Diabetes is a chronic metabolic disorder that afflicts 17 million people in the United States and is the fourth leading cause of death. Over 2 million patients suffer from its most severe form – childhood diabetes – also known as Type 1, juvenile or insulin-dependent diabetes. We now understand that childhood diabetes is an autoimmune illness, where the body’s own white blood cells, which normally fight infection, turn and act against the body.
These white blood cells target a specific group of cells in the pancreas – beta cells – that produce insulin, the hormone necessary to convert food into energy. Over time, such a large number of beta cells are destroyed that there is a lack of insulin and diabetes develops.
Scientists have long sought a means to predict the onset of diabetes through routine blood tests of destructive white blood cells so that high-risk individuals could be treated before all their beta cells are destroyed and they become diabetic. Progress has been so limited however, that it has been debated whether these cells were present in the blood at levels high enough to facilitate direct detection.
In the January 15 issue of the Journal of Clinical Investigation, Rusung Tan and colleagues at British Columbia’s Children’s Hospital, Canada, reveal a method for directly measuring the level of these self-destructive cells in the blood of mice and demonstrate that these levels reliably distinguish mice that go on to develop diabetes from those that do not.
Drs. George Eisenbarth and Brian Kotzin from the Barbara Davis Diabetes Center for Childhood Diabetes and the University of Colorado Health Sciences Center state in their accompanying commentary that “quantifying (these) cells in patients genetically at high risk to develop disease and in patients with prediabetes may be a more direct (and at least complementary) approach to detect beta cell autoimmunity and predict which patients will go on to develop disease”.
The researchers suggest that this technique may also be used to detect this group of self-destructive cells involved in other autoimmune disorders, thereby increasing our powers of predicting disease.