Childhood Diabetes Research Unit
More than 1,000 children in BC have Type 1 diabetes. Type 2 diabetes, which typically has been regarded as the adult form of the disease, is on the rise in children. Researchers in this unit are investigating new ways to predict, prevent and treat diabetes in children, with the ultimate goal of finding a cure.
Upwards of 250,000 people in BC and two million Canadians have diabetes, an incurable disease that costs the province about $1 billion a year. About 1,000 children in BC have Type 1 diabetes, which occurs when the pancreas no longer produces the hormone insulin, rendering the body unable to process glucose (sugar). People are usually diagnosed before they turn 30, most in childhood or during their teens. In Type 2 (T2D) diabetes, the pancreas does not produce enough insulin and the body cannot effectively use the insulin produced to control blood sugar levels.
Even with careful blood sugar monitoring, patients with diabetes are prone to life-threatening hypoglycemic episodes, which are caused by blood sugar levels dropping too low. These blood sugar fluctuations can lead to serious complications later in life, including kidney failure, heart disease, and blood vessel disease leading to blindness, and amputation. Historically, Type 2 diabetes has been an adult disease. But children are now being diagnosed with T2D with alarming frequency, particularly among First Nations and Asian-Canadian populations.
Researchers in the Childhood Diabetes Research Unit, located at the BC Research Institute for Children’s and Women’s Health, will use funding from MSFHR to investigate new ways to predict, prevent and treat both types of the disease in children:
Type 1 Diabetes
Prediction – Accurately predicting which children are at risk for developing T1D is an important step in preventing the disease. Current tests are unreliable, and do not detect the disease until the immune system has already begun destroying the beta cells that produce insulin. Researchers are now exploring the promising new method of detecting and counting cytotoxic T cells in the blood in order to predict T1D onset.
Prevention – Clinical trials to prevent Type 1 diabetes using insulin injections either had no effect or produced undesired toxicity. The trials revealed gaps in our understanding of how and why the body’s own immune system targets and kills beta cells. Researchers are examining the molecular defects that activate killer cells, and hope to develop vaccines to prevent diabetes.
Treatment – Transplanting pancreatic islet cells (clusters of cells that produce insulin and other hormones) holds great promise for a cure for Type 1 diabetes. But transplantation is limited by a lack of donors and the need for lifelong drugs to prevent the transplant recipient from rejecting the cells. Researchers are exploring new approaches that eliminate the need for drugs, or minimize the number of islet cells required to normalize blood sugar.
Type 2 Diabetes
Eight to 45 per cent of children newly diagnosed with diabetes are afflicted with T2D, or mature onset diabetes of the young (MODY) (similar to T2D and genetically-based), and this number is on the rise.
Researchers in the unit are working to better understand T2D in children. They believe that the genetic and environmentally-induced defects that cause T2D in children will be found to be similar to those in adults, but more severe, predisposing them to develop T2D earlier in life.
Award term completed September 2009.