Research Overview | jdrfannual

OUR RESEARCH PORTFOLIO

THREE PRIORITY AREAS FOR T1D RESEARCH: CURE || TREAT || PREVENT

CURE

Curing T1D means restoring the body’s ability to regulate glucose and finding a way for insulin producing beta cells to live in the body. There are two ways to do this: the REGENERATION of beta cells or the REPLACEMENT of beta cells.

JDRF funds projects in Australia tackling both approaches.

REGENERATION

Regeneration means finding a way to ‘wake up’ any remaining beta cells still in the body and

restoring their function.

WHAT WE KNOW:

Scientists have learned three different ways to help regenerate insulin-producing cells that are lost in T1D. The strategies work by triggering other cells in the pancreas, like alpha cells, to 'change teams' and become more like beta cells.

REPLACEMENT

Replacement means adding new Insulin producing cells into the bodies of those with T1D.

WHAT WE KNOW:

* 62 islet transplants have occurred in Australia, and of these, 18 people are insulin independent;

* Globally, we have cured T1D in mice 718 times;

* Researchers can grow insulin producing cells in a lab;

* Researchers identified a way to interrupt the body’s immune response to implanted medical devices. This could allow infusion sets, sensors for continuous glucose monitors, cell encapsulation containers and other devices to work better.

THE CHALLENGES WE FACE

1. The body will still attack any new beta cells.

2. Currently all transplants need human donors.

3. The cells we can create in a lab or through regeneration are not as efficient or productive as the naturally occurring beta cells in our bodies.

4. Translating findings in mice trials into human clinical trials.

WHAT WE ARE WORKING ON

1. Finding a way to reduce or remove the need for immunosuppressive drugs.

2. Investigating ways to transform other cells in the body into insulin producing cells.

3. Finding ways to produce an endless supply of insulin producing cells, from stem cells or from other cells already found in the pancreas.

4. Encapsulation techniques to protect islets from being attacked by the body e.g artificial skin and membrane system.

5. Increasing our number of human clinical trials.

PROFESSOR PETER THORN

DR HARALD JANOVJAK

TREAT

Daily management of T1D remains a significant burden.

Our Treat portfolio includes research in the development of closed loop systems, the discovery and development of glucose

responsive insulins (GRIs) and in treating and preventing complications.

CLOSED LOOP SYSTEM

A closed loop system, or ‘Artificial Pancreas’ is the ultimate tech treatment goal. The system consists of an insulin pump, CGM and a complex calculation that matches insulin dosing to blood glucose levels. The world’s longest and largest at home trial of a hybrid closed loop system in Australia is ongoing in FY18. A hybrid closed loop system automates about half of insulin delivery and is a step closer to a full closed loop system.

SMART INSULIN (GRI)

Glucose responsive insulin (GRI) means insulin that is automatically activated when blood glucose levels rise and deactivated when blood glucose levels (BGLs) fall. GRI therapy would revolutionise T1D treatment by keeping glucose levels within

the normal range and significantly reducing the daily burden of treatment, carb counting, dose calculations and fear. There are several groups globally investigating different approaches to GRI.

HEALTH COMPLICATIONS FROM T1D

We now know that complications from T1D can be reduced by up to 76% with tight

blood glucose control.

We are working on ways to increase access to technology to make glucose control easier to manage, as well as Improving food and exercise guidelines and education.

In addition we are researching predictive markers of complications and therapies for kidney and eye disease, which are the most common complications from T1D.

MELBOURNE COMPLICATIONS HUB

PREVENT

In order to prevent T1D we need to understand the cause and the early development of the disease. We know that T1D develops in stages with the disease beginning before symptoms appear. We know that the rates of T1D cannot be explained by genetics alone, which means that the environment must have a role.

We are working on:

understanding Predictive Markers for T1D;
ways to halt the progress and minimise the impact of T1D;
a vaccine for T1D through a global project;
collecting information such as exposure to bacteria and viruses, body growth and nutrition to determine if there are any links. The Australian ENDIA (Environmental Determinants of Islet Autoimmunity) study is the world’s largest study investigating environmental factors that might contribute to or protect against T1D development starting from pregnancy;
developing and applying machine learning methods to analyse years of global T1D research data to identify factors leading to the onset of T1D in children through a global partnership with IBM.