adAPT to Prevent Diabetes in Children?

Diabetes is a condition that causes a person’s blood sugar level to become too high. If diabetes is untreated — and large amounts of glucose build up in the blood — this can cause damage to blood vessels and organs.

Type 1 diabetes is the most common type of diabetes in children — although only about 10% of all diabetes patients have type 1 diabetes. Insulin is usually produced in the pancreas — a small organ located behind the stomach that produces several hormones and digestive enzymes. In type 1 diabetes, the pancreas doesn’t produce any insulin — meaning patients have to inject insulin to control their blood sugar levels — which can be traumatic for many children.

But a clinical study, led by Professor Wilkin of the University of Exeter, that aims to prevent type 1 diabetes has been launched at the children’s hospital in Dundee, Scotland.

adAPT and accelerate

Type 1 diabetes is an autoimmune disease — meaning that it is the body’s own defence mechanism that attacks the body — in this case, the immune system attacks the cells of the pancreas. The study led by Professor Wilkin is known by the acronym adAPT — autoimmune diabetes Accelerator Prevention Trial — and will test the Accelerator Hypothesis which is a new explanation for the cause of type 1 diabetes.

Stress of modern life

Type 1 diabetes develops when beta cells are lost from the pancreas. We are all born with a large reserve of beta cells and gradually lose them, so in effect we are all moving towards diabetes. The accelerator hypothesis says that the destruction and loss of the beta cells is accelerated when the cells are made to work too hard — beta cell stress — in a modern environment (type 1 diabetes is increasing in the population, particularly in children under 5).

In a press release from the University of Exeter, Professor Wilkin said:

“We still have no means of preventing type 1 diabetes, which, at all ages, results from insufficient insulin. We all lose beta cells over the course of our lives, but most of us have enough for normal function. However, if the rate of beta cell loss is accelerated, type 1 diabetes develops, and the faster the loss, the younger the onset of the condition. The accelerator hypothesis talks of fast and slow type 1 diabetes – beta cell loss which progresses at different rates in different people, and appears at different ages as a result.”

The trial will assess the impact of a drug called metformin on children in a high risk category of developing diabetes. Metformin can protect the beta cells from stress, stopping the immune system response that kills them and slowing the loss of beta cells — thus delaying the onset of type 1 diabetes.

Chinese medicine

Another trial — discussed in this article, Extracts of the Chinese Herbal Remedy Gymnema sylvestre Inhibit the Sodium-Dependent Glucose Transporter 1 — is looking at the effect of a Chinese herbal remedy on hyperglycaemia, high blood sugar.