Type I diabetes is caused by the destruction of insulin secreting cells and consequently treatments focus on either replacing or regenerating insulin production. In May Diabetes, Hideto Kojima and colleagues from Shiga University of Medical Science, Japan show that combined expression of pancreatic duodenal homeobox 1 (Pdx-1) and islet factor 1 (Isl-1) can cause immature intestinal stem cells to differentiate into insulin-producing cells (Diabetes 2002, 51:1398-1408).

Kojima et al. observed that overexpression of both Pdx-1 and Isl-1 in immature rat intestinal stem cells (IEC-6) gave them the ability to express insulin without exposure to betacellulin. In addition, implantation of these cells into diabetic rats reduced the animals' plasma glucose levels and increased the plasma insulin levels to almost 3 times higher than those seen in control animals.

These results may indicate new mechanisms that can be explored to induce normalization of insulin levels in patients...