Beta Cell Function Matters in People at Risk for Type 1 Diabetes
This is the first in our four-part series on beta cell function and why it matters for detecting type 1 diabetes early.
Key takeaways:
- For people at risk for type 1 diabetes, assessing beta cells, which produce insulin, is essential for understanding the progression and management of type 1 diabetes.
- Autoantibody and blood glucose testing offer a reliable way to see how well beta cells are working, especially prior to the diagnosis of type 1 diabetes.
- Early identification of increased risk for type 1 diabetes enables timely access to emerging disease-modifying therapies and clinical trials aimed at slowing the course of type 1 diabetes.
Type 1 diabetes is an autoimmune condition where the body’s immune system mistakenly attacks and destroys cells in the pancreas called beta cells. These cells are responsible for the production of insulin, a hormone that helps regulate blood sugar.
When beta cells are damaged or destroyed, your body doesn’t make enough insulin, and sugar builds up in the blood instead of being used for energy. This is what leads to the symptoms and complications of type 1 diabetes.
There are tests that can measure risk for type 1 diabetes by measuring autoantibodies and beta cell function – that is, how much insulin your body is creating. By monitoring beta cell function, people at risk for type 1 diabetes can stay informed, empowered, and proactive in their care.
These tests are most helpful for people at risk or newly diagnosed, but can sometimes guide care for others. However, there is a real opportunity for the diabetes community more broadly to help get the word out to family, friends, and broader social networks to identify those who may be at risk.
What are beta cells? How does type 1 diabetes affect them?
Beta cells are specialized cells located within the pancreas. Their primary function is to produce and release insulin. Insulin helps regulate blood glucose by promoting the uptake of glucose in our cells.
In type 1 diabetes, the immune system makes autoantibodies, which target and destroy beta cells, eventually resulting in a lack of insulin. This can lead to the lifelong need for insulin from external sources, including insulin injections or automated insulin delivery (AID) systems. Type 1 diabetes is frequently diagnosed in children and young adults, though it can occur at any age.
How can someone know if they are at risk for type 1 diabetes?
Autoantibody testing
There are blood tests to help evaluate the future risk for type 1 diabetes, called autoantibody testing. They do not directly measure beta cell function, but do help your healthcare professional understand your risk level, order the appropriate tests to track you over time, and decide if you might be eligible for disease-modifying therapies or clinical trials.
Oral glucose tolerance testing
This test is used to diagnose diabetes and measures how well your beta cells are working by how your body processes glucose. The test involves drinking a sugary solution and having your blood glucose levels monitored at timed intervals.
C-peptide testing
When beta cells are producing insulin, they also release a protein called C-peptide. Measuring how much C-peptide is present in your blood helps determine how much insulin your body is still making. The American Diabetes Association recommends the plasma C-peptide test, with random or postprandial sampling (with concurrent glucose) within five hours of eating for individuals on insulin.
Monitoring glucose levels
Using continuous glucose monitoring (CGM) is another way to provide information about beta cell function. In early type 1 diabetes, blood glucose levels may be normal due to the body’s ability to produce insulin. Once type 1 diabetes progresses and beta cell function declines, blood glucose levels will begin to rise.
Talking to a healthcare professional about these tests, especially prior to diagnosis or within the first year after diagnosis, can open important conversations around your diabetes management options and even clinical trial eligibility. This can be a tough discussion, but remember, you are your own best advocate. Start by asking your healthcare provider questions, such as:
- Could a blood test help me know if I am at risk for type 1 diabetes?
- How can we test my body’s ability to make insulin?
- Could a C-peptide test help me better understand where I am in my type 1 diabetes journey?
- I read that there are many clinical trials for people at risk of type 1 diabetes. Do you know of any clinical trials I might qualify for?
Why is it important to know how beta cells are functioning, especially in those at risk for type 1 diabetes?
Every person at risk for diabetes is different. Knowing how well your beta cells are functioning tells you how much insulin your body can still make.
Furthermore, knowing how well your beta cells are functioning sets realistic expectations early and is a reminder that every person’s journey is different. Knowing that each person’s rate of beta cell decline is unique, and – most importantly – beyond their control may help reduce stigma or judgmental attitudes towards people with type 1 diabetes.
Another reason early identification and testing are important is that they provide timely access to potential new disease-modifying therapies and opportunities to enroll in clinical trials. Large clinical trial networks such as Type 1 Diabetes TrialNet, INNODIA, and EDENT1FI play a central role in facilitating access to prevention and intervention studies, particularly for individuals early in their type 1 diabetes journey.
The bottom line
Understanding and preserving beta cell function lies at the heart of improving long-term outcomes for people at risk for type 1 diabetes. Early detection of beta cell decline not only confirms diagnosis but also opens the door to timely, disease-modifying therapies that may alter the course of your diabetes.
People at risk for type 1 diabetes are ideal for beta cell function monitoring. Those with recent-onset type 1 diabetes are also important to monitor, as they are most likely to benefit from personalized interventions that may alter the progression of their condition.
Research suggests closely monitoring beta cell activity, especially in the months following diagnosis, can help your healthcare team tailor treatment strategies, improving diabetes management and reducing the risk of complications later on. It may also offer you access to clinical trials that may eventually help with long-term remission or disease delay.
Ultimately, prioritizing early identification of beta cell function can empower you and your healthcare team to take a proactive, informed approach in managing a complex, lifelong condition.
Learn more about type 1 diabetes screening and treatment here: