Patients with type 1 diabetes commonly experience gastrointestinal symptoms, which can be severe. However, the underlying mechanism of disease, known as diabetic enteropathy, is unknown.
New research, published in Cell Stem Cell (2015;17:486–498)
, found that patients with type 1 diabetes and diabetic enteropathy have high levels of insulin-like growth factor binding protein 3 (IGFBP3), which is antiproliferative and promotes stem cell death in the intestinal lining, damaging its structure.
An international team led by Harvard Medical School found that in patients who underwent pancreas and kidney transplantation, resolution of hyperglycaemia was accompanied by normalisation of IGFBP3 levels and restoration of the intestinal lining.
Additionally, in a mouse model, an experimental drug that inhibits IGFBP3 allowed intestinal samples to grow normally in vitro, suggesting that a similar pharmaceutical strategy could be developed for diabetic enteropathy in humans.
 D’Addio F, La Rosa S, Maestroni A et al. Circulating IGF-I and IGFBP3 levels control human colonic stem cell function and are disrupted in diabetic enteropathy. Cell Stem Cell 2015;17:486-498. doi:10.1016/j.stem.2015.07.010.