The development of medications to treat diseases is based on understanding how cells work.

It is at this cellular level that scientists at the University of California, Los Angeles and University of California, Irvine have come close to understanding why people with type 2 diabetes experience a malfunction in a process that prevents the accumulation of a toxic protein known as islet amyloid polypeptide (IAPP).

The accumulation of this protein is linked to the loss of insulin-producing pancreatic beta cells. Insulin is the hormone responsible for distributing blood sugar into cells, thus maintaining healthy sugar levels.

This research was published 18 July, 2014 in the peer-reviewed Journal of Clinical Investigation.

Diabetes is a disease characterized by high blood sugar levels over a long period of time. This is usually caused by the inability of the body to effectively utilize blood sugar.

In type 1 diabetes, the pancreas produces little or no insulin. In type 2 diabetes, which forms 90 per cent of all diabetes cases, the body’s cells do not utilize insulin effectively resulting in insulin resistance. Increased body weight and prolonged lack of exercise are thought to be contributing factors to type 2 diabetes.

“Whereas the cause of type 1 diabetes is not fully understood but considered autoimmune, type 2 diabetes is one of the most challenging health problems in developed and developing countries,” says Raphaela Farrenkopf, an senior administrator at Merck Serono, the biopharmaceutical division of Merck, an international pharmaceutical company.

What has always perplexed researchers is the cause behind the accumulation of IAPP in the pancreatic beta cells of people with diabetes.

“Researchers from the University of California Los Angeles (UCLA) suggest that in people who do not have type 2 diabetes, autophagy prevents the accumulation of toxic forms of IAPP,” reported the Science Daily on 24 July, 2014. Autophagy is a process that clears damaged and toxic proteins from cells.

On the other hand, in people with type 2 diabetes, the process appears not to work properly, contributing to the destruction of beta cells.

“Only a few previous studies have reported that autophagy is important for beta cell function and survival,” said Safia Costes, the study’s co-author, to the Science Daily.

Those earlier studies, according to Costes, were not conducted to look into the role of this process in the regulation of IAPP, which is an important contributor to type 2 diabetes.

What scientists discovered from this new research is that autophagy plays a role in removing IAPP from pancreatic beta cells.

In the study, researchers found that mice that had beta cells in which autophagy didn’t work properly showed elevated levels of toxic IAPP, leading to the death of other beta cells. As a result, those mice developed diabetes.

Costes emphasized that the goal of this work is to understand the cellular mechanisms responsible for beta cell destruction so that they can identify the best targets for beta cell protection.

“This would aid the development of the next generation of treatments as well as combination therapies for type 2 diabetes,” she said.

A report compiled by the Baker IDI Heart and Diabetes Institute estimated that 6.4 per cent of people aged 20 to 79 had diabetes in 2010. They expect this number to increase to 7.7 per cent by 2030.

Farrenkopf explains that diabetes and the subsequent complications resulting from the disease are the fourth leading cause of death in most developed countries.

Treating type 2 diabetes is challenging because its symptoms are not clear-cut and thus the disease can go undetected for some time.

“The patient does not experience acute symptoms, and therefore the disease can go unnoticed for quite some time. It is a chronic progressive disease, and approximately 50 per cent of patients don’t know that they have it,” says Farrenkopf.

Type 2 diabetes can be managed by maintaining a healthy diet and weight. When diet and exercise are not enough, patients need to be treated with medications that decrease blood sugar levels or to receive insulin therapy. Type 1 diabetes always needs insulin treatment.

This article was first published in 2014 and is currently republished for its uniqueness.