Type 1 diabetes is a chronic condition, in which the immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas – the beta (β)cells, leading to little or no insulin production.
For patients, this requires a lifetime commitment to careful monitoring and control blood sugar levels, making it a challenging medical condition that demands constant care and attention.
The current standard treatment for type 1 diabetes involves insulin administration, which regulates blood sugar levels.
Additionally, people living with type 1 diabetes may be required to make several lifestyle and dietary adjustments to ensure blood sugar levels are managed effectively.
Angela Sarmiento Betancourt, MD. at myTomorrows, a global healthtech company, specialising in clinical trial discovery and access, has shared her insights into current strategies and patient-centric research advancements for the treatment of type 1 diabetes.
Advances in Type 1 Diabetes Technologies
Continuous glucose monitoring (CGM) technology uses a device to measure a person’s glucose levels 24 hours a day.
Newer CGM systems aim to be more accurate and provide more data, enabling better tracking of blood sugar trends and making it easier for individuals to make informed decisions about their insulin dosages and lifestyle adjustments.
Artificial pancreas systems use continuous glucose monitoring (CGM) to measure blood sugar levels in real-time and adjust insulin delivery through a type 1 diabetes insulin pump automatically.
This technology aims to maintain blood sugar levels within a target range without the need for constant manual intervention.
Going beyond the artificial pancreas, fully automated AID (automated insulin delivery) systems offer enhanced blood sugar management.
These systems continuously deliver insulin based on sensor data, effectively maintaining basal insulin levels between meals and during sleep.
However, they may struggle to precisely adjust for fluctuations caused by meals, physical activity, stress, and sleep patterns.
Users must still manually adjust settings before meals and exercise, and incorrect inputs can lead to hypoglycemia or hyperglycemia.
Ideally, a fully automated system would reduce user error by autonomously determining insulin needs throughout the day, including pre-meal dosing, to maintain stable blood sugar levels.
Emerging therapies for T1 Diabetes
Researchers are actively exploring novel therapeutic approaches for the treatment of type 1 diabetes.
All the following therapies are still in the investigational stages, with ongoing research and clinical trials needed to evaluate their safety and effectiveness.
- Immunotherapy
Immunotherapy involves treating diseases by regulating the immune response.
In type 1 diabetes, this approach focuses on preventing the immune system from attacking insulin-producing beta cells in the pancreas, aiming to halt or reverse cell damage.
One example is the use of antibodies—proteins that the immune system produces to combat infections.
Scientists are developing modified antibodies in laboratories to specifically target and deactivate the immune cells responsible for destroying insulin-producing cells in the pancreas.
- Cell encapsulation
Cell encapsulation is another experimental approach for transplanting insulin-producing cells into people with type 1 diabetes without needing them to take immunosuppressive drugs.
This technique involves using semi-permeable membranes (thin biological sheets that allow certain molecules to pass through more easily) to protect transplanted cells from being attacked by immune system while allowing nutrients and oxygen to pass through.
- Stem cell transplantation
Stem cells are special cells in the body that can be obtained from different sources in the body and that have the ability to develop into many different cell types.
Through scientific techniques, it is possible to turn stem cells into continuously dividing cell lines.
Angela Sarmiento Betancourt
This means that cells from a single donor can give rise to trillions more. During stem cell transplantation, these stem cells are introduced to an individual with the objective of replacing damaged cells.
In type 1 diabetes, investigators are researching if this approach might help restore insulin-producing cells.
- Gene Therapy
Gene therapy involves introducing genes into cells to correct genetic defects or enhance cell function.
In the treatment of type 1 diabetes, this approach could be used to promote the growth and survival of insulin-producing cells or to deactivate genes that contribute to their destruction.
It is however important to note that gene therapy for type 1 diabetes is still in the early experimental stages, with a significant portion of the research being conducted in the laboratory.
- Further investigational therapies
Some clinical trials are exploring combining techniques, such as immunotherapy, gene therapy, cell encapsulation and stem cell transplantation, in order to try to maximise potential benefits of these approaches.
For example, one innovation involves combining cell encapsulation and stem cell transplantation.
In this technique, stem cells are encapsulated in devices designed to shield them from the immune system. This approach addresses two major problems:
- It provides an unlimited supply of insulin-producing cells by using stem cells.
- Encapsulation protects these cells from the immune system, eliminating the need for immunosuppression.
This combination seeks to utilise the strengths of both approaches, which could potentially enhance the effectiveness of stem cell therapies for type 1 diabetes.
Summary
The management of type 1 diabetes has shifted towards a more patient-centric model, emphasising continuous blood sugar monitoring, lifestyle adjustments, and the incorporation of cutting-edge insulin therapies and glucose monitoring technologies.
These advancements not only enhance patient autonomy but also streamline the constant vigilance required in daily type 1 diabetes management.
Alternative treatments for type 1 diabetes, currently in development, all look to improve patient quality of life.
Combining these techniques may enhance their effectiveness, however, more clinical trial investigation is needed to confirm their efficacy and safety.
