2020 probably isn’t a year many of us will look back over fondly, but this year has truly highlighted the power of science and the incredible, life-saving breakthroughs it can bring.
Despite the challenges this year has brought, Diabetes UK-funded scientists and diabetes researchers across the globe have been making some incredible things happen. Here’s a look back at some of 2020’s research highlights.
January: Making islet transplants better
Islet transplants, where doctors transplant pancreas cells from a donor into people with type 1 diabetes, already exist. They can help people to temporarily produce their own insulin again, but they fall short of a cure.
Our researchers at the University of Edinburgh pioneered a new method, involving transplanting pancreas cells together with structural cells from umbilical cords - known as stromal cells. They found that when mice with diabetes received this new type of islet transplant they had better blood glucose (sugar) levels and were less likely to reject the transplant, compared to islet transplants without stromal cells.
It’s a promising step forward, which could lead to islet transplants becoming more effective and more widely available in the future.
February: Bringing back hypo awareness
Some people with diabetes can stop noticing when their blood sugars go too low, but we don’t fully understand why. Our researcher Dr Catriona Farrel found out that it could be down to habituation. This is when the body ‘gets used’ to low blood sugar levels and doesn’t respond in the same way after repeated hypos.
She discovered that introducing a ‘shock’ to the system, by giving people with type 1 diabetes a session of high intensity exercise, could override this response and reset how their brains adapt to hypos. We’re funding Dr Farrell to do a longer-term clinical trial, but this study hints that exercise could offer a new, simple way to help people with type 1 diabetes get their hypo awareness back.
March: Splitting type 1 into two
Researchers we co-funded showed for the first time that children who are diagnosed with type 1 diabetes under the age of seven appear to have a different form of the condition to those diagnosed aged 13 or above.
The team at the University of Exeter studied pancreas samples. They discovered that in younger children more immune cells had invaded the pancreas and not many insulin-making beta cells had survived. But in samples from people diagnosed over the age of 13, there were fewer attacking immune cells and they had more beta cells that were still producing insulin.
Our researcher, Professor Noel Morgan said:
“The significance of this could be enormous in helping us to understand what causes type 1 diabetes, and in unlocking avenues to prevent future generations of children from getting the condition."
April: World’s first artificial pancreas app
Developed by Professor Roman Hovorka and his team at the University of Cambridge, the world’s first licensed artificial pancreas app is backed by 13 years of research funded by our charity, JDRF and others.
To start out with, the app is being supported by a small number of diabetes clinics in the UK and is available to buy on subscription. But the researchers behind it hope that it will one day be available to anyone with type 1 diabetes who could benefit from it. They also hope it will work with a wider range of pumps and continuous glucose monitors.
Professor Hovorka said: “This is a major stepping stone towards providing widely available, clinically proven, and user friendly artificial pancreas technology.”
May: Early signs of type 2 risk
The team used a genetic risk score to pinpoint people who were at a higher risk of developing type 2 and then looked for differences in their metabolism. They found changes in levels of ‘good’ cholesterol began in children who had a high genetic risk of type 2 as early as 8 years old.
In the future, insights like this could mean we’re able to spot who is at a higher risk and - most importantly - find ways to reduce this risk much earlier in a person’s life than we’re able to today. This means we could potentially prevent more people from developing type 2 diabetes at all.
June: Delaying type 1 diabetes
In June, 12,500 scientists and healthcare professionals came together virtually to share the very latest on diabetes care and research at the 80th American Diabetes Association Scientific Sessions.
One of the highlights of the conference came from TrialNet scientists, who are working to find ways to prevent type 1 diabetes. They gave us an update on their breakthrough clinical trial, which showed for the first time that type 1 diabetes can be delayed.
Their latest result show that 78% of people who received a dummy (or placebo) drug had been diagnosed with type 1 diabetes during the trial and it took an average of two years for them to develop type 1.
This compares to only 50% of participants who were treated with an immunotherapy drug called teplizumaub, who took an average of five years to advance to a type 1 diagnosis. That’s an extra three years without type 1 diabetes, free from testing your blood sugar, carb counting, injections, hypos and the emotions that come with living with the condition.
