How VUB and UZ Brussel make Type 1 diabetes visible, from lab to patient
Type 1 diabetes is a disease you cannot see at first glance. Children and adults living with it look ‘perfectly normal’ on the outside, yet inside their immune system destroys the insulin-producing beta cells in the pancreas. That invisibility makes daily life with the disease complex: why does blood sugar suddenly rise? Why does staying healthy require so much planning and discipline?
At VUB and UZ Brussel, the hospital of the VUB, researchers have been working for decades to better understand and treat this condition. We spoke with paediatrician and researcher Prof Willem Staels (Beta Cell Neogenesis research group, VUB) and pancreas and cell-therapy surgeon Prof Dr Daniel Jacobs-Tulleneer-Thevissen (Head of Oncological, Thoracic and Transplant Surgery, UZ Brussel) about the importance of translational research, breaking through invisibility and the search for new treatments.
Prof Staels explains that the invisibility of Type 1 diabetes is one of its greatest challenges: “The disease unfolds at cell level. The immune system attacks the beta cells, the cells that produce insulin, and you cannot see that from the outside. For parents, teachers and children themselves, that is confusing. You see nothing, yet a lot is happening in the body. Symptoms such as frequent urination, thirst or weight loss only appear once the number of beta cells has already dropped dramatically.”
"Type 1 diabetes is an auto-immune disease and has nothing to do with lifestyle or upbringing"
That invisibility also carries an emotional weight. “Parents often feel guilty. They wonder whether they did something wrong. But Type 1 diabetes is an auto-immune disease. It has nothing to do with lifestyle or upbringing. The immune system makes a mistake and attacks the body itself.”
From lab to patient – and back again
Prof Jacobs-Tulleneer-Thevissen adds: “For us as researchers and as a clinical team, it is crucial to make the invisible visible. We study cells and develop treatments that can be translated directly to patients. That is what we call translational research: from lab to clinic, and back again.”
Prof Staels stresses how closely research and clinical practice are intertwined. “In the lab, we investigate why beta cells die and how they function. At the same time, in the clinic we see which treatments work and which do not. When something fails, we return to the lab to look for answers. That constant feedback loop is essential for developing new therapies.”
Prof Jacobs-Tulleneer-Thevissen is mainly active in clinical practice: “We perform pancreas transplants, but these are limited to a small group of patients because of donor shortages and the need for heavy anti-rejection medication. That is why we are also exploring stem cells. They offer an unlimited source of beta cells and could, in the future, help a much broader group of patients.”
In search of new beta cells
The researchers are working on several strategies to bypass or retrain the immune system. Prof Staels: “Some treatments aim to temporarily suppress the immune system so that beta cells can survive. In other projects, we work with genetically modified cells that are less visible to immune attack.”
For patients and their families, understanding what happens inside the body is vital. Technology plays a key role here. “Continuous glucose monitors and smart insulin pumps make visible what used to be completely hidden. That helps not only with treatment, but also with breaking taboos. Children feel less alone and parents better understand what is going on.”
Prof Jacobs-Tulleneer-Thevissen: “That visibility also feeds directly into our research. By tracking how patients respond to new therapies, we can adjust our research. That ongoing interaction between clinic and lab is what makes our work so powerful.”
Pancreas or beta-cell transplantation is currently an option for a select group of patients, Prof Staels explains: “The problem with transplanted cells is that they do not have their own blood-vessel network. During transplantation, a large proportion of the cells is lost, sometimes as much as 60 to 80 per cent. Our research focuses on improving cell survival, for example by stimulating the formation of new blood vessels.”
"Cell therapy has the potential to become a real game changer"
In parallel, researchers are working to create fully functional beta cells from stem cells. Prof Jacobs-Tulleneer-Thevissen: “It is a complex process. New beta cells need to mature and become fully functional. We study how the cell’s energy metabolism can be optimised, for instance by understanding the role of iron and oxygen. That knowledge can help cells survive and perform better after transplantation.”
Beyond treatment, predicting Type 1 diabetes is another key research area. Prof Staels: “In some families, we can identify an increased risk years in advance by mapping autoantibodies. That allows us to intervene before the disease fully develops.”
Prof Jacobs-Tulleneer-Thevissen adds: “By screening early, we hope to slow down disease progression. That could also reduce the need for intensive therapies later on.”
Both researchers are hopeful, yet realistic, about the future. Prof Staels: “Type 1 diabetes remains a complex, invisible disease. Research and technology are making it more manageable and are opening the door to future treatments. Our task is to support patients and families, and to turn new therapies into reality.”
Prof Jacobs-Tulleneer-Thevissen concludes: “Cell therapy has the potential to become a real breakthrough. We are working towards safe, widely applicable treatments without heavy immune suppression. It is a long road, but every step matters.”
Bio
Willem Staels graduated as a medical doctor from Ghent University in 2011 and was certified as a paediatrician in 2018. That same year, he obtained his PhD, after which he completed a postdoctoral fellowship at Institut Cochin in Paris and trained in paediatric endocrinology at Hôpital Necker. Since Staels’s research focuses on islet vascularisation and iron metabolism in beta cells. He also works part-time in the paediatric endocrinology department at UZ Brussel. Since September 2022, Willem has been a Principal Investigator at BENE, the Beta cell Neogenesis research group.
Bio
Daniel Jacobs-Tulleneers-Thevissen graduated as a medical doctor in 2004 and as a surgeon in 2013 at the Vrije Universiteit Brussel (VUB). He obtained his PhD in Medical Sciences in 2013. He specialises in abdominal transplant surgery, with a particular focus on pancreas transplantation and cell therapy for diabetes. Since 2015, he has been coordinator of the transplant programme at UZ Brussel and teaches anatomy at the VUB. He is also a member of several national and international scientific societies.
