Progress against diabetes

A new analysis method could allow earlier detection of Type 1 diabetes, someday making treatment of the disease easier.

Along with a team of Yale researchers, Kevan Herold, professor of immunobiology at the Yale School of Medicine and principal investigator of the Yale Autoimmunity Center of Excellence, invented a new method to measure the genetic changes of insulin as the result of cell destruction caused by Type 1 diabetes. The study, published in the Early Online Edition of Proceedings of the National Academy of Sciences last week, is the first time that this type of method of tracking an illness has been used for diabetes research. According to Herold and his team, the research increases scientists’ understanding of the progression of Type 1 diabetes, and may eventually lead to an effective treatment for the disease’s harmful effects.

Type 1 diabetes is a chronic disease caused by an overactive immune system, which kills the pancreatic beta cells, which are responsible for producing the hormone insulin. Since insulin regulates the level of glucose in the body, a loss of insulin results in dangerously high levels of glucose. It is currently incurable and fatal in the absence of treatment, such as insulin injections.

Herold and his team devised an early detection method for the rate of beta cell death, before the body is overwhelmed by glucose, or hyperglycemic. Through an experimental method that tracks the amount of DNA that is released from beta cells that are killed due to Type 1 diabetes, the rate of cell death can be examined. While similar methods have been used to detect tumor-specific DNA in patients with cancer, Herold and his lab are the first to use this testing method in relation to diabetes.

“This type of measurement is essential for rationally designing interventions to prevent beta cell death,” Herold said. He added that while the test may be used to target early cases of diabetes, his lab is now examining DNA in individuals who are at risk but have not yet developed diabetes.

Eitan Akirav, who is currently a research scientist at Winthrop University Hospital on Long Island, worked to develop the technique as a postdoctoral researcher in Herold’s lab. He said that while mice were used in early experiments, the technique was later applied to human insulin.

Assistant professor of medicine Ben Stanger, who studies the mammalian pancreas and liver, said Herold’s research is important because it provides insight into how diabetes might be halted before it can severely harm the body.

“This is exciting because it suggests that it may be possible to detect those who are going to develop diabetes with a blood test, although scientists haven’t done this yet,” Stanger said.

He cautioned that determining whether this technique has predictive value would be difficult and require further tests.

While the study looked only at Type 1 diabetes, Herold said might the method might also work for Type 2, or adult-onset, diabetes. It could enable scientists to determine whether the insulin shortage that marks Type 2 diabetes is a result of losing beta cells, or whether there is another still unknown cause, Herold said.

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