An autoimmune mystery:
Dr. Beth Cummings seeks clues to origins and prevention of type 1 diabetes
Scientists still have not settled on the reasons why some people’s immune systems react against their own insulin-producing cells to cause type 1 diabetes. “We know there’s a genetic component, but there are also environmental triggers,” notes Dr. Beth Cummings, a pediatric endocrinologist at the IWK Health Centre and associate professor at Dalhousie Medical School.
Some researchers believe that a viral infection can activate the immune system in such a way that it moves on to attack the islet cells after it has cleared up the virus. Others believe immune reactions to certain foods could be the trigger. Dr. Cummings is the Halifax lead of an international study that’s looking into the possibility that early exposure to cow’s milk proteins could set off the immune events that cause some children to develop type 1 diabetes.
“The study is following more than 2,000 children whose siblings or parents have type 1 diabetes,” explains Dr. Cummings. “Each centre enrolled the children at birth and encouraged their mothers to breastfeed. After breastfeeding, half of the babies received a standard cow’s milk-based infant formula and half received a special formula in which the proteins are broken down so the immune system doesn’t recognize them.”
The researchers examine yearly blood samples from each child until their 10th birthday. “We’re looking for sugar imbalances, antibodies and markers of immune activation and comparing how these line up with the development of diabetes over time, to see if the special formula can prevent diabetes,” says Dr. Cummings. She’s involved in another international study of relatives of people with diabetes that’s looking for better ways to identify who’s at risk. Some of those at risk can join a study to see if oral insulin reduces their chances of developing diabetes.
“If we can identify an effective means of screening for type 1 diabetes and a preventive treatment that works, we could intervene in early childhood to alter the course of people’s lives,” Dr. Cummings says. “This would be an extraordinary breakthrough.”