World Diabetes Day is marked every year on the 14th November, a date chosen to coincide with the birthday of Sir Frederik Banting, who, along with Charles Best, discovered insulin in 1922.
Insulin, a hormone made by the pancreas, is a key player in diabetes. Insulin is required to maintain blood glucose homeostasis. It is produced by beta cells in the pancreas in response to high glucose levels in the blood stream. Insulin then signals to liver, muscle and fat cells to take in this glucose to maintain a constant blood glucose level. Diabetes is a chronic condition in which blood glucose homeostasis is impaired or lost due to either the loss of insulin producing beta cells (Type 1 Diabetes) or when the beta cells become progressively dysfunctional (Type 2 Diabetes). The absence of insulin results in hyperglycaemia, which, when improperly managed can be fatal, and many secondary complications including those affecting the eyes, nerves, kidneys and cardiovascular system can arise.
There are 2 main types of diabetes:
- Type 2: This type of diabetes accounts for at least 90% of cases of diabetes, and often goes undiagnosed for a long time. Sufferers are unable to control their blood glucose concentration due to insulin resistance, in which the receptors responsible for detecting insulin are no longer responsive to normal insulin levels. Additionally, the cells producing insulin become damaged and therefore insufficient insulin is produced to meet the body’s demands. However, in the majority of cases Type 2 diabetes can be managed through changes in diet and exercise. Unfortunately, for others drug treatment is likely to be required.
This year, the theme of World Diabetes Day is “Protect Your Family”. They are aiming to raise awareness of the signs of diabetes as well as how to prevent type 2 diabetes and how to manage living with diabetes.
Key habits to adopt to try to prevent and/or manage Type 2 diabetes:
- Eating healthy
- Regular physical activity: Being active – 30 to 60 min moderate or 15 to 30 mins of vigorous aerobic activity.
- Losing weight if you are overweight
- Avoiding sitting still for long time periods
For more information about Type 2 diabetes visit https://worlddiabetesday.org/
- Type 1: Type 1 diabetes is an autoimmune disease, in which the body’s own immune system attacks the insulin producing cells in the pancreas. Little or no insulin is produced and therefore must be injected daily to control the levels of glucose in the blood. Type 1 diabetes is fatal without regular injections with insulin. It is not fully understood why the autoimmune reactions against insulin producing cells occurs.
The current most common treatment for type 1 diabetes, injection of insulin, only ameliorates the symptoms of the disease by lowering or normalising blood glucose levels. The goal of the large-scale research imitative RESTORE is to move beyond merely treating the symptoms of a disease, to actually cure those diseases currently deemed “incurable”. Transplantation of islets can normalise blood glucose levels for several years, although in most cases, supplemental insulin is also required. However, islet donors are very scarce and the transplanted cells often evoke an immune response, therefore transplantation is only reserved for a subset of diabetes patients. Thus, it is necessary to develop methods of producing unlimited reserves of functional pancreatic insulin producing beta cells. Huge progress has been made in the area of stem cell derived beta cells that behave as endogenous beta cells , and there is already an ongoing clinical trial investigating the safety of transplanted stem cell derived pancreatic progenitor cells (https://clinicaltrials.gov/ct2/show/record/NCT03163511). Additionally, in parallel, research into pancreatic tissue engineering is also ongoing to improve islet cell engraftment and function and to protect transplanted cells from unwanted immune responses . The continued development of Advanced Therapies for treatment of diabetes highlights the importance of foundational research  to inform the development of and ensure the future progression of stem cell products onto the market and their availability to patients. RESTORE aims to support the entirety of this Advanced Therapies pipeline, from the bench to the bedside, to accelerate the development and availability of these therapies to patients. Veres, A. et al. Nature 569, 368–373 (2019)  J Tissue Eng. 2019 Jan-Dec; 10: 2041731419884708.
https://journals.sagepub.com/doi/pdf/10.1177/2041731419884708 Int. J. Mol. Sci. 2019, 20, 5417; doi:10.3390/ijms20215417