Preventing Diabetes May Take Guts

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Researching the link between intestinal microbes and type 1 diabetes

83405456A report recently published online in the journal Diabetes offers a glimpse into the future of research on type 1 diabetes (T1D). It emphasizes the link between T1D and the microbial community that colonizes the human gut, called the microbiome, and suggests that changes to the microbiome could be useful as early markers of T1D, providing a therapeutic window for interventions that could delay or prevent the onset of symptoms.

The report follows an October 2014 research symposium on diabetes and the microbiome sponsored jointly by JDRF and the American Diabetes Association. During the symposium, a unique group of specialists in diabetes, immunology and microbiology gathered to discuss how the microbiome might be involved in the development of diabetes. One of the group’s objectives was to define the research that is needed to understand the role of the microbiome in diabetes and its potential as a therapeutic strategy in diabetes prevention.

The idea that aspects of the microbiome could be involved in autoimmune diseases such as T1D is rooted in the close functional relationship between the immune system and the microbiome. JDRF is already involved in funding studies that address this connection. One example comes from an international collaboration led by researchers at the Broad Institute of MIT and Harvard (Cambridge, MA) with researchers from Finland. As reported in the February 2015 issue of Cell Host and Microbe, the researchers identified changes in diversity of the gut microbiome in young children who were at high risk of developing T1D as much as a year before diagnosis.

Results from other JDRF-supported work published in the June 2014 issue of Diabetes showed that interactions between gut microbes were also markedly different in children who went on to show preliminary indicators of autoimmunity than in children who did not have these indicators. The findings came from the BABYDIET study at the Helmholtz Zentrum München in Germany, which is examining whether nutritional factors influence risk for developing T1D.

But data on the possible connection between the microbiome and T1D development are still emerging, and much more information is needed to determine whether the microbiome holds keys to diagnosing or preventing T1D. The symposium report identifies several questions that need to be answered: Do alterations in the microbiome influence the disease process and long-term health? Can certain characteristics of the microbiome predict onset or progression of T1D? How do factors such as diet and circumstances of birth and early life affect the microbiome?

Ongoing investigation of these questions could determine whether changes to the microbiome can be used as early markers of T1D, enabling T1D diagnosis very early in life and, potentially, therapeutic strategies for delaying or preventing the onset of symptoms.

Why It Matters

If specific changes in the microbiome could be used as early indicators of T1D, then disease could be detected very early in development, presenting an opportunity to delay or prevent the onset of symptoms.

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By Monica Harrington