Scotland could lead the field in the international effort to cure type 1 diabetes

Scots research has a big role in battle against condition, says Catriona Morrice

Scotland is a hotbed of bioscience. And it could win the international race to cure a life-threatening condition – if only we make the most of what we have.

Our bioscience power is strongly evident in type 1 diabetes research, where Scottish institutions, scientists and charity supporters already play a leading role in the international battle against the condition. I believe the role that Scotland plays could be even bigger.

Type 1 diabetes is an autoimmune condition. The body’s own immune system attacks and destroys the insulin-producing beta cells in the pancreas. A diagnosis is life-changing. A child diagnosed at the age of five can need more than 19,000 insu- lin injections before their 18th birthday.

I work for JDRF, a charity that invests in research that is transforming the lives of people with type 1 diabetes. The organisation has invested more than £1 billion globally since its inception. Ultimately our goal is to find that cure.

With the excitement around the future potential of type 1 diabetes research, our plea to the Scottish Government is to encourage an even greater focus on this condition. After all, Scotland has among the world’s highest rates of incidence.

In Scotland, we have committed nearly £4 million to projects at the Universities of Edinburgh and Glasgow and have drawn heavily on the expertise of clinicians here.

But whilst Scotland wants the glory of being the country that cures type 1 diabetes, we’re being matched by wonderful work investigating the condition around the world.

Across the international JDRF network, we are delivering groundbreaking work. Three areas of research which, internationally, are helping us treat and perhaps one day beat type 1 diabetes are encapsulation, immunotherapy and investigating medicinal foods.

Taking a look at these in turn demonstrates the variety and increasing progress of type 1 diabetes research.

Our encapsulation research, taking part in the United States and elsewhere, is developing ways to implant insulin-producing cells in the body, while protecting them from the immune system which has mistakenly identified them as hostile.

Wrapped in a protective coating, these encapsulated cells would be able to do the same job as ones in a healthy pancreas. This works because the protective capsule is a little like a sieve – tiny holes in the coating allow nutrients to fit through, enabling the cells to live and work well, but are not big enough to allow anything as big as an attacking immune cell to get close.

Immunotherapy, meanwhile, works to alter the actions of the immune system. In autoimmune conditions, like type 1 diabetes, there is potential to use immunotherapy to ‘retrain’ the immune system to no longer attack cells such as the

insulin-producing beta cells of the pancreas.

In a lab in Boston, in the United States, a research team is working on a technique to ‘hijack’ red blood cells by attaching insulin fragments to them. The blood cells can travel quickly throughout the body and do not themselves cause an immune response as they are produced by the individual.

Then there are ‘medicinal foods’. While there is no evidence that diet is responsible for type 1 diabetes, Jdrf-funded research in Australia has shown that the types of bacteria living in our gut can impact on our overall health.

This has opened up questions about whether food as medicine, ‘neutraceuticals’, could in future help us treat or prevent type 1 diabetes without harmful drugs.

In Scotland we have something that almost every other country in the world (including England) doesn’t have. It’s a database of people living with type 1 diabetes that allows us to collaborate with families affected by type 1 diabetes who are willing to opt in to join clinical trials.

It’s called the Scottish Care Information – Diabetes Collaboration (SCIDC) and it is something to be treasured. It is such a vital resource for our research scientists and the community affected by type 1 diabetes that they support.

Our overwhelming wish is for Scotland to step forward and take the lead role on type 1 diabetes. We have the resources here and the expertise. With over 30,000 adults and children in Scotland living with the condition there is also a pressing need to solve this complex problem. l Catriona Morrice is development manager for JDRF in Scotland