Understanding childhood diabetes

On January the 11th 1922, 14-year old Leonard Thompson lay dying at Toronto General Hospital. Diagnosed with type 1 diabetes and weighing only 29 kilograms, Leonard was in a ward with 50 other diabetic children. With no treatment available, many of these children already lay in a coma, with grieving relatives by their sides, as they awaited inevitable death.

Just hours from slipping into coma himself, Leonard was selected for an experimental treatment, the injection of a protein called insulin, purified from the pancreas of cattle. Following a remarkable recovery, Thompson’s treatment became the new standard of care for people with diabetes world-wide.

Skipping almost 90 years forward and Professor Tom Kay, head of SVI’s Immunology and Diabetes Unit, explains where cutting edge diabetes research stands today.

“The discovery of insulin was an amazing step forward for people with type 1 diabetes. However, in the 21st century diabetes remains a complex disease, which is difficult to control and can lead to devastating complications. The aim of research in our Unit is to develop more effective treatments for people with the disease.”

He goes on to explain that people with type 1 diabetes lack insulin, the hormone that regulates the body’s use of glucose. Insulin is produced by beta cells in the pancreas, which are contained within small clumps of cells called islets. In type 1 diabetes, beta cells are mistakenly attacked and destroyed by the immune system.

Tom continues, “Our researchers are studying the precise mechanisms by which this destruction occurs, and work to find ways of preventing it from happening. We do this using mice that develop diabetes in a similar way to man. However, our focus is the translation of our studies in mice to a more clinical level. We do this by using human islets for laboratory studies and through our pivotal role in the Australian Islet Transplantation Program.”

The Program involves the isolation of insulin-producing islets from organ donors and transplantation into people with difficult to control type 1 diabetes. The Victorian arm of the Program, headed by SVI, has resulted in four recipients becoming insulin independent to date.

In addition to this work, SVI researchers are furthering their research into the mechanisms of type 1 diabetes, looking at:

  • the immune mechanisms that cause type 1 diabetes
  • how beta cells die 
  • the contribution of genes and environment to disease development
  • how and why human T cells kill beta cells

Leonard Thompson lived a further 13 years thanks to the development of insulin, but died at the age of 27 due to diabetic complications. Ninety years after this landmark treatment, the goal of researchers at SVI is not very different from that of the team in Toronto in 1922: to help people with type 1 diabetes live longer and healthier lives.