Insulin-Producing Cells May Last Longer in People With Type 1 Diabetes

In September 2020 at the Annual Meeting of the European Association for the Study of Diabetes, researchers presented a groundbreaking study on Type 1 diabetes (T1D). The researchers concluded that people living with T1D may have more residual insulin-producing cells, or beta cells, than previously thought.

For years, it was believed that people living with Type 1 diabetes had suffered a complete destruction of their beta cells. However, through non-invasive nuclear imaging, the study’s researchers found that six of its 10 participants, who ranged from 21 to 54 years old, still had residual beta cells years after their initial diagnosis. 

“We now know that many Type 1 diabetic patients may still have residual beta cells, which this study shows,” Emory Hsu, MD, an endocrinologist at Santa Clara Valley Medical Center in San Jose, California, tells Verywell. Hsu was not involved with the study.

The study’s conclusions provide hope that people living with Type 1 diabetes may be able to use their own residual beta cells to produce insulin. 

Current Treatment for Type 1 Diabetes

Finding optimal blood sugar levels to prevent hyperglycemia (high blood sugar) as well as hypoglycemia (low blood sugar) is an ongoing challenge for people with Type 1 diabetes. “Someone with T1D has to take care of his or her blood sugar and insulin needs 24/7, every day, without any vacations or breaks," Hsu says.

Fortunately, the medical field has made some progress over the years to make glucose management more effective and convenient. 

“With the advent of new tools such as continuous glucose monitors, and improved pharmacologic insulins, as well as more sophisticated insulin pumps, [managing blood sugar] has become more attainable," Joseph Barrera, MD, an endocrinologist with Mission Hospital in Orange County, California, tells Verywell.

Despite these advancements, there is still no cure for Type 1 diabetes.  

The Journey Towards a Cure 

“There are efforts to try to cure Type 1 diabetes so that people with T1D do not need to use insulin every day," Hsu says. "One method is to reintroduce functioning beta cells."

An islet transplant uses cells from a donor pancreas to help those living with T1D regain beta cells and improve their quality of life. Hsu says that other initiatives include stem cell therapies as well as injectable drugs that stimulate the body to create its own functional beta cells. However, he says that these developments “are still in their infancy.”  

These therapies, often collectively referred to as beta cell replacement, have become one of the most promising scientific developments in diabetes research. But, according to the Juvenile Diabetes Research Foundation (JDRF), beta cell replacement is only available to a small number of people living with Type 1 diabetes.

The challenge of not only producing but also maintaining beta cells remains a barrier for researchers. They are still looking for ways to prevent these cells from being destroyed by the autoimmune system.

Do The Study’s Findings Make a Difference? 

Despite these new findings, experts are not certain whether the residual beta cells of a person with Type 1 can replace beta cell replacement therapies. 

“More studies are needed to determine whether at the time of [T1D] diagnosis, the volume of non-functioning beta cells and their capacity to produce insulin would be sufficient to completely avoid the need for insulin therapy," Barrera says.

“This study is very small in number of patients, but even if the findings were widespread, the amount of residual beta cells is so small that they do not produce enough insulin," Hsu says. “I am not sure that it would necessarily remove the need for new beta cell replacement therapy, whether this is done through transplanting new cells or finding ways for the body to regenerate functional beta cells without a transplant."