Targeting the brain for the treatment of type 1 diabetes

Targeting the brain for the treatment of type 1 diabetes Michael W. Schwartz, MD, explains the role played by the brain as a cause of elevated blood sugar and related metabolic derangements in type 1 diabetes, and how therapeutic targeting of this brain system can eliminate the need for insulin therapy in animal models. There are two primary forms of diabetes, referred to as type 1 and type 2. While the latter is associated with obesity and is more common in adults, type 1 diabetes (T1D) is an autoimmune disease that typically begins in childhood. The disease is caused by an immune attack on the cells that make the hormone insulin, known as pancreatic beta cells. Apparently, the immune system misidentifies these beta cells as foreign invaders and proceeds to destroy them. The resulting state of severe insulin deficiency, if left untreated, is incompatible with life. Indeed, afflicted patients were condemned to an early death until insulin was discovered in the early 1920s. It is no surprise, therefore, that the discovery that insulin prolongs the life of afflicted patients was heralded as a miracle and, in 1923, was rewarded with a Nobel Prize. To this day, T1D simply cannot be treated without insulin – or so we thought.