Project summary
Type 1 diabetes can affect anyone at any age, but it does not progress in the same way for everyone. We can identify people who are developing the condition, before symptoms appear. But we can't accurately predict when they will progress to 'full' type 1, when insulin is needed. For some people, progression through the early stages is rapid, while for others it can take many years.
Professor Gillespie and her PhD student will build on existing research to investigate the biological factors linked to these differences in progression. Their findings could help predict how quickly someone is likely to fully develop type 1 diabetes, and support the development of new ways to delay or prevent it.
Background to research
In type 1 diabetes, the immune system attacks insulin‑producing beta cells in the pancreas. This process happens gradually over months or even years, before symptoms appear and someone needs to start insulin therapy.
During this hidden, symptomless phase, the immune system gives off early warning signs of its attack. These signs, called autoantibodies, can be picked up in a simple blood test. Once someone has two or more autoantibodies, we say they have early-stage type 1 diabetes. This means the immune attack will continue and – once enough beta cells have been picked off – they will eventually fully develop type 1 diabetes and need insulin therapy.
Some people progress quickly through the early, symptomless stages of type 1. While for others its progression is much slower.
Early research suggests this timing may be linked to differences in immune cells, immune signals, and changes in the pancreas, but these links aren't yet well understood.
Research aims
Professor Gillespie and her PhD student will focus on three promising biological clues that could help predict how fast someone is likely to progress through the early stages of type 1 diabetes.
First, they’ll look at differences in immune cells from people with early-stage type 1 diabetes, comparing those who progress quickly vs slowly. They’ll look for simple, measurable signals in these cells that could indicate slower progression.
They’ll also explore whether immune proteins that influence inflammation in the pancreas could help slow the development of type 1 diabetes. These could be important markers of progression rate.
Finally, they’ll study the parts of the pancreas that don’t make insulin to see whether enzyme levels and genetic factors may reveal new clues about how quickly the condition develops.
Potential benefit to people with diabetes
We’re entering a new era in type 1 diabetes, where we can find it early and use new immunotherapy treatments to slow down its progression. But to make the most of this new era, we need better ways of knowing how people will move through the early stages of the condition.
By uncovering the biological clues that influence how quickly someone progresses, doctors could give people much clearer timelines. For example if they are likely to need insulin within months versus decades. This could reduce uncertainty and the anxiety of living in the early phase of type 1 diabetes.
Over time, these insights could lead to better monitoring for people with early-stage type 1, and support the development of new treatments to disrupt the immune attack and delay or prevent the condition.
