Advances in Diabetes Treatment and Prevention

A case reported in Nature last year documents a 25-year-old woman now producing her own insulin after receiving cells derived from her reprogrammed stem cells. Her successful treatment ended a year of insulin injections and allowed her to eat previously restricted foods, including sugar and hotpot. In Shanghai, a 59-year-old man with type 2 diabetes experienced similar results with insulin-producing islets from his own stem cells.

The science builds on foundational work from Shinya Yamanaka at Kyōto University. Deng Hongkui's team, from Peking University, adapted this approach using small molecules instead of proteins for enhanced control. They developed 3D clusters of insulin-producing islets and introduced a new transplant method - placing cells in abdominal muscles instead of the liver. This 30-minute procedure allowed for MRI monitoring and potential removal if needed.

In a clear case of hitting the ground running, Vertex Pharmaceuticals launched clinical trials using donor stem cells. Their early results indicate participants receiving islet cells produced insulin within three months. Some stopped needing insulin injections entirely. Their next trial tests protective devices for these cells, aiming to remove the need for immunosuppressants.

A parallel trial in Brazil involving 21 adults with type 1 diabetes demonstrated stem cell infusions helped manage the disease for several years. Most patients lived insulin-free for about three and a half years, with one patient maintaining insulin independence for eight years. However, not all participants saw improvements.

Meanwhile in Aotearoa, research points to pressing prevention needs. A study of 11-13 year olds indicates 35% risk developing prediabetes. Pacific and Māori children show higher weight, hip circumference, and blood glucose measurements than their peers. The study took advantage of routine dental checkups to screen children for diabetes risk factors.

Socioeconomic factors influence these patterns significantly. Children in crowded homes and deprived areas face increased risks. The research identified two main dietary approaches: one centered on snacks, takeaway foods, and sweetened drinks; another featuring vegetarian and legume-based meals with limited processed foods.

The dietary analysis revealed specific patterns affecting health outcomes. Children consuming diverse food items showed particularly high intake of snacks, takeaway foods, and sugary drinks. A second pattern emphasized vegetarian options and legumes, associated with better health indicators. Living conditions correlate strongly with risk factors.

Pacific Island children were more likely to live in crowded housing, with 31.8% in crowded conditions compared to 3.7% of non-Māori non-Pacific Island children. Nearly half of Pacific and Māori children resided in areas ranking highest for socioeconomic deprivation.

When it comes to health metrics, the numbers paint a clear picture. Even though the normal range for the Body Mass Index of Pacific people remains a moot point, Pacific children averaged BMI percentiles of 91.2, significantly higher than the 78.1 percentile of non-Māori non-Pacific children. Blood glucose levels followed similar patterns, with Pacific children showing higher average readings.

Early intervention proves essential. New Zealand researchers advocate screening children from age 10, particularly in high-risk groups for maʻi suka (diabetes in Samoan language). This timing matches international guidelines while recognizing local health patterns documented since 2014.

Looking forward, researchers outline several priorities. Larger studies must examine children aged 10-15, with specific attention to blood glucose measurement across different populations. Prevention programs on the risks of toto vene (diabetes in Cook Islands Māori) require careful consideration of social and cultural elements to serve Pacific communities effectively. And that's where our translation work comes into play indeed.

The VX-880 clinical trial, a stem cell-derived therapy for suka kalasi 1 (type 1 diabetes in Tongan language), shows ongoing progress in treatment approaches. Initial results present restored insulin production and improved glucose control in patients receiving half the target dose. Five additional patients now receive the full dose, with plans to treat ten more concurrently.

These developments hold particular significance for our Pacific island communities, where diabetes rates exceed national averages in the land of the long white cloud. Early screening could identify at-risk children before complications develop, while cultural awareness in prevention strategies may reduce new cases.

In a nutshell, diabetes research advances on multiple fronts. Stem cell therapy introduces promising treatment options, while prevention efforts focus increasingly on early intervention and cultural considerations. As translators, we remain committed to helping pass the message from the research to our vulnerable communities.