Study shows type 1 diabetes early diagnosis may be possible

A breakthrough discovery could see type 1 diabetes being diagnosed before symptoms kick in which may help with efforts to delay development of the condition, researchers have said.

In most cases, type 1 diabetes is usually identified following symptoms such as extreme thirst, excessive urination and tiredness, all of which are a result of hyperglycemia (high blood glucose).

A team from the Scripps Research Institute in America have found a way to test whether someone may be at risk of type 1 diabetes.

Their findings involve immune-regulating molecules called human leukocyte antigens (HLAs). Researchers have previously linked their presence to a breakdown of the immune system.

Blood samples taken from non-obese mice modelled to have a form of type 1 diabetes were analysed in a series of experiments over the course of five years.

CD4+ T cells are immune cells that, in type 1 diabetes, can incorrectly identify the body’s own insulin as a foreign agent, and bring about the destruction of the pancreas’ insulin-producing beta cells.

The research team discovered a structural mechanism, which they called the ‘P9 switch’, that enables CD4+ T cells which enables CD4+ T cells to spot the mutated HLA protein and attack the beta cells. The researchers observed that the P9 switch resulted in an anti-insulin response before it quickly disappeared.

If the process is found to be the same in humans, this could allow researchers to detect type 1 diabetes very early o, which could allow for interventions to delay type 1 diabetes at an early stage.

Lead researcher Luc Teyto, professor of immunology and microbiology at Scripps Research, said: “The translational aspect of this study is what’s most exciting to me.

“By using single-cell technologies to study the prediabetic phase of disease, we have been able to mechanistically link specific anti-insulin T cells with the autoimmune response seen in type 1 diabetes. And that has given us the confirmation we needed to move into human studies.”

Prof Teyton has secured approval to conduct a study in humans that are at high risk of type 1 diabetes. The study will involve collecting blood samples and looking for early signs indicating early development of type 1 diabetes.

The findings have been published in the Science Immunology journal.

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