A view from Vienna, day 3: Making diabetes complications less complicated


While a lot of the research we fund at JDRF is working towards a cure, we also want to help people who have type 1 to live longer, healthier lives until the cure is found. That’s why we fund a number of projects looking at preventing and treating complications, alongside work to make controlling glucose levels safer and easier. And from Wednesday’s sessions at EASD it’s clear we’re not alone in this: researchers from around the world were here to discuss their work on understanding diabetes complications.

A lot of the studies presented today focused on understanding what causes complications – if we can understand this, we may be able to develop strategies to address these root causes before complications develop.

Stijn Peeters, from Maastricht University, is focusing on the extracellular matrix (ECM) – essentially, the space between the body’s cells, and the molecules that are found there. He has found that people with type 1 tend to have higher than normal levels of molecules that break down the ECM. He also discovered that having high levels of some of these molecules is associated with conditions like retinopathy and cardiovascular disease. Although these molecules are part of the body’s way of getting rid of old and damaged parts, it seems like having too many could indicate a higher risk of complications. Knowing this, researchers may be able to identify steps we could take to reduce that risk.

Other researchers looked at different complications.  A team from Manchester led by Dr Steven Brown looked at the effect of diabetic neuropathy on something that on the surface doesn’t come up much in conversations about diabetes – falling down the stairs. People with nerve damage to their limbs had greater trouble balancing when going up and down stairs than people without this nerve damage. The team are now working to understand whether strength training and other interventions can help mitigate this risk for people who do develop nerve damage.

Being able to diagnose complications early is a key goal for many researchers. Dr Vincent Monnier of Cape Western Reserve University announced how his team had been able to link the fluorescence of collagen in the skin to a person’s risk of retinopathy and kidney disease. It certainly seemed like a novel way to test for a person’s risk of these conditions, and new ideas like this are incredibly important for the future.

The fact that getting the best possible glucose control is still the best way to reduce risk of complications seems to be reinforced by a study from Sweden looking at difference in rates of complications between people using insulin pens and those using pumps – the pump group were 43% less likely to develop fatal cardiovascular disease than the group using pens. The authors were rightly careful to highlight that pump usage alone probably doesn’t account for all of this risk reduction. Other important factors, such as the intensive education people in Sweden receive when they go on a pump, are likely to play an important role in the difference between the two groups. Unpicking these factors, and deepening our understanding of how to detect and treat complications if they do arise, mean that we can look forward to a future where complications of diabetes are less, well, complicated!

Photo: Types of Vienna by Flickr user Igor, used under a CC-BY 2.0 licence.

This article originally appeared on the JDRF website.

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