Type 1 diabetes worsens over time – but like most marriages, it starts with a honeymoon. In type 1 diabetes the honeymoon follows diagnosis. The disease is caused by the loss of insulin-secreting beta cells in the pancreas. Type 1 diabetes can arise at any age, although it often is associated with youth. About half of cases arise in childhood or adolescence.
The honeymoon, or remission phase, refers to the period following initial diagnosis when the remaining insulin producing beta cells are functioning well. During this honeymoon, it is easier to control blood sugars, with fewers swings, less risk for hypoglycemia, and lower overall average blood-sugar levels.
Stephen Gitelman, MD, who leads clinical trials of new treatments for the UCSF Diabetes Center, would prefer to see the honeymoon never end. His goal is a marriage between newly diagnosed patients and new treatments that could keep type 1 diabetes under control forever.
Gitelman, director of the UCSF Pediatric Diabetes Program, is enrolling patients in new clinical trials. Among them is a first-in-humans evaluation of a treatment in which a specific type of cell found in the patient’s own blood, will be removed, purified and grown up in the lab, and then infused back into the patient.
“The idea of intervening in new ways at this early stage has really exploded,” Gitelman says.
Since 2000, the UCSF Diabetes Center has rapidly accelerated the pace of research and clinical care in diabetes, including playing a significant leadership role in TrialNet, a research program dedicated to the discovery of new therapies to delay, or prevent, the onset of type 1 diabetes in at-risk individuals. Gitelman serves as UCSF’s study director for TrialNet, a consortium of investigators from 18 of the leading diabetes institutions around the world.