Gut cells could produce insulin in type 1 diabetics

Cells in a person's intestine have the ability to make insulin and could one day replace the cells lost in type 1 diabetes, according to Columbia University Medical Center in New York.

This new discovery could one day replace research in stem cell transplantation, which until now was considered the ideal way to replace insulin-making cells destroyed by type 1 diabetes.

In type 1 diabetes, the body destroys its insulin-making cells in the pancreas. Once these cells are lost, they cannot be replaced by the pancreas. People living with type 1 diabetes most monitor their blood glucose levels multiple times during the day and take insulin injections to control their glucose levels.

Currently, stem cell transplants are not a viable option. Embryonic stem cells can product insulin-making cells in laboratories, but those cells are not yet able to adjust the amount of insulin released into the bloodstream in response to blood glucose levels.

A study by Columbia University researchers identified progenitor cells in mice intestines that can make insulin-producing cells. These intestinal cells have glucose-sensing receptors that release insulin in response to blood glucose levels.

These progenitor cells are normally responsible for producing cells that make serotonin, gastric inhibitory peptide, and other hormones secreted into the gastrointestinal tract and bloodstream.

“Our results show that it could be possible to regrow insulin-producing cells in the GI tracts of our pediatric and adult patients,” said Domenico Accili, MD, professor of medicine at Columbia University Medical Center. “Nobody would have predicted this result.”

The insulin made by the intestine cells was released into the bloodstream. It work as well as normal insulin and was made in sufficient quantity to almost normalize blood glucose levels in diabetic mice.

“All these finding make us thing that coaxing a patient's gut to make insulin-producing cells would be a better way to treat diabetes than therapies based on embryonic or iPS [induced pluripotent stem] cells,” said Accili.

The discovery could one day eliminate the need for insulin injections in people with type 1 diabetes.

“It's important to realize that a new treatment for type 1 diabetes needs to be just as safe as, and more effective than, insulin,” said Accili. “We can't test treatments that are risky just to remove the burden of daily injections. Insulin is not simple or perfect, but it works and it is safe.”

Source: Columbia University Medical Center