WHO Calls for Better Diabetes Research, Prevention on World Health Day

We took a brief look at some of the diabetes research happening in Boston.

Approximately 422 million adults worldwide live with diabetes. The disease costs the healthcare system $825 billion each year. In 2012 alone, it also cost 1.5 million people their lives.

The World Health Organization (WHO) wants all of that to change. The group has declared diabetes the focus of today, this year’s World Health Day.

As such, the WHO released a nearly 100-page report about the global state of diabetes, calling for better prevention, treatment, education, and research related to the condition. Diabetes, the report says, is “a serious threat to population health.”

While Massachusetts isn’t immune to the reach of diabetes—studies have shown that between 7 and 10 percent of adult Commonwealth residents have the disease—it is home to the kind of research the WHO demands in its report.

Just this week, for example, a study from institutions including Harvard School of Public Health (HSPH) helped determine the $825 billion financial burden of diabetes, as well as the sobering fact that diabetes prevalence has quadrupled since 1980; another recent study from three Boston institutions, including HSPH, found a lower diabetes risk associated with full-fat dairy consumption.

A great deal of that research also takes place at Joslin Diabetes Center, one of the country’s foremost diabetes groups.

For example: Jason Gaglia, a physician at Joslin, is behind a potentially groundbreaking new method of detecting type 1 diabetes, using magnetic nanoparticle imaging to see the early stages of the disease.

“One of the issues with type 1 diabetes is most of the action occurs within the pancreas, which is a difficult organ to get access to,” he says. “We needed a way that we could non-invasively image what’s going on within the pancreas.”

To do that, Gaglia and his colleagues developed a new test, currently under study. Patients are injected with magnetic nanoparticles, which normally pass through the bloodstream in a few days. If, however, an imaging test shows that the particles remain in the pancreas after two days, it suggests inflammation-related leakage—a tell-tale characteristic of diabetes.

“This will let us identify appropriately at-risk individuals, it will let us select appropriate individuals for clinical trials, it will let us follow the natural history of individuals when we couldn’t follow that before, and it will let us monitor the effects of immune interventions,” Gaglia explains. “With this imaging technology, you can actually see the disease process itself.”

Joslin was also behind another diabetes breakthrough: brown fat. In 2009, Joslin researchers determined that adult bodies, not just those of babies and animals, contain brown fat, a substance that actually burns calories instead of storing them. If harnessed properly, the thinking goes, brown fat could be used to prevent obesity and associated diseases like diabetes. Even seven years later, George King, Joslin’s chief scientific officer, calls it one of the most significant diabetes discoveries of recent history.

“[Distinguishing between] brown fat and white fat is, I think, one of the most exciting things,” King says. “Can you stimulate or prevent different types of fat from developing? Can you prevent white fat from developing in the abdomen? If you stimulate the brown fat, that could burn up more calories.”

King says that type of discovery, along with the increasing data around diet, is cause for hope, despite the staggering number of people now living with diabetes globally. Still, he says the focus must shift to stopping preventable cases of diabetes before they ever start, an attainable goal if people can maintain solid nutrition, exercise, and sleep.

“The approach has to be more on the preventing or reversing side, rather than from purely using medicinal intervention,” King says. “The good news is, almost all of these [prevalence] increases are due to type 2 diabetes, [which] has been shown by multiple studies to be a reversible at the early time point.”