UC San Francisco scientists ushered in the era of type 1 diabetes prevention, nearly 40 years ago. Now, they're working to solve the biggest challenges standing between patients and functional cures for the disease.
An estimated 2.1 million Americans live with type 1 diabetes, which is chronic and requires constant monitoring through pricked fingers and blood tests or continuous electronic monitoring - and comes with a higher burden of complications, like heart disease, stroke, and blindness.
Professor Mark Anderson , MD, PhD, is the director of the UCSF Diabetes Center. He is also the A.W. and Mary Margaret Clausen Distinguished Professor in Metabolism and Endocrinology, and the Robert B. Friend and Michelle M. Friend Endowed Chair in Diabetes Research. This year, the center marks a quarter century of science aimed at saving lives and revolutionizing what the world thought possible in diabetes prevention and care. Anderson tells us what the future may hold, including a functional cure.
What is type 1 diabetes?
In type 1 diabetes, the pancreas loses its ability to produce insulin - which allows our cells to use sugar for energy. As a result, sugar builds up in the bloodstream, causing many of diabetes's symptoms and complications.
People who develop type 1 diabetes have to take insulin injections for the rest of their lives. In the U.S., type 1 diabetes accounts for roughly 8-10% of all diabetes cases, as compared with type 2 diabetes, which has its roots in family genetics and individual lifestyle.
What causes type 1 diabetes?
Type 1 diabetes is an autoimmune disease: Your immune system turns against you, attacking insulin-producing cells in your pancreas.
You said there's an FDA-approved treatment that UCSF helped develop?
Yes, the Food and Drug Administration approved the first immune therapy, Teplizumab, to delay the onset of type 1 diabetes in 2022.
In the 1980s, UCSF discovered that people with type 1 diabetes - or who were likely to develop the disease - had a specific type of malfunctioning antibody in their blood. This antibody, they found, could be used as a biomarker, or a measurable sign to diagnose whether a person had the condition or was at risk of developing it later.
In the early 2000s, UCSF formed the Diabetes Center and recruited renowned immunologist and Professor Emeritus Jeffrey Bluestone , PhD. His team learned that the immune system's T cells were key to orchestrating the autoimmune attack in type 1 diabetes. Jeff and the center played an integral role in developing an antibody drug that could target specific molecules on T cells' surfaces, at least partly shutting T cells down.
Ultimately, we were able to give the antibody drug (Teplizumab), to people who we knew were on their way to developing type 1 diabetes because they had antibody biomarkers in their blood. The antibody therapy worked and delayed the onset of type 1 diabetes by years in many patients, which led to the 2022 approval.
