August 2014 | ISSUE 13
Profile: Breaking new ground in diabetes care

​By Nicole Lim, Assistant Director, Communications & External Relations

Working long hours and juggling many commitments is the norm for most people these days. With so many demands on our time, it is no wonder that stress levels often run high. But that is cause for concern, according to LKCMedicine Visiting Professor Per-Olof Berggren.

Eleven per cent of Singapore’s population is diabetic, whereas in Sweden it is three to four per cent and in the US it is around eight per cent. “This is fascinating because you don’t see so many overweight people here, which is the normal classification,” said Prof Berggren.

He believes that stress could be the cause. In his view, Singaporeans, like South Koreans who have a similar risk of diabetes, are very high performing and hard working, “and alongside that you get stress,” said Prof Berggren.

That’s why Prof Berggren, an expert in experimental endocrinology, jumped at the chance to work in Singapore where his novel research can have a significant impact on the ground.

“I’m very grateful for the opportunity to come here,” said Prof Berggren.

Main photo for story (Cropped) (Custom).jpgProf Berggren’s interest in endocrinology, and in particular insulin-producing beta cells, was sparked by his mentor when he his medical degree to complete a PhD, Prof Berggren only returned to finish his medical training before heading back to the laboratory to pursue his research. Now he splits his time between Singapore and Stockholm, where he works alongside clinicians and scientists in the Department of Molecular Medicine & Surgery at the Karolinska Institutet.

“I think that just as a lot of things in life, it was coincidence that got me into this field,” he said.

Insulin-producing beta cells are found in tiny micro-organs called islets inside the pancreas. They either become blind to the levels of glucose in the blood as happens in Type 2 diabetes; or are destroyed by the immune system, preventing the body from producing insulin, as happens in Type 1.

“In the past, we took out the islets and then looked at the beta cells and we learnt a lot about the beta cells. But this was as smart as if you want to understand how a car works, by taking out a piece from the engine and looking at it. You will learn a lot about that piece, but you will definitely not learn about how the car works or how that piece works in the context of the car,” said Prof Berggren.

To tackle this challenge, Prof Berggren and his team decided to develop a systems-based approach. They discovered that by transplanting the islets containing the beta cells into the eye, they are able to not only study the cells in as much detail as before, but they can also observe how other systems interact with and affect these cells’ behaviour.

“We transplant pancreatic islets into the anterior chamber of the eye, then we allow them to get enervated and vascularised. This creates the perfect system where we can study that piece of the engine in a living organism non-invasively, longitudinally and at single cell resolution,” said Prof Berggren. “And I’m convinced that this will break new ground and we will finally get a much better understanding of how the insulin-secreting cell works, why it doesn’t work and how we can identify novel drug targets.”

The model developed by Prof Berggren and his team also has wider implications. It could be used to study small samples of cells from other organs to see how they behave, what affects them and even how they interact with novel drugs.

In addition, it has already opened the doors to collaborations, including one with NTU. Prof Berggren is working with a team from NTU’s School of Materials Science and Engineering, using their novel micro-containers to deliver localised immunosuppressant drugs. “We then transplant them into the eye and observe the protective effect on the transplanted islet cells,” said Prof Berggren.

He is also looking forward to the new Clinical Sciences Building at LKCMedicine’s Novena Campus which will bring his lab closer to the hospital.

“At the moment, we have collaborations with the Singapore Eye Research Institute and obviously that is natural from the ocular imaging point of view. But we are also very interested in trying to reach out to clinicians interested in diabetes,” said Prof Berggren.

While a cure for diabetes is unlikely in the near future, Prof Berggren hopes that his work will lead to better treatments for diabetics. “This fantastic novel ground-breaking work done with in vivo imaging will put Singapore and LKCMedicine on the map and become a better treatment option.”