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Type 1 Develops More Slowly Than Thought

Feb 21, 2012

Study finds gradual decline in insulin production, which could extend treatment options….

According to a new study, insulin production may continue for decades after the onset of type 1 diabetes.  The Massachusetts General Hospital researchers said that, the findings add to growing evidence that the period of time for treatment after the onset of the disease is longer than previously believed.

Study leader Dr. Denise Faustman, said in a hospital news release, “Traditionally, it was thought that beta cell function completely ceased in patients with advanced type 1 diabetes.” “However, data from this study and others suggest that the pancreas continues to function at some level even decades after the onset of type 1 diabetes.”

The researchers analyzed blood samples from 182 patients with type 1 diabetes and found that C-peptide production can continue for decades after disease onset and remains responsive to blood sugar levels. C-peptide is a marker of insulin secretion/beta cell function.

C-peptide levels were lower in patients who had type 1 diabetes for a longer time, but the decrease was gradual and not the sudden decline believed to occur in people with the disease.

Even among patients who’d had type 1 diabetes for 31 to 40 years, 10 percent still produced C-peptide and beta cell functioning remained intact at very low C-peptide levels, according to the study.

Researchers say the new findings suggest that type 1 diabetes patients with low C-peptide levels or advanced disease may benefit from new treatments to preserve or enhance beta cell function.

“Our results contribute to a growing body of evidence suggesting there might be a longer window for therapeutic intervention in this disease and also may help explain the transient restoration of insulin production we saw in patients who received BCG (the generic drug bacillus Calmette-Guerin) in our phase 1 clinical trial,” Faustman said.

Diabetes Care, Mach 2012