A practical cure for Juvenile diabetes focuses on results, not potential research pathways. However, any project that is likely to yield a practical cure for the condition is welcome. Although reversing juvenile diabetes would be an ideal outcome, a practical cure encompasses maintenance therapy and periodic treatment.
Therefore, a practical cure research project for the condition draws on a very wide range of possible research projects and pathways. Currently, there are 4 wide research projects in development that could deliver a practical cure. Even though each approach has the potential to yield a cure by itself, it’s also possible that a practical cure will require a combination of various elements from different research pathways. The 4 broad research projects are
1. Transplantation of Pancreas and Islet Cells
Several hundred islet cell transplants have already taken place and the success rate of the procedure has been steadily improving and could soon rival kidney transplantation’s success rate!
Such transplants usually depend on suppressing the system to prevent rejection. However, immune suppression has side effects that rival the complications of diabetes.
On the other hand, transplantation of islet cells requires solutions to protect the cells from attack by the immune system. The main approach to protect the islet cells has been encapsulating the cells in implantable devices that act as physical barriers between the immune attack and islet cells. Despite extensive research, various encapsulation methods have been tested with limited success
2. Biomechanical Devices that Mimic the Pancreas
Researchers are developing an artificial pancreas that combines an insulin pump, a glucose sensor, and a computer that regulates the pump speed. A device incorporating a glucose sensor and an insulin pump is already being used by many diabetes patients around the globe, and this research field is progressing at a very fast pace.
One of the main problems is that most glucose sensors are not sufficiently sensitive, stable, and accurate. To deliver a practical cure, the device would require a closed-loop system that is reliable, stable, and adaptive to each patient. Also, studies suggest that a glucose sensor alone cannot regulate the pump in the absence of accurate information about calorie intake.
3. Glucose-Responsive Insulin
This pathway aims at developing “smart insulin” in the sense that the insulin is only activated in response to rises in glucose levels. The insulin would remain inactive until the chemical compounds around the insulin detect that blood glucose level has risen above a certain point in order for the smart insulin to kick in and bring blood glucose levels down.
The glucose-responsive insulin would become inactive once the blood glucose level reaches a normal point, thus preventing low blood sugar.
4. Modifying the Immune System
This pathway aims to stop the immune system from attacking beta cells. The three main approaches to modifying the immune system are:
- Blocking
This is a direct way to stop juvenile diabetes by stopping the autoimmune attack without compromising the body’s ability to fight infection and disease. In order for this approach to provide a practical cure, the body needs to have sufficient residual beta cells that could multiply, mature, and produce enough insulin after the attack is stopped.
- Balancing
Some scientists believe that type 1 diabetes develops when the immune system becomes unbalanced. This means either the body is producing very few regulatory T-cells (which keep killer T-cells in check) or too many killer T-cells (which fight disease and kill beta cells in T1D). Balancing involves an approach that aims at restoring the balance between regulatory T-cells and killer T-cells.
- Retraining
This approach involves retraining the body’s immune system not to attack and kill beta cells. It may be possible to take immune system cells and retrain them not to attack islet cells, either by a mechanized approach that involves taking, treating, and reinserting immune system cells in the blood or by exposure therapy (periodic injections).
While juvenile diabetes can be effectively controlled, decades of extensive research have not yielded a permanent cure. An ideal cure for diabetes would be to get rid of the cause, but a more practical approach is to maintain normal blood sugar levels without the need for insulin injections.
