A four year study between the Royal Melbourne Hospital and the Walter and Eliza Hall Institute has found inflammation in fat stores could be responsible for diabetes
Presenter: Geraldine Coutts
Speaker: Dr John Wentworth, Royal Melbourne Hospital and Eliza Hall Institute
WENTWORTH: We've known obesity is associated with diabetes and that if you lose weight it improves type-2 diabetes, but we haven't really understood how obesity causes the problem. We've been investigating or following up a lead that suggested that inflammation in the fat tissue was a cause or a link, and we have some strong laboratory data using human tissue as our starting material, human fat tissue taken from surgery, that suggests a certain type of inflammation is causing diabetes. And this is exciting because it opens other treatment options up to us, particularly an anti-inflammatory approach to treating diabetes.
COUTTS: Can we just get a bit more on the inflammation, I mean what does it matter if fat is inflamed and what story is that telling you?
WENTWORTH: Well I think it's just again telling us how obesity causes diabetes. The inflammation I think in plain terms when we get obese our fat cells become sick and die and when they do, the body thinks they're actually invading bugs rather than normal cells, and the body activates an inflammation pathway. And that's well and good except the inflammation at the same time is trying to react to what the body thinks is a foreign invader.
COUTTS: So does that mean that a person who tends to be overweight if they get this kind of inflammation will then get mixed messages, the cells and body will get mixed messages and then stores fat and then produces it?
WENTWORTH: Yes during infection in other settings you do have problems or you can cause diabetes if you have severe infections, and it's a way our body works I suppose is when we are trying to fight off infection we do try to increase our blood sugar levels I think to provide energy to the immune system to fight the infection. And this same sort of mechanism is happening in obesity, except there's no infection, it's just overloaded fat tissue.
COUTTS: Can this kind of inflammation occur in people who aren't obese?
WENTWORTH: Well we're not entirely sure of that, we know that if you are obese and you lose weight this inflammation is markedly reduced, but so to does diabetes disappear. We haven't yet studied lean people who have diabetes to see how much of a problem this is.
COUTTS: Well now that we've got this breakthrough and this understanding what will it allow you to do in terms of treatment or even prevention?
WENTWORTH: Well we're excited because it does open doors towards development of anti-inflammatory therapies for diabetes, and this is exciting because it would help improve the treatment arsenal, and it may lead to better drugs. The current drugs do carry some side effects, and most notable weight gain with certain types of drugs used to treat diabetes, and that is somewhat self-defeating when you're treating a disease that's largely caused by obesity.
COUTTS: So do you actually have a test now to know whether this inflammation exists and so you can treat it earlier and prevent some of the problems that follow?
WENTWORTH: Well we do but it would require taking a sample of fat tissue from near the belly button and I don't think that's going to be rapidly taken.
COUTTS: What because it's uncomfortable or a nasty procedure?
WENTWORTH: Correct and also because it's quite a detailed procedure, so no, we don't have a simple test yet, that's something we'd be interested in developing. But first we're quite interested in trying to tease out the exact nature of the inflammation with a view to finding some things that we can target in its treatment.
COUTTS: Dr John Wentworth with respect diabetes sufferers out there are groaning and I can hear them saying oh god, here's another point where they've teased us, they've got us this far but there's nothing they can do about it for us yet?
WENTWORTH: Yeah I think we need to put this into perspective and really diabetes is a lifestyle issue primarily, and I don't want to take away from the importance of diet and exercise in the treatment of diabetes. So we're a long way off, but you've got to start somewhere and we're quite excited where we are at the moment.