We take a look at some of the exciting diabetes research developments announced in December 2025, and what the findings could mean for people living with or affected by diabetes.
In this month's article:
- Common type 2 drugs linked with slower frailty in older people
- Using genetic risk to spot type 1 diabetes earlier in adults
- How GLP-1 drugs protect insulin-producing cells
Common type 2 drugs linked with slower frailty in older people
Older people with type 2 diabetes are more likely to become frail over time, which can affect strength, independence and overall health. New research, published in Diabetes Care, suggests that some type 2 diabetes drugs may help slow this process.
Researchers at Harvard University compared older people in the US who had just started one of four types of type 2 diabetes drugs.
- GLP-1 receptor agonists
- SGLT-2 inhibitors
- DPP-4 inhibitors
- sulfonylureas
They followed people for one year and measured changes in frailty using information from medical records. They found that people taking GLP-1s or SGLT-2s became frail more slowly than those taking DPP-4s. There was no difference in frailty progression for people taking sulfonylureas.
The slower progression of frailty was not mainly explained by fewer heart problems or side effects, suggesting these drugs may help in other ways.
The findings raise the possibility that GLP-1 receptor agonists and SGLT-2 inhibitors could help protect older adults with type 2 diabetes from becoming frail. However, this was an observational study based on health records, meaning clinical trials are needed to confirm whether these drugs directly reduce frailty.
Using genetic risk to spot type 1 diabetes earlier in adults
Researchers at the University of Exeter found that adults with a high genetic risk of type 1 diabetes are more likely to have early-stage type 1 diabetes. This suggests that genetic risk scores could help identify adults who should be offered further testing to find type 1 diabetes before symptoms develop and insulin therapy is needed.
Type 1 diabetes starts years before symptoms appear. This hidden phase is well understood in children but has been studied less in adults.
An immunotherapy drug called teplizumab has now been licensed in the UK to slow down the early stages of type 1 diabetes and delay the need for insulin treatment. To use teplizumab effectively, we first need better ways to identify adults who could benefit from it.
Dr Richard Oram and team investigated if genetic testing could help. They used a genetic risk score based on 67 small genetic changes linked to type 1 diabetes, developed with funding from Diabetes UK.
Researchers compared genetic risk scores from adults who had recently been diagnosed with type 1 diabetes to adults from the general population without diabetes. They found:
- Almost half of adults diagnosed with type 1 diabetes had a high genetic risk score.
- Adults with a high genetic risk score were more likely to have islet autoantibodies – markers which show the immune system is attacking beta cells. Having two or more autoantibodies indicates early-stage type 1 diabetes.
- Adults with a high genetic risk were about five times more likely to have early-stage type 1 than those at a lower genetic risk.
- Targeted autoantibody screening of adults with high genetic risk was much more efficient than testing everyone in the population. For example, testing high genetic risk adults found one early-stage type 1 diabetes case for every 90 people tested. Whereas testing the general population would need 430 tests to find one case.
This study suggests that using genetic information to guide type 1 diabetes screening could be a promising way to find the condition earlier in adults. But more research, including larger studies with people from more diverse backgrounds, is needed before this approach could be used routinely.
This study was published in The Lancet.
How GLP-1 drugs protect insulin-producing cells
Researchers at Imperial, with support from Diabetes UK, have discovered a previously hidden way that a family of type 2 diabetes drugs help protect the pancreas. The findings could help scientists develop better treatments in the future.
The study, published in Nature Communications, looked at how GLP-1 receptor agonists work inside insulin-producing beta cells.
GLP-1 drugs are already known to lower blood sugar levels by helping the body release insulin. But researchers have also seen that these drugs can help keep beta cells healthier for longer. Until now, it wasn’t clear exactly how this extra protection worked.
Normally, a drug attaches to a receptor on the outside of a cell and sends a message.
The Imperial team, led by Dr Alejandra Tomas, discovered that when a GLP-1 drug sticks to a receptor on a beta cell, the receptor doesn’t just stay on the outside of the cell. Instead, it moves inside the cell and acts like an internal communication system.
From there, the receptor sends helpful messages to the cell’s mitochondria, which are like tiny power plants that provide energy to keep the cell running.
By strengthening the mitochondria, the beta cells are better able to cope with stress and continue producing insulin effectively.
This discovery reveals an entirely new way in which GLP-1 drugs protect beta cells. The researchers also believe this communication system may allow the receptor to send signals to other parts of the cell, not just mitochondria. Understanding this could open up new ways to improve type 2 diabetes treatments.
Next, the research team want to find out whether this signalling system is disrupted in people with type 2 diabetes – and whether future treatments could restore it.
