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Finnish scientists have reported that children who develop type 1 diabetes experience disturbances in their lipid and amino acid metabolism months or years before the onset of the disease. Their finding of distinct markers that precede the disease could lead to treatments designed to prevent the body's autoimmune system from attacking the pancreatic insulin-producing cells.
Before the scientists published their study in the December 15, 2008, issue of the Journal of Experimental Medicine, the earliest reliable indicators of potential type 1 had been islet autoantibodies, which show up as the body begins to make an autoimmune assault on pancreatic beta cells. Unfortunately, although their appearance can precede full-blown type 1 by months or years, islet autoantibodies sometimes fail to materialize until it's already too late to intervene with preventive therapies.
The Finns found that people who develop type 1 are born with reduced serum levels of succinic acid and phosphatidylcholine. Later, they experience reduced levels of triglycerides and antioxidant ether phospholipids. Several months before developing immunity to their own pancreatic beta cells, they experience increased levels of lysophosphatidylcholines-a kind of acid-that produce inflammation.
Because the sequence and agents involved are so clear, the scientists hope to eventually develop preventive strategies based on them. Their research used metabolomics, the systematic study of the chemical "fingerprints" in cells, tissues, and biofluids, taking into account both physiology and the environment. Because a person's metabolism can be affected by age, lifestyle, food, and intestinal microbes, plotting their effects could lead to changes or adjustments that stave off type 1.
Finnish interest in diabetes is a response to that country's high incidence of type 1: One out of every 120 Finnish children develops the disease, and the rate of incidence is increasing yearly. The country is expecting the number of new cases to double in the next 15 years.