Major discovery in treating type 1 diabetes. The brain plays an essential role, a new analysis shows

Researchers have found that a hormone can normalize blood sugar levels in type 1 diabetes even without insulin, acting directly on the brain, writes News.ro. This information opens the way to new treatments, which could reduce or even eliminate the need for daily insulin injections.

More than a decade ago, researchers found that an acute complication of type 1 diabetes, diabetic ketoacidosis (DKA), can be solved with leptin hormone, even in the absence of insulin.

Now, a recent analysis, published, on August 1, in the Journal of Clinical Investigation explains how leptin affects the brain and how it could be used in future therapies.

Diabetic ketoacidosis occurs when the body no longer produces insulin and begins to break down fats to achieve energy. This can lead to a dangerous accumulation of sugar (glucose) and ketone acids in the blood.

Traditionally, doctors have given insulin to treat this complication, but new evidence shows that when insulin is insufficient, the brain plays an essential role in triggering DKA, according to the new analysis based on specialty literature and research that includes UW Medicine since 2011.

What leptin does

When the pancreas no longer produces insulin, “the brain receives the signal that the body no longer has fuel, even if it is not. This information is partially transmitted by a low level of leptin hormone,” said the main author, Dr. Michael Schwartz, professor of medicine at the Metabolism Department, Endocrinology and Nutrition Nutrition) of the Faculty of Medicine at Washington University (UW Medicine), quoted in a statement.

Leptin helps the brain regulate appetite and body weight. The hormone is produced by the body's fat cells and transported by blood to the brain, especially in the area called hypothalamus, which controls when and how much we eat.

When leptin is insufficient, the brain activates circuits that mobilize energy sources, including glucose and ketones.

Schwartz and his team discovered this connection in 2011, when they first administered leptin in the brains of rats and mice with type 1 diabetes.

The discovery aroused confusion

At first, nothing happened. But four days later, they were amazed to find that glucose and ketone levels in animal blood became completely normal, despite the severe lack of insulin.

“I think the most amazing thing was that the blood sugar did not only decrease, but it stabilized. Even though we were trying to grow or drop it, it returned to a normal level. These reactions suggest that, in the absence of insulin, the brain can maintain a normal blood sugar,” explained Dr. Schwartz.

At that time, the discovery aroused confusion among the scientific community specialized in diabetes, who did not know how to interpret it.

“Now we understand much better a result that was largely ignored by the scientific community when it was first reported in 2011,” says Dr. Schwartz.

The team from UW Medicine is now aims to request the approval of the American regulatory authority, FDA, to start clinical tests and check if leptin can really normalize blood sugar levels in people with type 1 diabetes.

Obtaining positive results could open the way to drug therapies that target the brain to treat type 1 diabetes.

“The discovery of insulin 104 years ago is one of the biggest discoveries of the last century, but this is the next stage. It could be a better way,” said one of the study co -authors, Dr. Irl Hirsch, professor of metabolism, endocrinology and nutrition at UW Medicine, who has a 1 childhood type diabetes.

Type 1 diabetes treatment without insulin, doctors' target

Insulin management is a significant burden for patients and their families.

“I think if we could treat type 1 diabetes without daily injections with insulin and without constant blood sugar monitoring, it would be the best possible,” he added.

If the brain may be convinced that fuel reserves are not exhausted or if certain neurons in the brain that trigger glucose and ketone production are disabled, the body stops the reaction to severe hyperglycemia and diabetic ketoacidosis.

“This discovery questions the old idea, accepted for decades, that only the lack of insulin causes diabetic ketoacidosis, and shows that the brain also contributes to the imbalance of blood sugar-that is, the fact that the level of blood sugar gets out of control-which turns it into a new potential.”