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Can We Teach an Old Pancreas New Tricks?

We’ve come to think of Type 1 diabetes as a condition where the pancreas just gives up the ghost, for good, end of story. But in recent years, researchers have grown increasingly skeptical of that tidy narrative.  Now, a new study seems to cast that idea even further in doubt.

Researchers at the University of Exeter Medical School (UK) recently found that nearly ¾ of all people with T1 still produce some insulin, no matter whether they’ve had diabetes for 5 months or 50 years.  Findings like this suggest that the T1 pancreas might be like an old dog that needs to learn a new trick, or at least relearn a trick it has forgotten.

For the study, the researchers tested 74 volunteers with T1 to monitor whether or not they produced insulin after meals. They found that 73% of those monitored produced a low level of insulin in response to ingesting food. Obviously, the levels detected weren’t enough insulin to help the body regulate BG levels, but they were significant enough to be measured.

Though this was a small study, the findings lend credence to the theory that the body of a person with Type 1 diabetes still might be capable of producing the insulin necessary to function; the trick is figuring out the mechanism for boosting that insulin to a more than symbolic level. Some researchers believe that beta cells that produce insulin are dormant in people with diabetes, and what’s needed is a way to reactivate them (see “Sleeping Betas Get a Wakeup Call”). Others are focusing on ways to prevent the body’s immune system from attacking the pancreas, so it can get back to the business of making insulin (see “Reverse Vaccine for Diabetes Shows Promise”).

Next up, the researchers will undertake a bigger study to find out if genes play a factor in whether or not T1s still produce insulin. Also, the researchers want to determine whether this micro-insulin production shields people with diabetes against some complications.

But at the very least, the study changes the narrative of the T1 pancreas as permanently out of order.

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Craig Idlebrook is a past editor for Insulin Nation, Type 2 Nation, and Información Sobre Diabetes. He is now the community engagement and content manager for T1D Exchange.

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