Breakthroughs and hopes for Type 1

In a typical middle school, two or three children have Type 1 diabetes, the form of the disease that typically strikes during puberty (but sometimes in kindergarten or even earlier), wiping out the body's ability to make insulin.

Right now, there's no cure. And Type 1 is especially tough to manage because the insulin that kids need to stay alive can't be taken as a pill or a syrup.

The biggest new breakthrough is an insulin pump that works in tandem with a glucose monitor using radio signals, says Dr. Steven Willi, director of the Diabetes Center for Children at Children's Hospital of Philadelphia.

A glucose sensor that sits just beneath the skin continuously checks a child's blood-sugar levels, then sends that data to the pump - a palm-sized machine worn like a pager. The child clicks through some screen prompts on the pump and gives the machine the go-ahead to dispense a precision dose of insulin into his body, without the need for injections.

"It's a lot easier in school," Willi says. "They don't have to go to the school nurse to have anything and everything done, and they're toting around less stuff."

As pumps get smaller and monitors more sophisticated, the goal is to one day implant a system that would operate with zero input from the child - essentially an artificial pancreas (the organ in the body that makes insulin).

Promising research also is being done on medicines that help prevent a child's body from shutting down its insulin-producing cells in the first place. Willi, a national leader in this auto-immune research, says a medicine called teplizumab has helped delay Type 1 diabetes by as long as 18 months in children enrolled in research trials.

As doctors and scientists learn more, they hope to stretch that timeline and eventually hold off Type 1 diabetes indefinitely in children at risk.

Replacing damaged cells in the pancreas with fresh new stem cells is another hope for the future. Willi says that medical science could make it a reality in 15 to 20 years, or earlier with a few lucky breakthroughs. *