DEAR DOCTOR K: My teenage daughter has had Type 1 diabetes since she was 8 years old. Fortunately, exercise, a good diet and insulin treatments have kept her healthy. I recently heard of a breakthrough at Harvard that might someday cure Type 1 diabetes. Can you explain?
DEAR READER: The research you’re referring to was conducted in the Harvard laboratory of Dr. Douglas Melton. Like you, Dr. Melton has a child with Type 1 diabetes.
First, some basics. When we eat, sugar (called glucose) gets absorbed into the bloodstream. Almost every cell in our body needs glucose to function normally. However, the cells prefer a steady level of glucose in the blood – not too high, not too low, but just right.
To keep the glucose level steady, the pancreas – a finger-shaped organ in our abdomen – makes insulin. Specifically, when we eat and blood levels of glucose rise, cells in the pancreas called beta cells make insulin. Insulin drives glucose from the blood and into cells throughout the body. This lowers blood levels of glucose.
Type 1 diabetes is an autoimmune disease. For reasons that remain unclear, the immune system attacks and kills beta cells. As a result, people with Type 1 diabetes no longer can make their own insulin. People with Type 1 diabetes require insulin every day to remain in good health. The discovery of insulin treatment for diabetes (in part by scientists here at Harvard) was a Nobel Prize-winning accomplishment. But it was not a cure. For years, scientists have dreamed of somehow replacing the beta cells that have been killed by the disease. Until now, no one has figured out a technique for transforming stem cells into beta cells, in the large number required to replace the beta cells killed by the disease.
Dr. Melton’s team seems to have accomplished that feat. It will be years before we know if this treatment will work in humans. So while this research does not represent a cure, it is likely to be a landmark event on the road to a cure.
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