July: We funded new research into coronavirus
We announced that in partnership with JDRF, Moorfields Eye Charity and Fight for Sight, we're committing over £400,000 to support five new research projects that will help to drive forward our understanding of the impact of coronavirus on people with diabetes.
You can read more about all five projects and how they will help us to better provide the care, information and reassurance people with diabetes need during the pandemic.
August: Unlocking immunotherapy secrets
Our researcher Professor Lucy Walker discovered that by looking at a particular type of immune cell we can predict which people with type 1 diabetes will benefit from a type of immunotherapy, called abatacept.
Previously, we’ve known that the immunotherapy worked really well for some people, but in others appears to have no effect at all. Professor Walker's findings open the way for scientists to able to tell who will respond to abatacept. This means they can invite the right people onto clinical trials, giving us hope that we could see this treatment made available to people with type 1 who would be most likely to benefit. This would be a huge leap forward in how we treat type 1 diabetes and in changing lives.
September: Remission restores pancreas size
We’ve known for some time that the pancreas in people with type 2 diabetes is smaller and more irregularly shaped than in people without the condition. But it’s never been clear whether this is reversible.
To learn more about what happens to the pancreas when people with type 2 diabetes go into remission, our DiRECT researchers used MRI scans to measure the size and shape of the pancreas in a subgroup of their participants.
After two years on the weight management programme, the size of the pancreas had increased by 20% in people who were in remission - returning to almost normal size - and their pancreas shape was completely restored. But in people who did not go into remission, the increase in pancreas size was far smaller and the pancreas shape showed little change.
This is the first evidence we have that remission of type 2 diabetes helps to restore the health of the whole pancreas, unlocking answers about how remission works.
October: Type 1 could begin in the womb
We used to believe that type 1 diabetes couldn’t happen in the very first few months of life. Instead, if a baby was diagnosed with diabetes under six months old we thought it must be neonatal diabetes, which is caused by a single genetic spelling mistake.
But our research fellow Dr Richard Oram discovered a rare group of children who were diagnosed with diabetes under six months old, but didn’t have any of the genetic mistakes known to cause neonatal diabetes.
In a new study, he found evidence which confirms that type 1 diabetes can develop in children under six months of age. This is important because type 1 and neonatal diabetes are treated differently, so it’s really important children get the right diagnosis.
What’s more, Dr Oram found evidence hinting that the immune attack behind type 1 diabetes could even begin in the womb. The next step will be to figure out how it is possible for type 1 diabetes to develop so early and whether these insights could open up new ways to prevent or treat the condition in the future.
November: Weight loss key to preventing type 2
Findings from the Norfolk Diabetes Prevention Study (NDPS) - one of the largest type 2 diabetes prevention research studies in the world - showed that losing just two to three kilograms of weight can almost halve the risk of developing type 2 diabetes.
The NDPS ran over eight years and involved more than 1,000 people at high risk of developing type 2 diabetes. Half of the participants received a group-based support programme to help them make small changes to their diet and physical activity levels over two years, and the other half received usual care.
These findings are important as they show that a real-world lifestyle programme can make a huge difference in helping people to reduce their risk of type 2 diabetes. And that even small reductions in bodyweight can help to reduce risk. You can find out more about your own risk by using our free Know Your Risk tool.
December: Smarter insulin
Researchers in Copenhagen have developed a new ‘smart’ insulin that can sense blood sugar levels. The new type of insulin has a built-in molecular switch - as blood sugar levels rise, the molecule becomes more active and releases more insulin. As blood sugar levels drop, less insulin is released.
The research team tested the insulin molecule in rats and showed that changes in blood sugar levels were able to effectively drive the release of insulin or stop it. The next step is to refine the molecule so that it works more rapidly and accurately.
In the future, smart insulin could mean that people would only have to take insulin once a day, and then the insulin would handle the rest at a molecular level to keep blood sugar levels in range.
It’s exciting, but this research is at a very early stage. Years of further research and clinical trials are needed to find out if this insulin could be used safely and effectively by people with diabetes.
It's thanks to your support and generosity throughout 2020 that this amazing progress has been possible. If you donate, you'll be helping us fund more vital research and make more breakthroughs sooner.