Injection-free future for diabetics

Insulin injections are set to become a thing of the past for children and adults diagnosed with a particular rare form of diabetes, as researchers find a way to repair the faulty switch that causes the disease.

The research, led by Dr Ewan Pearson in Medicine and Therapeutics with Prof Andrew Hattersley of the Peninsula Medical School, has shown that tablets commonly used to treat the common type 2 diabetes can remove the need for insulin injections in 90 per cent of diabetes patients tested.

This is seen in a rare subtype of diabetes caused by mutations in a gene called Kir6.2. This type of diabetes, which was first discovered by Dr Pearson and his colleagues two years ago, accounts for 30 to 58 per cent of all cases of diabetes diagnosed in patients under six months of age.

Normally the body responds to sugar by secreting insulin from the pancreas. The insulin acts to decrease the blood sugar by increasing its uptake into muscle and liver where it can be used as energy or stored.

However, when the Kir6.2 gene is faulty, the pancreas is unable to respond to sugar and does not secrete insulin, resulting in diabetes. People with the condition are typically treated with insulin injections in order to restore normal blood sugar levels.

Dr Pearson and his colleagues have now found the key to opening the locked pores.

They discovered that a class of drug, called sulfonylureas, could overcome the Kir6.2 fault, allowing the pancreas to regain its ability to release its own insulin on demand - removing the need for insulin injections.

"The striking finding was not just that patients could stop insulin, but in every case the overall blood sugar was lower without patients having problems with too low blood sugar," Dr Pearson said.

"It is rare to find such an excellent response to any treatment, but it is important to stress that this finding does not mean that patients diagnosed after 6 months of age with type1 diabetes will be able to stop their insulin. This is likely to affect at most 300 patients in the UK"

The Wellcome Trust-funded study was conducted while Dr Pearson was a Wellcome Trust clinical research fellow at the Peninsula Medical School, and involved patients in the UK, France and Norway. The findings were published in the New England Journal of Medicine. The research team are now conducting studies to explore the long-term effectiveness of the treatment.

Any diabetes sufferers who were diagnosed before six months of age can find out about testing for this type of diabetes at www.diabetesgenes.org.