Many type 1 diabetics still producing tiny amounts of insulin

by Barbara Hewitt on October 15, 2013

Around three quarters of type 1 diabetics still have a small number of beta cells that are not only producing insulin, but also doing so in response to food, according to new research.


Researchers have used new technologies which are able to detect far lower levels of insulin than was previously possible.

It is a sign that the cells are healthy and active and proves that a previous theory that early onset diabetes kills off all the insulin secreting beta cells in the pancreas within a few years is not necessarily correct.

‘This implies that beta cells are either escaping immune attack or undergoing regeneration,’ said the researchers from the University of Exeter Medical School in a ground breaking piece of research funded by the charity Diabetes UK.

The scientists found that 73% of the volunteers in the study of 74 people produced low levels of insulin, regardless of the length of time since their diagnosis. Using new technology they were able to detect tiny amounts of insulin production that were so low that without this response to food, the effect could have been ascribed to ‘analytical noise.’

Some 68% of the volunteers who had lived with their diabetes for over 30 years showed levels of insulin that would have been hidden previously, when a proportion of just 11% of participants would have shown working beta cells.

‘The researchers used new technologies which are able to detect far lower levels of insulin than was previously possible. The levels are so low that scientists had previously thought no insulin was produced,’ explained Dr Richard Oram of the University of Exeter Medical School, who led the study.

‘It’s extremely interesting that low levels of insulin are produced in most people with type 1 diabetes, even if they’ve had it for 50 years. The fact that insulin levels go up after a meal indicates these remaining beta cells can respond to a meal in the normal way. It seems they are either immune to attack, or they are regenerating,’ he added.

Diabetes UK’s head of research, Dr. Matthew Hobbs, said that there has been a lot of research into ways of making new beta cells that can be transplanted into the body. This is driven by the fact that preserving or restoring even relatively small levels of insulin secretion in type 1 diabetes can prevent the low glucose levels of hypoglycemia and reduce complications.

‘This research shows that some of a person’s own beta cells remain and therefore it may be possible to regenerate these cells in the future. It is also possible that understanding why some people keep insulin production whilst others lose it may help answer key questions about the biology of type 1 diabetes and help advance us towards a cure for the disease,’ he pointed out.

Dr Oram is now planning a larger scale study to help understand the genetics and immune systems of people with type 1 diabetes who are still making insulin. The research would also help answer the important question of whether these people have fewer complications.

Developments in this area would mean a lot to people like Alex Nesbitt, one of the participants in the study. At 56 years of age he was diagnosed with type 1 diabetes when he was 20. He is monitored by an insulin pump that is permanently attached to his body.

He described having diabetes as ‘trying in the extreme’, with a stigma attached to it. ‘For a very long time people have believed that if you have type 1 diabetes, that’s the end of your insulin production,’ he said.

‘This study raises some major questions about whether that’s actually the case. It’s very exciting for current opinion to be challenged in this way, and I’m fascinated to know what difference it will mean for the future,’ he added.

The opinions expressed in this article do not necessarily reflect the views of the Community and should not be interpreted as medical advice. Please see your doctor before making any changes to your diabetes management plan.

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