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Many patients with type 1 diabetes have functioning beta cells, produce insulin
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Researchers in the United Kingdom detected low-level insulin production in the 73% of patients with type 1 diabetes they studied, including patients who had the disease for a prolonged duration, according to data.
“It’s extremely interesting that low levels of insulin are produced in most people with type 1 diabetes, even if they’ve had it for 50 years. The fact that insulin levels go up after a meal indicates these remaining beta cells can respond to a meal in the normal way — it seems they are either immune to attack or they are regenerating,” Richard A. Oram, BMBCh, BA(Hons), MRCP, of the Royal Devon and Exeter NHS Foundation Trust’s Blood Sciences Laboratory at the University of Exeter Medical School, said in a press release. “The researchers used new technologies which are able to detect far lower levels of insulin than was previously possible. The levels are so low that scientists had previously thought no insulin was produced.”
Oram and colleagues conducted a mixed-meal tolerance test in 74 patients with type 1 diabetes (median age at diagnosis, 16 years), with a disease duration of 30 years.
C-peptide was detected at very low levels (>3.3 pmol/L) in 54 of 74 (73%) patients, according to data. C-peptide either increased (n=43; 80%) or remained the same (n=11) after a meal, with no signal of the levels falling (P<.0001) in patients with detectable levels, researchers wrote.
Furthermore, C-peptide levels remained high in patients whose disease continued for more than 30 years (68%), researchers wrote.
“We are now able to study this area in much more detail. By studying differences between those who still make insulin and those who do not, we may help work out how to preserve or replenish beta cells in type 1 diabetes. It could be a key step on the road to therapies which protect beta cells or encourage them to regenerate,” Oram said in the press release. “The next step is a much larger-scale study, to look at the genetics and immune systems of people still making insulin, and to answer the important question of whether the complications of type 1 diabetes are reduced in people with low levels of insulin.”
Disclosure: The researchers report no relevant financial disclosures.
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