Our annual professional conference (DUKPC) is up and running. Thousands of healthcare professionals and scientists have gathered in Liverpool to dig into what’s new and next in diabetes care and research. Here are some of the research highlights emerging from the conference so far.
Creating the right conditions for transplanted beta cells
In a collection of studies from the Type 1 Diabetes Grand Challenge, researchers shared important advances in understanding how to improve the survival, function and availability of insulin-producing beta cells for transplantation.
This is a major focus of the Grand Challenge’s ambition to find transformative treatments and cures for type 1 diabetes sooner.
Type 1 diabetes destroys insulin‑producing beta cells found in clusters in the pancreas, called islets. Replacing these cells using islets from a donor pancreas or lab‑grown beta cells could help restore insulin production. But keeping transplanted beta cells alive and working remains a major challenge.
Across three linked laboratory studies, researchers at King’s College London led by Professors Shanta Persaud and Aileen King explored how supportive cells, called mesenchymal stromal cells (MSCs), could help overcome these barriers. MSCs are found in tissues such as bone marrow or fat. They act as ‘helpers’, supporting other cells by releasing protective signals and substances.
In the first study, Dr Lydia Daniels Gatward showed that MSCs can help rebuild the natural support structure of islets, much of which is lost during the process of preparing them for transplantation.
When MSCs were combined with islets, they produced key support proteins that helped the islets release insulin more effectively and respond better to glucose in the lab. This could make transplanted islets stronger and better able to cope with stress after transplantation.
In a second study, Dr Tzuwen Hong showed that MSCs release tiny particles that carry helpful messages to beta cells. When islets were exposed to these particles, they released more insulin and were better protected from damage caused by inflammation. This suggests these particles, rather than whole MSC cells, could potentially be used to give a simpler way to protect transplanted islets.
In a third study, Rosie Sullivan focused on beta cells built from stem cells. These lab-grown cells could one day solve the supply shortage of donor islets, but they're currently less effective. The researchers found that treating lab-made beta cells with helpful substances released by MSCs reduced cell damage and increased insulin production.
Together, these studies are building a picture of how and why MSCs can help fragile donor or lab-made beta cells survive and function better at a critical moment.
While this research is still at an early laboratory stage, it marks an important step towards improving the future success of beta cell replacement treatments, which would be life-changing for people with type 1 diabetes. And demonstrates the exciting momentum and progress emerging from our Type 1 Diabetes Grand Challenge community.
Protecting the heart in type 2
People living with type 2 diabetes who’ve had a heart attack face a high risk of further serious heart complications. This risk is driven in part by inflammation in the body in the weeks and months after.
In the Early-Career Investigator Award session, University of Lincoln PhD student Joanna Ward presented her research exploring whether a type 2 diabetes medication - the SGLT2 inhibitor empagliflozin - could help to limit this harmful inflammation.
Joanna and her Diabetes UK-funded supervisors investigated empagliflozin's effects on inflammation levels in immune cells from 55 people with type 2 diabetes who'd had a heart attack. They compared samples from people who began empagliflozin within 90 days of their heart attack with those who started treatment later, or not at all.
The results showed that empagliflozin significantly reduced key inflammatory markers, including those linked to inflammation that’s known to drive heart damage.
They also found that levels of inflammatory markers were lower in people who'd started empagliflozin early compared to those who hadn't yet taken it. And by 180 days, people who'd started empagliflozin earlier continued to show lower levels of inflammation than those who'd started it earlier.
These findings suggest that early treatment with SGLT2-inhibitors like empagliflozin soon after a heart attack may help lower inflammation during a critical high-risk period. And this could potentially reduce risk of further heart damage in people with type 2 diabetes.
Reduced calorie diet is manageable for women with gestational diabetes
At last year’s DUKPC, Professor Claire Meek announced results from the pivotal Dietary Intervention in Gestational Diabetes (DiGest) trial, funded by us. It showed that a reduced calorie diet in late pregnancy is safe and beneficial for women with gestational diabetes who are living with overweight or obesity.
The findings lay the foundation for new clinical support that could help thousands of women with gestational diabetes avoid the challenges of insulin treatment and improve health for them and their babies. But even the most effective interventions won't work in practice unless they are acceptable and practical for people with diabetes.
At this year's conference, Dr Laura Kusinski shared qualitative research from the DiGest trial. The researchers interviewed 20 DiGest participants to find out how women with gestational diabetes actually feel about the reduced calorie diet during pregnancy.
The interviews revealed six key themes in the women’s experiences. For example, women valued support and reassurance and relayed how managing gestational diabetes takes a toll on their emotional and mental health.
Women were motivated to try the DiGest intervention because they felt supported, wanted to avoid taking diabetes medication, like insulin, during their pregnancy, and found the meal deliveries convenient. But they also highlighted barriers, which included feeling uncertain about the effectiveness of the diet and eating in social situations.
Overall, the study revealed that pregnant women with gestational diabetes find a reduced calorie diet manageable and beneficial to their emotional and physical health - especially with support from healthcare professionals in place. This reinforces its potential for use in routine care to help more mothers experiences a healthy pregnancy, give birth to healthy babies, and reduce their risk of type 2 diabetes in the future.
