To date there is no proven way to prevent juvenile or type 1 diabetes.

Promising developments to prevent and reverse type 1 diabetes

In a recent study published in the journal Diabetes, researchers injected special immune cells called dendritic cells into diabetic and pre-diabetic mice. The study found that one injection significantly delayed the onset of juvenile or type 1 diabetes, while eight consecutive injections prevented the disease entirely. In addition, the injection of these cells appeared to reverse type 1 diabetes in mice that recently developed the disease.

“It's quite promising,” says Dr Hans-Michael Dosch, Senior Scientist of Neurosciences and Mental Health at the Hospital for Sick Children and Professor of Immunology & Pediatrics at the University of Toronto. While optimistic the research may in the end be useful in the future treatment of humans, Dr Dosch cautions the research is still in the early stages of development. “However, it's innovative” and deserving of further study, he says.

Immature dendritic cells help regulate the immune system
Dendritic cells, found naturally in the immune system, help regulate immune function. In their immature form, that is to say before they take their final shape and serve their final function, dendritic cells have shown to suppress parts of the immune system. For this reason, they have been studied with the hope of improving treatments for several autoimmune diseases such as lupus and diabetes.

Typically in these studies, dendritic cells are collected either from donors or from the patient himself, and then injected into a concentrated area of the patient’s body. However, researchers have had difficulty keeping the dendritic cells immature. Three different proteins were found to stimulate dendritic cell maturity: CD40, CD80, and CD86. Because of this, the effectiveness of dendritic cells as a treatment was greatly reduced. 

New delivery system keeps dendritic cells immature
What is unique to this new study is that the immature dendritic cells were combined with a series of short gene sequences designed to “shut off” CD40, CD80, and CD86. These gene sequences ensured that the dendritic cells stayed in their immature form. Researchers found that injecting this cell/gene combination just under the skin near the pancreas of diabetic and pre-diabetic mice could not only prevent type 1 diabetes, but also reversed new-onset disease. 

The explanation for this reversal is that newly diagnosed patients still have some functional beta cells that can produce insulin in response to increased blood glucose levels. By acting early, these cells may be preserved and able to resume normal function once the body’s autoimmunity has been controlled. The ultimate hope is that this process will cure type 1 diabetes.

“I think it’s a little too early to say whether this treatment will cure diabetes, but it inherently has a lot more promise than a lot of other diabetes research,” says Dosch, who is less optimistic on the technique eventually leading to a cure. Since only up to 15% of patients can be identified as being high risk for the disease through a first-degree family member, “the prevention of type 1 diabetes may be difficult.” However, if this technique can effectively treat new onset cases, “then the target population will be much more impressive.” 

Dosch says another major challenge “will be to make sure that patients do not develop subtle immune deficiency.” In other words, for the treatment to be effective, it must reverse diabetes without dangerously affecting other areas of the immune system. To determine safety in humans, a preliminary study is currently being conducted on adult patients with type 1 diabetes.