Diabetes is known as a complicated and difficult chronic health condition, but researchers have made consistent progress on opportunities for management of and, eventually, a potential cure for type I and type II.
In the past year, the first man to be tentatively cured of type I diabetes was treated with an infusion of stem cells that worked like the pancreas, producing insulin. The patient no longer needs type I diabetes management. The clinical trial by Vertex Pharmaceuticals continues and, over five years, will study 17 people with severe type I diabetes.
The insulin-secreting islet stem cell research took place over 30 years before reaching the point of clinical trials. Many experts say the human embryonic stem cell is the best chance for a cure.
When it comes to diabetes, the different types will require different cures.
Type I diabetes is an autoimmune disorder that most often develops in childhood and adolescence, while type II develops over time and can be slowed or stopped with diet and exercise changes.
Dr. Kristin Stanford is a researcher with the Diabetes and Metabolism Research Center at The Ohio State University Wexner Medical Center and College of Medicine. She studies the mechanisms behind the metabolic benefits of exercise.
Knowing that exercise can reduce the risk of developing type II diabetes, Stanford hopes to glean knowledge about how that actually happens in the body.
Exercise is a therapeutic for diabetes, Stanford says, but not everyone is able to exercise. Determining the modality of exercise’s benefits could extend those benefits to individuals who are unable to exercise conventionally.
Stanford is now studying exercise-induced adaptations to brown and white adipose tissue.
“We always want to assume that we have the tools and we can trick a disease,” she says. “The
more technologically savvy we become as researchers, the more tools we can use and find different ways to intervene.”
Brown adipose tissue was previously only known to exist in animals and newborns, but in 2009, it was discovered in adults as well. The biggest takeaway of late has been that there is such a thing as good fat in the human body, something only previously known in animals.
Beige and brown tissues dissipate energy as they regulate temperature, while white fat stores excess energy.
A January 2021 study in Nature Medicine found that brown adipose tissue has the potential to promote cardiometabolic health.
In a study of 52,487 patients, researchers found a lower prevalence of cardiometabolic diseases in those with brown adipose tissue (BAT). Independently, they also found BAT to be correlated with a lower chance of “type II diabetes, dyslipidemia, coronary artery disease, cerebrovascular disease, congestive heart failure and hypertension.”
In addition, BAT had more pronounced beneficial effects in overweight individuals, leading the scientists to think BAT may play a role in “mitigating the deleterious effects of obesity.”
A February 2021 study in the International Journal of Molecular Sciences shows that the structural components of brown adipose tissue, adipocytes, are activated by a variety of factors that include cold, diet and exercise. Thyroid hormones and B3 agonists also trigger BAT, along with “increased energy expenditure, decreased fat content, and enhanced glucose and insulin homeostasis.”
This, in turn, leads to lower levels of obesity and type II diabetes.
“Diabetes is a beast of a disease,” Stanford says.
They’re getting closer to a cure, though, she says: The ideas are all there.
Claire Miller is an editor at CityScene Media Group. Feedback welcome at cmiller@cityscenemediagroup.com.
