Diabetes occurs when the pancreas fails to produce enough insulin or the insulin that is produced does not work properly.
Insulin is a hormone produced by the beta cells in the pancreas that allows glucose to move from the bloodstream into cells to provide them with energy. Not having enough insulin results in abnormal blood glucose levels and cells in the body not functioning properly.
In the UK more than 3.2M people are diagnosed with diabetes, and numbers in Scotland have doubled over the past 10 years. The healthcare costs of treating and caring for diabetes patients in Scotland alone have risen to more than £1b.
There are two main forms of diabetes.
Type 2 diabetes is the most common form and occurs when the pancreas doesn’t make enough insulin or the insulin produced cannot function properly. In many cases Type 2 diabetes can be managed by controlling the diet, exercising and self-monitoring blood glucose. However, if blood sugar levels cannot be controlled, insulin production stops resulting in a similar disease course as Type 1 (described below).
Type 1 diabetes is an autoimmune condition where the body’s own defence system mistakenly attacks and destroys the beta cells in the pancreas that produce insulin. Diabetic ketoacidosis (DKA) is a life-threatening condition where the body starts to break down other body tissue as an alternative energy source to glucose. This produces toxic by-products called ketones. DKA accounts for around half of all diabetes-related hospital admissions in people with type 1 diabetes.
What causes the immune system to attack the beta cells in Type 1 diabetes is not entirely known and there is currently no cure. Most patients with type 1 diabetes can stabilize their blood glucose levels by regularly administering insulin (either by injections, or an insulin pump) but there are complications associated with this treatment and life expectancy is reduced by 20%.
Transplantation of donor-derived pancreatic islets containing insulin-producing beta cells has been shown to effectively treat diabetes, however the shortage of donor material limits the wide-spread use of this treatment. This means that there is an urgent need to find alternative sources of replacement pancreatic islets to address this shortfall.
Work at CRM
- Dr Gillian Morrison investigates the mechanisms that turn stem cells into pancreatic cells. For this work, she uses embryonic and induced pluripotent stem cells and also works on finding a technology that will transform adult cells such as skin cells into pancreas cells. The aim of this work is to provide a source of pancreatic cells that can be used for transplantation and help overcome the donor shortage.