Non-invasive technique detects residual beta cells in longstanding diabetes
medwireNews: A non-invasive imaging technique could make it possible to determine if people with longstanding type 1 diabetes have residual beta cells, researchers have reported at the virtual 56th EASD Annual Meeting.
The team identified residual beta cells via detection of the glucagon-like peptide (GLP)-1 receptor, using the stable GLP-1 analog exendin-4, radiolabeled for imaging purposes.
Marti Boss (Radboud University Medical Center, Nijmegen, the Netherlands) reported that they found a small amount of tracer uptake in all 10 people with type 1 diabetes of at least 5 years’ duration included in their study. Further investigation suggested that some of this background tracer uptake was due to the expression of GLP-1 receptor on non-insulin-producing delta cells.
Nevertheless, although exendin-4 uptake was significantly lower overall in the people with diabetes than in 10 healthy volunteers, six people had uptake that was “in the lower half of the range of the uptake in the healthy individuals,” said Boss.
This did not correlate with levels of plasma C-peptide, which was detectable in just two of the people with diabetes. “So it seems that we’re actually looking at residual dysfunctional beta-cell mass here,” noted Boss.
Supporting these findings in living people, 12 of 19 postmortem pancreas samples from people with longstanding type 1 diabetes contained limited numbers of cells that stained positive for both insulin and GLP-1 receptor.
“It seems that we can use GLP-1 receptor imaging to see residual beta cells in people with type 1 diabetes, and really see differences between beta-cell mass in different patients,” concluded Boss.
“And therefore we can use GLP-1 receptor imaging for non-invasive imaging of beta-cell mass and it’s actually a very valuable tool to further understand the pathophysiology of type 1 diabetes.”
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