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Type 1 diabetes could be defined as 2 subtypes, new research suggests

Type 1 diabetes could be defined as 2 subtypes, new research suggests

Researchers at the University of Exeter have demonstrated children who are diagnosed with type 1 diabetes under the age of 7 years old seem to have different forms of type 1 diabetes to those aged 13 and above.

The team, funded by Diabetes UK, studied 130 pancreas samples across three age groups, defined as: under 7 years old, 7-12 years old, and 13 years and above. The pancreas samples were stained so that insulin and proinsulin could be seen.

Insulin is a hormone which plays a key role in the regulation of blood glucose levels. Proinsulin is a precursor to insulin made in the beta cells of the islets of Langerhans.

It was noted that proinsulin was not processed properly in samples in the younger age group and was released at the same time as insulin. In the older age group, this was less common.

The research suggested that a blood test could be used to measure proinsulin and amount of insulin being produced, in order to determine if someone’s ability to process proinsulin, denoting the subtype of type 1 diabetes.

Researchers at University of Exeter proposed 2 different forms of type 1 diabetes:

  • Type 1 Diabetes Endotype 1 (T1DE1) for young children
  • Type 1 Diabetes Endotype 2 (T1DE2) for those who are older at diagnosis

A more precise ways to define which type of diabetes children is now being worked by, with the team studying the small amounts of insulin released into their blood.

Professor Noel Morgan, who worked on the study, said: “The significance of this could be enormous in helping us to understand what causes the illness, and in unlocking avenues to prevent future generations of children from getting type 1 diabetes. It might also lead to new treatments. This would be a significant step to find a cure for some people.”

Discussing the possibility of new treatments, fellow researcher Dr Sarah Richardson said: “We’re seeing a lot of promise in immunotherapies which can slow disease progression, but so far that hasn’t translated into effective new treatments. It could be that we need to focus on the use of different therapies in each age group, for these to be effective.”

Dr Elizabeth Robertson, Director of Research at Diabetes UK, add: “The era of being able to halt the immune attack behind type 1 diabetes is in reach, but to make new treatments as effective as possible we need to really get to grips with the complexity of the condition. Today’s news brings us one step closer to achieving that.

“Being able to make the distinction between different subtypes of type 1 diabetes is an exciting new development and we’re proud to have supported this landmark research. We now need to make sure this discovery is used to help design trials and tailor future treatments, so we can move closer to stopping and preventing type 1 diabetes.”

Read more: Studies of insulin and proinsulin in pancreas and serum support the existence of aetiopathological endotypes of type 1 diabetes associated with age at diagnosis

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