Scientists: Type 1 Diabetes Is Not One, But Two Diseases

Scientists: Type 1 diabetes is not one, but two diseases

Scientists argue that type 1 diabetes can be viewed as two different diseases. The two subtypes differ in age at onset and microscopic changes in the pancreas, a new study shows.

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Scientists argue that type 1 diabetes can be viewed as two different diseases. The two subtypes differ in age at onset and microscopic changes in the pancreas, a new study published in the journal Diabetologia shows.

Scientists have previously noted that various immunological mechanisms may be involved in the development of type 1 diabetes. Experts suggested identifying two “endotypes” of diabetes.

In the new study, researchers analyzed approximately 130 pancreatic tissue samples from young adults and children with type 1 diabetes. The scientists report that they have found "two strikingly different patterns" that relate to the fate of the precursor of insulin (proinsulin) in the gland.

In children who were less than seven years old at the time of diagnosis, proinsulin did not go through the correct conversion cycle. It was produced by the cells of the pancreas unchanged. That is, its amount, which was converted into insulin, was insufficient.

In samples of the pancreas, which were obtained from children who fell ill at age 13 and older, scientists found a different picture. In this case, proinsulin did not lose its ability to convert into insulin.

In addition, the cells in the pancreas that produce insulin are destroyed in different ways in different subtypes of type 1 diabetes. In younger children, the process of their damage was more aggressive.

“Our data suggests that type 1 diabetes exists in the form of two different pathologies, which can be divided based on the age at the time of diagnosis, as well as the differences in the histological picture,” the scientists write.