Diabetes remedy – from insulin to transplants

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This year marks the 100th anniversary of the discovery of insulin. Diabetes, which had previously led to certain death, suddenly became treatable. Since then, insulin drugs and methods of measuring blood sugar have improved. In the future, the researchers hope to be able to cure the disease with stem cells.

Insulin is a vital hormone that regulates blood sugar levels and helps cells absorb nutrients. If your body cannot produce insulin, you will develop diabetes. Prior to the discovery of insulin in 1921, the disease amounted to a death sentence and patients disappeared within months. However, when it became possible to inject the hormone, the patients lived several years longer.

“Insulin was first given to a person in January 1922. The patient who was treated first, a boy, survived for 13 years. It was absolutely amazing. In the same year, the first commercial compounds with insulin became available, ”says Per-Ola Carlsson, Professor of Medical Cell Biology at Uppsala University.

Insulin was improved

Per-Ola Carlsson, Professor of Medical Cell Biology.

Photo: Mikael Wallerstedt

Initially, the researchers used animal pancreases to produce insulin. They didn’t start producing human insulin using E. coli bacteria until the 1970s. When more synthetic insulin arrived in the 1980s, it was possible to alter the molecular structure so that the hormone was absorbed faster or slower to better suit the patient’s needs.

Insulin isn’t the only thing that has been improved. Great advances have also been made in the techniques for delivering the hormone into the body and in the methods of measuring blood sugar levels.

“We have started to develop techniques in which glucose sensors and insulin pumps communicate continuously so that the glucose concentration in the blood regulates the insulin infusion. With these closed-loop insulin pumps, patients do not have to give themselves insulin injections. The system sensors keep the right level, ”says Carlsson.

Revolutionary Treatments

Future diabetes treatments could be just as revolutionary as the introduction of insulin. Researchers around the world are working to ensure that the disease can be cured in the not too distant future.

“The strategies that are being tested to prevent type 1 diabetes include working with immunomodulatory therapies that stop the development of diabetes. Other strategies replace the damaged insulin cells in the pancreas with new cells, ”says Carlsson.

When tissue is transplanted from another individual, it can be difficult for the body’s immune system to accept the new cells and not destroy them. This can be prevented with medication, but these have serious side effects. As a result, Per-Ola Carlsson’s research team is developing a transplant method that does not require immunosuppressive drugs.

Transplant cells

Insulin-producing cells obtained from a skin biopsy

which has been transformed into immature trunk

Cells and then differentiated into insulin-producing

Cells.

“We now have strategies to develop insulin-producing cells from the patient’s own tissue – for example a skin biopsy – and reverse their development to convert them into insulin-producing cells. This has been shown to be feasible in animal experiments, but has not yet been transferred to humans, ”says Carlsson.

He believes that in 10 to 15 years it may well be possible to transplant insulin-producing cells from stem cells for use in patients.

“A lot of companies are developing this in parallel and we hope that by working together we can come first,” says Carlsson.

The Diabetes Center brings research together

Although there is extensive research into diabetes, more knowledge is needed to fully understand the various diseases that make up the concept of diabetes. For example, we don’t clearly understand what causes type 1 diabetes and why it affects more and more people. To make the topic more multidisciplinary, Uppsala University set up the Uppsala Diabetes Center in collaboration with the Swedish University of Agricultural Sciences (SLU) earlier this year. Different research areas work together to develop new knowledge about one of our most important widespread diseases.

“You can draw a parallel with the development of insulin, where a surgeon and then a chemist worked together in experimental studies and clinical studies. We need many types of expertise for development, ”says Per-Ola Carlsson, one of the initiators of the center.

Åsa Malmberg