Insulin: still a miracle after all these years
Fabrizio Barbetti1 and Simeon I. Taylor2
1Bambino Gesù Children’s Hospital IRCCS, Rome, Italy.
2Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Address correspondence to: Simeon I. Taylor, University of Maryland School of Medicine, HSF-III, Room 4182, 655 West Baltimore Street, Baltimore, Maryland 21201, USA. Email: staylor2@som.umaryland.edu.
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1Bambino Gesù Children’s Hospital IRCCS, Rome, Italy.
2Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
Address correspondence to: Simeon I. Taylor, University of Maryland School of Medicine, HSF-III, Room 4182, 655 West Baltimore Street, Baltimore, Maryland 21201, USA. Email: staylor2@som.umaryland.edu.
Find articles by Taylor, S. in: JCI | PubMed | Google Scholar
First published July 2, 2019 - More info
J Clin Invest. 2019;129(8):3045–3047. https://doi.org/10.1172/JCI130310.
© 2019 American Society for Clinical Investigation
The discovery of insulin almost 100 years ago has resulted in a remarkable increase in lifespan and quality of life for patients with type 1 diabetes. The Joslin Medalist Study has allowed researchers to access and study patients (Medalists) with type 1 diabetes who have been insulin dependent for 50 years or more. In this issue of the JCI, Yu et al. evaluated HLA variants, autoantibody status, β cell function, C-peptide release, and monogenetic diabetes genes in a cohort of Medalists. Postmortem analysis of pancreata from Medalists revealed the presence of insulin-positive β cells in these patients. Moreover, some patients were still able to respond to metabolic stimuli despite long-term insulin dependence. Overall, the Medalist cohort was highly heterogenous, and genetic testing suggested that several patients would fall into categories other than type 1 diabetes on the basis of REVEL (rare exome variant ensemble learner) classification and may be able to transfer to other therapy options.
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Copyright © 2019 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)