“We will stop type 1 diabetes”: five highlights from ATTD 2024

In March, we went to the 2024 international conference on Advanced Technologies and Treatments for Diabetes (ATTD). Over four action-packed days, more than 5,000 attendees from 95 countries talked about the latest innovations in diabetes research and identified the most important areas for future research and access to treatments and technologies.

Our Research Communications Lead, Josie Clarkson, shares her insight into the key themes of the conference.

1. Early Detection

One of the main topics discussed was the benefits of detecting type 1 diabetes before symptoms begin. Identifying people in the early stages of developing type 1 gives us opportunities to treat people, potentially with new immunotherapies that can slow the progression of type 1 and improve long-term health outcomes. There are many other benefits of early detection, including reducing rates of diabetic ketoacidosis, improved quality of life, and cost-effectiveness for healthcare providers. Find out more in this article by JDRF UK CEO, Karen Addington.

Early detection projects around the world, like the JDRF co-funded ELSA study, are exploring the most effective and feasible ways to screen the general population for type 1 diabetes. We’re also leading a global group of 73 experts to develop an international consensus on how to carry out early detection. This includes how best to screen, who should do it, and how to support people during and after early detection tests.

2. Language matters

Using the right language featured in many sessions throughout the conference, demonstrating that healthcare professionals, researchers and people with lived experience all recognise the importance of the words we use.

Terms for early detection

As we move forward with early detection, the language used to refer to people who have begun to develop type 1 is crucial. We need to be clear when to use the words ‘at-risk’ of type 1 and when to instead say ‘early-stage’ or ‘presymptomatic’ type 1 diabetes.

If you have genes linked to type 1 diabetes, it means you are ‘at-risk’ of developing type 1 and may or may not go on to develop the condition. This is also true if you have one biological marker of type 1 (known as autoantibodies). Whereas, if you have two or more autoantibodies then the immune attack responsible for type 1 has started and you are in the earliest stages of the condition. This is ‘early-stage’ or ‘presymptomatic’ type 1 diabetes, which eventually progresses to clinical type 1 diabetes.

Find out more on our webpage about screening.

Talking about people living with type 1

In one of the first sessions of the conference, Professor Partha Kar tackled the issue of healthcare professionals and researchers using words like ‘non-compliance’, ‘non-adherence’ and ‘poorly controlled’ to describe people struggling to manage their type 1. These terms put blame on people with type 1 and dismiss how challenging the condition can be. Partha said: “As healthcare professionals, the one thing we should all do is be kind.”

Diabetes advocate Renza Scibilia, who works in the JDRF Global Access team, urged people to avoid referring to people with diabetes as ‘patients’. This is because it medicalises people, when they are only ‘patients’ for a small amount of the time they are living with type 1 diabetes.

Find more guidance on language and diabetes in NHS England’s Language Matters document.

3. Global parliamentary session

On the penultimate day of the conference, the Global Diabetes Advocacy Network (GDAN), a group dedicated to transforming diabetes policy, held an event for international parliamentarians with an interest in type 1 diabetes.

T1DE Parliamentary Inquiry

Sir George Howarth MP spoke about the Parliamentary Inquiry into type 1 diabetes and disordered eating (T1DE), which he co-chaired with our Global Health Ambassador, Rt. Hon Theresa May MP, and for which we provided support services. Sir George Howarth MP outlined the devastating impact T1DE has on around a third of people living with type 1, and the recommendations established in the report. He raised the key issue that there are no agreed-upon international diagnostic criteria for T1DE and urged the GDAN to help rectify this situation by raising awareness of T1DE with policymakers around the world.

Sir George Howarth MP ended his speech by saying: “For all of us, it’s personal, but it’s also about getting policy right. Let’s hope between us we can get a better and brighter future for people living with T1DE.”

T1D Global Index

Renza Scibilia took to the stage to speak about the global Type 1 Diabetes Index, a first-of-its-kind tool that measures the human and public health impact of type 1 diabetes around the world. She encouraged politicians to use the Index to identify attainable interventions in their countries and present these insights to policymakers to help change the lives of people living with type 1.

Renza said: “I do this for the 8.7 million people living with type 1 around the world and the 3.9 million people who should be alive today. Let’s claw back the healthy life years we lose to diabetes. We just want things to be easier, we’re not asking a lot.”

4. Immunotherapies

One of the many benefits of early detection of type 1 is that it enables us to intervene early to change the course of the disease using treatments, such as immunotherapies, which target the immune system.

On the final day, Professor Laura Jacobsen, explained that people who have received immunotherapies have a lower risk of hypos and retinopathy (eye problems) and have a prolonged honeymoon period. This is because the treatment can slow the progression of type 1 and delay or reduce the need for insulin therapy.

However, the way type 1 develops varies between individuals meaning different types of immunotherapies work best for different individuals. Laura said: “We need to reframe treatment of type 1 diabetes – we are currently not treating it as an autoimmune condition. Insulin is just a band aid for managing type 1.”

5. Cell replacement therapies

Throughout ATTD 2024, we heard lots about replacing the insulin-producing cells lost in type 1, which covers islet transplants from organ donors and those made from stem cells. This culminated in the final session of the conference, aptly named ‘Cure for diabetes’.

Islet transplants of donor cells have been used to allow people with type 1 to make their own insulin since 2000, but they come with significant risks. Currently, people who have islet transplants need to take strong immunosuppressant drugs. Researchers from around the world explained how they are devising innovative ways to overcome this challenge.

Encapsulation

Scientists are engineering ways to protect the new islets by encasing them in a protective coating, which is known as encapsulation. Researchers are exploring ways to either coating each islet, like a bubble, or put all the cells to be transplanted – which can be up to million – in a porous device that allows nutrients in and waste out but doesn’t let immune cells in. Dr Victoria Salem is developing this kind of device in her research project funded by the Type 1 Diabetes Grand Challenge.

Genetic editing

Another exciting research area is genetically editing islet cells before transplanting them. Removing the proteins on the surface of the cells stops the immune system from recognising them. One exciting study transplanted gene-edited islet cells from one primate into another which had type 1 diabetes, making it insulin-independent.

A message of hope

Professor Jay Skyler, a leading JDRF-funded stem cell researcher, said: “In past years, I’ve been the only person speaking about stem cell therapies at this conference, this year there have been three whole sessions! We have made much progress on islet replacement using stem cells. There are several challenges that remain, but there are ways forward to overcome them. Ultimately, we will succeed. We will stop type 1 diabetes.”