Picture by Leo Arslan

New research, published in the journal, Diabetic Medicine, has revealed that children who develop type 1 diabetes (T1D) under the age of 12 activate genes involved in immune responses that does not occur in people who develop the disease at an older age.

The study – which comprised scientists from the University of Exeter, the University of Lincoln, and Nottingham Trent University – shows that the disease does not exist as a single entity, but as two distinct subtypes, or endotypes, possessing unique characteristics. The discovery has significant implications for the development of targeted treatments to prevent diabetes in young children.

As a chronic autoimmune disease that affects millions of people worldwide, T1D is the result of the destruction of insulin-producing cells in the pancreas by the immune system.  However, the nature of immune cells invading the pancreas differ in people who develop diabetes at different ages.

The team conducted a comprehensive analysis of genes involved in immune responses that are activated in archival samples of pancreas tissue from T1D cases of different ages originally collected over 30 years ago.

Their findings help us to understand differences in immune responses that occur in people developing diabetes at different ages. This is crucial for the development of effective treatments and prevention strategies. By tailoring therapies to target the specific characteristics of each endotype, researchers hope to improve outcomes for individuals with type 1 diabetes.

Professor Noel Morgan, who co-led the study at the University of Exeter, said: “Previous work has suggested very strongly that type 1 diabetes is not a single disease and that children diagnosed at the youngest ages may have a particularly aggressive form. Our new study sheds light on the immune mechanisms involved and this information will be important for the design of targeted therapeutic approaches to slow disease progression in children and teenagers.”

Dr Mike Christie, Visiting Senior Fellow at the University of Lincoln, said: “The incidence of T1D is increasing fastest in very young children. The findings from our study are important as they identify several signals used by the immune system to activate immune cells that are increased in the pancreas only in people developing T1D at a young age. In the pancreas, these signals may intensify the immune responses that destroy insulin-producing cells, leading to T1D developing at a young age.”

The study marks a significant milestone, not only to unravel the complexities of type 1 diabetes, but also paving the way for similar discoveries in other autoimmune diseases.

The paper is available to read online: https://onlinelibrary.wiley.com/doi/10.1111/dme.15155