Researchers uncover why type 1 diabetes can have more serious impact on young people
The landmark study findings could provide new solutions to prevent condition from developing, according to researchers.
The findings of a new study have reported causes for why type 1 diabetes is a more aggressive condition when it affects people in early childhood.
Researchers found that in young children with type 1 diabetes, nearly all insulin-producing cells are destroyed before they can mature.
The study results, recently published in Science Advances, could redefine how type 1 diabetes is understood and treated, refocusing research and potentially offering new ways to stop the condition before it starts.
The new study, led by Professor Sarah Richardson at the University of Exeter, used cutting-edge scientific techniques to study these small clusters in unprecedented detail.
The team analysed rare pancreas samples from more than 250 people of varying ages, both with and without type 1 diabetes. They looked at how these clusters change as we age and how they are affected by the immune system.
As previously reported, Professor Richardson is a past DRWF Fellow, who subsequently went on to secure funding to support this latest work.
Professor Richardson received part of a £5 million funding award, the Type 1 Diabetes Grand Challenge programme – set to provide £50 million towards diabetes research over the coming years.
On receipt of the funding Professor Richardson announced the study to investigate how and why a person’s immune system destroys their own beta cells and how this process may differ between people with type 1 diabetes.
The researchers also study how beta cells can fight back against the immune attack.
With this knowledge, the research team aim to support the development of an armoury of new treatments that target different lines of the immune system's attack.
Professor Richardson said: "Ultimately, this will help us tailor existing and emerging therapies to the individual, maximising the benefits for people with type 1 diabetes."
Type 1 diabetes affects around 400,000 people in the UK and is an autoimmune condition, where the immune system attacks and destroys the insulin-producing cells in the pancreas.
In young children – typically under the age of 7 – type 1 diabetes often progresses more rapidly, increasing the likelihood of medical emergencies and requiring higher doses of insulin than those diagnosed at an older age.
Until recently, scientists had limited tools to study the early development of the insulin-producing cells, that are found in clusters in the pancreas.
In young children these clusters are small and still forming and contain few insulin-producing cells.
The findings from this study confirmed that in early childhood, people without type 1 diabetes have many small clusters of insulin-producing cells, which normally increase in size and mature with age, with the most rapid development happening in the first few years of life.
For the first time, the researchers showed that in people with type 1 diabetes, these small clusters are almost completely absent, having been destroyed by the immune system.
While it was reported that some people with type 1 diabetes retained a few large clusters, allowing them to produce small amounts of insulin, this was not the case for those diagnosed at a young age.
The results suggested that the abundant small clusters found in young children were especially vulnerable to the type 1 diabetes immune attack. Their rapid destruction prevented them from maturing, leaving very few insulin-producing cells later in life.
Researchers suggested this was why children diagnosed with type 1 diabetes at a young age were typically unable to produce any of their own insulin, making the condition particularly difficult to manage.
A statement from the University of Exeter said: “This research underscores the critical role of these small clusters in healthy pancreas development and opens the door for new treatments to protect children’s small clusters of insulin-producing cells, giving them the chance to mature into large clusters that are less vulnerable to the immune attack. It also strengthens the case for early type 1 diabetes screening – particularly in young children – essential for identifying those in the early stages of type 1 diabetes before these crucial cells are lost.”
Professor Sarah Richarson said: “These tiny insulin-producing beta cell clusters – once overlooked – hold big clues to understanding type 1 diabetes. This new perspective has the potential to reshape how we screen, treat, and even prevent type 1 diabetes. Protecting small beta cell clusters early could be key to stopping type 1 diabetes before it starts.”
Gareth and Joanne Nye, whose daughter was diagnosed with type 1 diabetes aged 23 months, said: “Gracie’s diagnosis was traumatic for our whole family. In less than 48 hours she went from being a toddler with what we thought was a slight cold, to lying unconscious in a hospital bed with diabetic ketoacidosis (DKA), close to death. We lived in constant fear, setting alarms every two hours to finger prick her at night, worrying if she’d still be with us in the morning.
“Research like this, and the possibilities it holds, will be vital in reducing the number of children diagnosed in critical care, like Gracie. It gives us confidence that one day she could be free from her condition – and that fewer parents and children will have to go through this same experience.”
This research was made possible through a Senior Research Fellowship awarded to Professor Sarah Richardson at The University of Exeter.
Professor Richardson received the DRWF Professor David Matthews Non-Clinical Fellowship for her study Enteroviral infection as a causative factor in human type 1 diabetes in 2010.
Sarah Tutton, DRWF Chief Executive, said: “It has always been a priority for DRWF to offer grant funding for early career researchers who are the budding principle investigators and innovators of the future. It is especially rewarding to see the success that Professor Richardson has had, along with others, in securing significant sums of funding from the Diabetes Grand Challenge programme to deliver research outcomes that could change the way we prevent, treat and research diabetes going forward.”
Professor Richardson said: “The support provided by the DRWF Non-Clinical Research Fellowship was critical for my early training in type 1 diabetes research. It helped instil my drive to better understand this condition and my passion to translate this improved understanding into better treatments for those living with it.”
Read the report in Science Advances
Read more DRWF Research: Researchers awarded part of £5 million towards a cure for type 1 diabetes
Find out more about type 1 diabetes
Find out more about DRWF-funded research here
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