News ways of understanding the complex biology of diabetes using biomedical imaging
by Olof Eriksson
Modern biomedical technology has massively increased our knowledge on the cause,
development and treatment of diabetes during the last decades. However, it is still difficult to
directly study what happening inside the human body as diabetes develops. It is difficult to
take biopsies from the pancreas, and therefore diabetes-related processes such as
inflammation and beta cell dysfunction are often invisible to the physician treating a patient.
Olof Eriksson’s research group at Uppsala University in Sweden is using biomedical imaging
technology to take “digital biopsies” of the pancreas:
– Nowadays, many hospitals have advances PET scanners to help the physicians
diagnose and treat patients with for example cancer. We realized we could use the
same scanners to help diagnose and treat diabetes.
Figure 1. The yellow and green colors show the accumulation of the contrast agent in the
insulin-producing cells in the pancreas.
A contrast agent containing a small amount of radioactivity is injected in a patient, and using
the PET scanner, the physician can accurately diagnose the patient. The radioactivity is very
low and is gone after just a few hours. The commonly used contrast agents are designed to
accumulate in for example tumors and the brain.
– When we were talking to diabetes physicians, many of them said the same thing: they
would like to be able measure the amount of insulin producing cells in the pancreas of
Olof Eriksson’s research group therefore developed new contrast agents, that accumulates in
the insulin producing cells.
– After injection of the radioactive contrast agent, we can see the insulin producing cells
in the pancreas shine on the PET images! Importantly, since the examination is safe
and well controlled, it can be performed repeatedly on individuals with diabetes or
individuals at risk for developing diabetes.
– If we can see the immune cells in the pancreas early in the process, we may give the
physician time to respond with the correct treatment before the insulin producing cells
The research group is depending on the support mainly from T1D patient organizations for
– The development of these contrast agents has been supported by the JDRF and the
Swedish Barndiabetesfonden (Childrens Diabetes foundation). We are very grateful
for this support and realize that it’s the donation from individuals that make this and
other research on T1D possible.
COVID19 has delayed the clinical PET imaging studies, but they are planned to resume as
soon as possible. Initially, the contrast agents (both for insulin-producing cells and immune
cells) will be tested in individuals at T1D debut or with long standing diabetes. If the clinical
trial is successful, further studies will be possible:
– The PET scans could be used to directly evaluate the effect of new types of drugs,
aiming to stop the immune cell attack and thus the loss of the insulin producing cells.
This kind of direct evidence of treatment effect would potentially help to take new
immune-modulating drugs to the market faster than otherwise.
For more information:
Eriksson O, Långström B, Antoni G. News ways of understanding the complex biology of
diabetes using PET. Nucl Med Biol. 2020 Apr 27:S0969-8051(20)30016-0. Review.
Research group website: https://www.ilk.uu.se/research-groups/translational-imaging/