As new cases of type 1 diabetes (T1D) increase worldwide, JDRF has continued to focus on preventing T1D in those at risk.  By the time symptoms of T1D appear, however, the destruction of insulin producing beta cells may have already been occurring for some time.  In order to effectively prevent the disease, researchers first need to understand when and how T1D begins, even before symptoms appear.  They also need a way to determine whether potential interventions to prevent T1D are working properly.

Researchers involved in a study at Yale University, funded by JDRF and the Lilly Foundation, have announced a breakthrough that may, for the first time, help identify the beginnings of T1D and test new treatments to prevent the disease.  In new findings published in Proceedings of the National Academy of Science, the research team, led by Dr. Kevan Herold, reports the discovery of a new blood test that may be able to detect the loss of pancreatic beta cells in those at risk of developing T1D prior to disease diagnosis.

In this study conducted in mice, the researchers developed a non-invasive method to detect beta cell loss by looking for the appearance of DNA released by dying beta cells into the blood.  Specifically, they looked for the portion of DNA containing the insulin gene, which they distinguished from DNA released by sources other than dying beta cells.   When they used this test to analyze the blood of mice as they developed diabetes, the researchers found that they could detect the beta cell insulin DNA as soon as beta cells began to die, even before blood sugar began to rise and the mice developed symptoms of diabetes. Initial data using human blood samples demonstrated that the same type of test may detect beta cell loss in people with recent-onset type 1 diabetes before symptoms begin to appear.

These promising results suggest that one day this test could be used to monitor beta cell loss in individuals at risk for and in the early stages of type 1 diabetes, although more work will be required to develop a test that can be used in a physician’s office.   In addition to diagnosing and monitoring T1D, this method could help test new drugs aimed at protecting beta cells and preventing T1D’s onset.

Methods to detect beta cell loss, such as the one discovered by Dr. Herald’s team, are critical, according to Dr. Andrew Rakeman, Senior Scientific Program Manager at JDRF.  “Dr. Herold’s work has the potential to develop a tool that will not only allow us to better understand the fate of beta cells in type 1 diabetes,” explains Dr. Rakeman.  “It will also help guide the development of clinical trials aimed at protecting or preserving beta cells in T1D by allowing us to select the most appropriate patient population and providing a marker for whether the therapy is working.”