D., JDRF senior scientific program manager. “It will also help guide the development of clinical trials aimed at protecting or preserving beta cells in type 1 diabetes by allowing us to select the most appropriate patient population and providing a marker for whether the therapy is working.”

JDRF is pursuing the pathway toward a cure for T1D by preventing beta cell death and promoting beta cell health in those at risk for or at very early stages of T1D, either through stopping the immune attack or preventing beta cells from dying.

Dr. Herold’s work was also supported by the Lilly Foundation and was reported in the Early Online edition of the Proceedings of the National Academy of Sciences. For more information, please click here.