As World Diabetes Day (November 14) approaches, Team Rotary is getting ready for the Walk for a Cure at Dodger Stadium on Sunday morning, November 6. What then is the purpose for the Walk? The immediate beneficiary is the Juvenile Diabetes Research Foundation (note the word “research”). The ultimate beneficiaries are those around the world who are victims of juvenile diabetes, some of whom in Third World countries would be unable to survive for lack of insulin and other necessary supplies. What then are the avenues of research being funded by J.D.R.F.? The research goes in three directions: cure, treatment, and prevention.

I. Cure (via Islet Transplants)

Absent reliable and safe immune suppressants, doctors are not yet prepared to recommend pancreas transplants. In the meantime, most prefer the option of islet transplants. Islets refer to clusters of pancreatic cells that produce insulin (and which comprise only 1 or 2 percent of the pancreas) – the same cells that are destroyed in type 1 diabetes. Islet transplantation involves removal of such cells from a donor pancreas and their transplantation into the patient’s pancreas. Once implanted, the transplanted cells commence the manufacture of insulin in the patient. This would replace the daily injections of insulin in type 1 victims.

Research so far has gradually lengthened the time interval before the transplanted islets lose effectiveness and the patient must return to daily insulin injections. Major problems with the procedure include the dangers of rejection of the transplant by the recipient’s immune system, and the shortage of islets from suitable donor pancreases.

2. Treatment (via Development of Artificial Pancreas)

A multi-million dollar per year research project funded by JDRF has three aspects: (a) a program to guage the benefits (clinical and economic) of continuous glucose monitors, and (b) a program to develop a closed loop artificial pancreas. Communication between continuous glucose sensors and insulin pumps requires (c) the development of varied computer “algorithms.”

Included in this JDRF-funded research are a worldwide consortium (of diabetes researchers, mathematicians, and engineers), and a 10 site clinical trial (including Cambridge University, Boston University, Oregon Health & Science University, Sansum Diabetes Research Institute, Stanford University, University of Colorado, University of Virginia, Yale University, and University of California Santa Barbara). Finally, this research will then require JDRF–industry partnerships to integrate the finalized (a) glucose monitoring, and (b) insulin delivery technologies, with the (c) algorithms

3. Prevention (via Blocking Immune Attack)

New research indicates that, during the “honeymoon” phase of the disease (before all the insulin-producing beta cells are destroyed), the immune attack which causes type 1 diabetes can be blocked by increasing a specific protein (CCL22) in the insulin producing sectors of the pancreas. In most cases using laboratory mice, this protein attracts T-regulatory cells, which block the attacking immune cells and prevents the development of type 1 diabetes. This may lead to a future drug preventing the further progression of the disease.

These then are among the research directions to be funded by the November 6 Walk for a Cure of Type 1 Diabetes. Participation as part of Team Rotary can enable the Juvenile Diabetes Research Foundation to underwrite research that will eventually reverse the rapidly growing world-wide epidemic of Type 1 Diabetes.