How close we are for the cure of diabetes?

How close we are for the cure of diabetes?

Diabetes also known as diabetes mellitus is a group of metabolic disorders characterized by high blood sugar levels over a prolonged period of time. Diabetes has become endemic sentencing over 422 million people worldwide to lifelong medication. It has become the major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation. Science is striving to find the cure for this endemic. Buthow close we are?

Despite there is a huge impact, there is still no cure for any type of diabetes. The biotech industry has seen this opportunity and is striving to develop new diabetes treatments and chasing the holy grail: a cure. Let’s have a look at what’s brewing in the field and how it will change the way diabetes is treated.

Cells can change identity 

Researchers at University of Bergen in collaboration with other researchers has discovered that glucagon producing cells in the pancreas can change its identity. They have the capability to change their identity and adapt so they do the job their neighboring cells when they are damaged or missing insulin cells. They came to know that it is not passive process, but is a result of signals from the surrounding cells. In the study, researchers were able to increase the number of insulin producing cells to 5 per cent by using a drug that influenced the inter-cell signaling process. Thus far, the results have only been shown in animal models.  "We are possibly facing the start of a totally new form of treatment for diabetes, where the body can produce its own insulin, with some start-up help," says Researcher Luiza Ghila. 

"If we gain more knowledge about the mechanisms behind this cell flexibility, then we could possibly be able to control the process and change more cells' identities so that more insulin can be produced, " Ghila explains.

Replacing missing cells with cell therapy

Cell therapy is one of the biggest hopes towards developing a cure for diabetes, especially for type 1 diabetes. Replacing the missing insulin- producing cells could potentially recover normal insulin production and cure patients. However, early attempts to transplant pancreatic cells have largely failed, mostly due to immune reactions that reject and destroy the implanted cells. The lack of donors is also a limitation.

One of the most advanced alternatives comes from the Diabetes Research Institute in the US, which is developing a bioengineered mini-organ where insulin-producing cells are encapsulated within a protective barrier. In 2016, the DRI announced that the first patient in Europe treated with this approach in an ongoing phase I/II trial no longer requires insulin therapy. 

“This can be the beginning of a new era in islet transplantation. Our ultimate goal is to prevent the need for life-long anti-rejection therapy,” stated Camillo Ricordi, Director of the DRI.

Attacking the origin with immunotherapy

In type 1 diabetes immune system progressively attacks the pancreatic beta cells which are responsible for insulin production also known as insulin producing cells. Stopping this process early enough could preserve the cells and provide cure.

With this goal, Imcyse, a Belgium company running a clinical trial with an immunotherapy designed to stop type 1 diabetes by specifically killing the immune cells that destroys the pancreas. 

Early after diagnosis, between 3 to 6 months, it is estimated that around 10% of the insulin-producing cells are still alive and producing insulin. After stopping the autoimmune process, the remaining beta cells would be protected and could continue producing insulin,” Pierre Vandepapelière, CEO of Imcyse, told me.

ActoBio Therapeutics, a company in Belgium, is now running a phase I/II clinical trial with an unusual approach to stop the progression of type 1 diabetes. The company uses cheese-producing bacteria to deliver two drugs that stimulate regulatory T cells to instruct the immune system not to attack insulin-producing cells.

“It is potentially a safe oral treatment that will be given for a limited period of time and could lead to patients who develop type 1 diabetes not needing to use insulin, or delay the need for insulin after diagnosis” said Pieter Rottiers, CEO of ActoBio.

Diabetics researchers are making great progress in understanding the basic of science of diabetes. Many findings have already proceeded on the road to new treatments. For every new strategy that succeed, the benefit to millions of people will be huge.