Cure research

Is there a cure for type 1 diabetes?

A cure for type 1 diabetes means different things to different people. In terms of biology, a cure for type 1 must do two things:

• stop the immune system destroying the cells that make insulin
• replace the insulin-producing cells which have been lost

While we don’t have a cure yet, our researchers are working on lots of different ways to develop one. Explore our current cure research projects to discover more about how our world-class scientists in the UK are working on cures for type 1.

Which cells make insulin?

Specialised cells in the pancreas called beta cells make and release insulin. They are found in clumps of around a hundred cells in the pancreas, called the Islets of Langerhans – or islets for short.

A large part of the cure research we fund is about understanding beta cells and islets. This includes how they grow, how they stay healthy and how we can give new cells to people with type 1.

Find out more about beta cells.

Can we replace damaged beta cells?

Islet transplants from donors

Islet transplants take islets from organ donors’ pancreases and put them into people who are really struggling to manage their type 1. Islet transplants allow the recipient to live without giving themselves insulin or managing their blood glucose levels.

But islet transplants are a last resort because people who have received islet transplants need to take immunosuppressant drugs so that their bodies don’t attack the new cells. These drugs make people incredibly vulnerable to infection and disease. Plus, the transplanted islets gradually decline in function, so people need multiple transplants over their life. With a shortage of pancreas donors, this means very few people can benefit from islet transplants.

With the Medical Research Council, we are co-funding a clinical researcher called Daniel Doherty to make islet transplants work better, for longer, so they can help more people with type 1.

Growing new beta cells in the lab

To combat the lack of donor islets, some researchers are trying to grow beta cells in their labs. They are using stem cells, which are cells that can develop into other cells, including beta cells.

For years, we funded a researcher called Professor Doug Melton who pioneered the process of growing beta cells from stem cells. He is now part of the team at Vertex Pharmaceuticals who are giving people with type 1 these lab-grown beta cells in clinical trials.

We are currently funding Dr Rocio Sancho and Dr Fiona Docherty, who are both trying to grow highly functional beta cells in the UK.

How can we stop the immune system attacking beta cells?

If people with type 1 receive replacement beta cells, their immune system is still primed to destroy these new cells. To cure type 1, we also need to find ways to stop the immune attack. Our researchers are trying different ways to protect beta cells from the immune attack from retraining the immune system to hiding beta cells in protective coatings.

Immunology research

The immune system is finely tuned and can usually regulate itself so that it doesn’t attack healthy tissue in the body. This system goes awry in type 1 diabetes, but we don’t yet understand why.

UK researchers are currently developing treatments that will help to cure type 1 – and prevent it too. Clinical trials have shown that seven drugs that target the immune system (known as immune therapies or immunotherapies) can slow the progression of type 1.

Find out more about immunotherapies and our immune therapy research.

Encapsulation: hiding beta cells from the immune system

Encapsulation means putting precious beta cells in a protective casing before giving them to people with type 1. The capsules around the beta cells protect them from the immune system, working a bit like a sieve. Tiny holes in the coating allow nutrients to fit through, enabling the cells to live and work well. But the holes are not wide enough to allow anything as big as an immune cell to get inside.

Vertex Pharmaceuticals (the company making beta cells from stem cells) are developing an encapsulation system to protect their beta cells, which they are currently testing in clinical trials in the US and Canada.

We are co-funding Dr Victoria Salem’s Senior Research Fellowship as part of the Type 1 Diabetes Grand Challenge, in which she is developing a jelly-like device linked to a blood supply to enclose beta cells within. Read more about Dr Salem’s encapsulation research project.

Regeneration: Can we regrow people’s own beta cells?

Regrowing beta cells would mean getting cells in the body to produce insulin. This could be encouraging them to regrow new beta cells or reprogramming other cells to make insulin.

Reprogramming other pancreatic cells to make insulin

Research shows that another type of cell which grows alongside beta cells in the islets, called alpha cells, could be reprogrammed to make insulin. Alpha cells make the hormone glucagon and are undamaged by the immune system in type 1 diabetes, so people with type 1 still have plenty of them.

As the cells are very similar in how they develop and how they work, ‘switching’ these cells into beta cells may be more straightforward than using another cell type. Breakthrough T1D UK-funded researchers in Australia have made another type of pancreatic cell, called ductal cells, release insulin. Learn more about this research.

Turning beta cell replication back on

Throughout life there are times when we need to grow more beta cells – for example as we grow from childhood to adulthood, or during pregnancy.

We know that people with type 1, even those who’ve lived with it for many years, have some beta cells remaining. These cells make a perfect target for attempting to regenerate the cells that were lost. So, researchers are trying to find the natural triggers that control beta cell growth and use them to turn the system back on in people with type 1.

We are co-funding Dr James Cantley’s Type 1 Diabetes Grand Challenge project to regrow beta cells directly in the pancreases of people with type 1 diabetes. Read more about Dr Cantley’s regeneration research.