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A Long Road Ahead


ICT: Do you think that there is going to be a cure and, if so, which direction do you think that cure is going to come from?

Chantal Mathieu: For the whole of my career, I’ve been working on trying to better understand what Type 1 diabetes is, because the bottom line is we still do not fully understand the disease. We have known for 30 years that there is a genetic predisposition. There are certain genetic traits that make you more susceptible to Type 1 diabetes, but it is not a disease like cystic fibrosis, where you only need one gene to get it. Type 1 is like a predisposition, a higher susceptibility. What we've also discovered is that certain triggers probably contribute to the whole process of beta cell destruction. Certain viruses, especially the diarrhoea viruses, have been studied quite intensively in Scandinavia, and there are some arguments to say that certain viral infections can indeed push a predisposed person towards Type 1 diabetes. We also have a good understanding that it is the immune system that will start to destroy this one cell that is able to produce insulin in a glucose-dependent manner – namely, the beta cell in the islets of Langerhans, in the pancreas. These things we know, but we also think that the beta cell itself is a part of the problem. The beta cell behaves in a strange way and almost ‘triggers’ the immune system to attack itself. Instead of escaping the attack, it then does things that will precipitate its own demise. It’s a very strange ballet of incidences in people with Type 1 diabetes. All of this work over the last 20-30 years is to gain a better understanding. What INNODIA was set up to do was find better biomarkers. Looking for biomarkers is important to better understand what is really happening, so we can find novel targets to stop the disease, and also to identify people who are at risk of getting this disease.

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Chantal Mathieu is Professor of Medicine at the Katholieke Universiteit Leuven, Belgium, and is Chair of Endocrinology at the University Hospital Gasthuisberg Leuven, Belgium. Professor Mathieu received her medical degree and PhD at the Katholieke Universiteit Leuven, where she subsequently completed training in internal medicine and endocrinology. Her basic research is focused on the prevention of Type 1 diabetes, effects of vitamin D on the immune system and diabetes, and functioning of the insulinproducing beta cell. Professor Mathieu has authored or co-authored more than 400 peerreviewed publications in international journals. She presently coordinates the INNODIAproject on prevention and intervention in Type 1 diabetes in Europe.
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